Date of Paper/Work
Doctor of Physical Therapy
David D. Chapman, PT, PhD
BACKGROUND AND PURPOSE:
Previous research with infants younger than eight months old has shown that the context in which an infant is placed is directly correlated with leg movement frequency. Increased frequency of leg movements has been linked to earlier ambulation. Infants with Spina Bifida (SB) demonstrate decreased leg movements and delayed ambulation compared to typically developing (TD) babies. Spina Bifida is the most common neural tube defect and leads to delayed functional mobility. Guided by the concept of neural plasticity, our goal was to document the ability of 27 to 44 week old infants with lumbar or sacral SB, to spontaneously move their legs and generate kicks - leg movements that involve flexion and extension of the hip and knee joints - when they were supine, seated in a conventional infant seat and seated in a specially designed infant seat.
Infants with SB between the ages of 27 and 44 weeks of age at entry into the study were videotaped in their homes while they were supine, seated in a conventional seat, and seated in a specially designed seat. The videotaped data, collected once a month for three months, were behavior coded to identify leg movements and kicks. These data were summed and then averaged to obtain a per minute frequency.
Our results, consistent with previous research showed that infants with SB generated the most and fewest leg movements and kicks in a special seat and conventional infant seat, respectively. There was not a significant age effect on how often infants moved their legs. There was a moderate correlation between leg movements and kicks with hip abduction, calf circumference, calf skinfold, and thigh skinfold.
The results from this pilot study can be used by therapists to design treatment plans that facilitate leg movements and kicks. This will enable infants with SB to strengthen the muscles and neural connections that support the functional leg movements needed to walk. In addition, these data suggest that therapists educate parents about the detrimental effects a conventional infant seat may have on their child’s ability to move h/her legs and generate kicks.
Meissner, Sarah; Ogaard, Megan; Shirley, Jeanna; and Warfield, Kristin, "Lower Extremity Activity of Infants with Spina Bifida: Does Context Still Matter" (2011). Doctor of Physical Therapy Research Papers. 9.