Role of Occupational Therapy in Spina Bifida

  • June 26, 2018
Paediatric Rehab OT PT SLP

What is Spina Bifida?

Spina Bifida is a condition of defect the neural tube closure and the overlying posterior vertebral arches. There are 2 types of Spina Bifida There are varying types of Spina Bifida ranging from mild to more life-altering. It is a congenital spinal cord injury.

Types Of Spina Bifida

Two types of Spina Bifida is there Spina Bifida Occulta and Spina Bifida Cystic

Spina Bifida occulta is characterized by a failure of one or more of the vertebral arches to meet and fuse in the third month of development. The common site for this defect is the lumbosacral area.

Spina Bifida cystic is again divided into two types. That is meningocele and myelocystocele or myelocele.

Clinical manifestations

Loss of sensory and motor functions in below the level of the lesions. Sensory loss including kinesthetic, somatosensory information, proprioception.

Musculoskeletal impairment

Two types of motor dysfunction in the lower extremity. The first type involves the complete loss of function below the level of lesion resulting in flaccid paralysis, loss of sensation, and absent of reflex.

Associated orthopedic deformities are lumbar kyphosis, scoliosis, postural deformity, club foot, rocker-bottom deformity, and knee flexion deformity.

Associated neurological impairments are hydrocephalus, Chiari malformation, hydromyelia, and tethered cord.

In some cases have also cognitive impairments.

What are the daily life problems in Spina Bifida

Difficulty in doing self-care activities such as bathing and dressing

  • Environmental difficulties such as access to the bathroom, toilet, house.
  • Difficulty with access to education

Role of Occupational Therapy in Spina Bifida :

Occupational therapy plays an important role in children with Spina Bifida to promote their participation and independence in daily life such as self-care, school, and play/leisure.

Newborn to Toddlers:

The occupational therapist (OT) can help you to provide safe and enjoyable ways for your baby to play. Providing these opportunities encourages all areas of your child’s development such as:

  • Learning the mobility
  • Using their hands
  • Exploring their surroundings
  • prevent the contracture and deformity and encourage normal sensorimotor development
  • Developing the sitting on head righting and equilibrium reaction.
  • Eye-hand coordination activity
  • Comprehensive home program

Toddler Through Adolescent:

  • Promote independence in self-care skills.
  • Facilitate perceptual-motor skills.
  • Maintain strength in the trunk and lower extremities.
  • Promote self-esteem and social interaction.
  • Facilitate ADL training like dressing, feeding, hygiene and bowel and bladder care.
  • Provide activities for sensorimotor integration.
  • Gait training

The OT can assist with your child’s start at pre-school/school.

Before your child starts school, the OT can complete an assessment to understand where they are at and what support they might need. The OT will check things like your child’s hand skills, including fine motor skills and handwriting skills.

During this stage primary importance is preparing the child for independence in ADLs, which may be broken down into self-care, locomotion related, and social interaction activities.

The school setting was chosen for the child, the therapist should be able to serve the classroom teacher as a consultant. Advice for an adaptive setup which is good for facilitating the optimal conditions for learning. When a child is moving from the preschool to the elementary school setting, the support of the therapeutic team is essential.

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