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Fluids and Barriers of the CNS

Open Access

Ambulation in children and adolescents with spina bifida

Cerebrospinal Fluid Research20096(Suppl 1):S53

Published: 3 February 2009


Clinical DataOutpatient ClinicSpina BifidaSpecific SkillWalk Distance


Ambulation is the specific skill of biped walking, supported by braces and walking aids in patients with spina bifida. [according to: Shurtleff D. (Editor) Myelodysplasias and Extrophies (1986)]. In the last years our therapeutic goal was to enforce ambulation as early and as long as possible in these patients. In the study presented we wanted to look at the results in the children and adolescents of the outpatient clinic for spina bifida of the Cologne Children's Hospital.

Materials and methods

We collected clinical data and information about ambulation of 90 spina bifida patients (47% female, 53% male, age 1.4 to 27 years) using a questionnaire. Patients were grouped by their walking distances according to Hoffer [Hoffer MM et al; J Bone Joint Surg Am 55: 137 (1973)]. Statistical analysis was performed using SPSS™


See Table 1. Walking distance improved in 39%, worsened in 24% and stayed equal in 37% of the patients.
Table 1

Hoffer Criteria correlated with the level of paralysis (Pearson correlation, p = 0.01).

Ambulation Criteria (Hoffer)


   Community Walker


   Household Walker


   Exercise Walker





A multidisciplinary care in a specialised institution can achieve a high level of ambulation in spina bifida patients and maintain this skill over a long period of time in a majority of patients. Data will be used for pre- and postnatal counseling of parents.

Authors’ Affiliations

Children's Hospital, Cologne, Germany


© Pauly and Cremer; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.