Physical fitness, ambulation en physical activity in ambulatory children with spina bifida

Abstract

Children with chronic disease or child-onset disability, like Spina Bifida (SB) are at increased risk of being inactive. Earlier studies in adolescents and young adults, have found correlations between an inactive lifestyle and lower levels of aerobic fitness. A second important issue being raised in this chapter is that of raised levels of energy cost of locomotion; with ambulation levels decreasing during the teenage years in many ambulatory children with SB, reducing energy cost of locomotion could be beneficial for this group of children. The two factors are combined in the hypothesis of “diminished physiologic reserve”; this study builds on this hypothesis in that with improving aerobic fitness, and/or decreasing energy cost of locomotion, walking will become easier for ambulatory children with SB. Many ambulatory children with (SB) experience functional decline in ambulation despite stable or even improving motor exams. Improving or maintaining low energy cost of locomotion during childhood and throughout the teenage years, could be an important goal for children with SB. The last study describes the effects of a home-based treadmill training program on both ambulatory measures and aerobic fitness. The training consisted of intervals of different speeds, increasing throughout the 12 week period based on fatigue and heart rate intensity during exercise. Results show the intervention to be effective for both short term and long term outcomes regarding walking, with short term effects for aerobic fitness in ambulatory children with SB. Both parents and children report improvements in ambulation and fitness in activities of daily life.