Findley T W, Agre J C, Habeck R V, Schmalz R, Birkebak R R, McNally M C
Arch Phys Med Rehabil. 1987 Aug;68(8):518-22.
Birth records identified 192 children with myelomeningocele born in Minnesota in the years 1966-1970. In 1981 current ambulation, neurologic level, and early motor achievement were determined in 77 of the surviving 80 children by chart review and questionnaire. Of these 77, 20 were not walking at all, one was walking only in therapy, and the remaining 56 were community ambulators (16 of these occasionally used wheelchairs). The actual distance walked daily varied from 100 to 5,000 meters in this group, with 19 of these community ambulators never walking as far as around a block. Five children never walked, 16 had stopped walking by 1981, and another six, although still walking, were doing less than they had previously. In 20 of the 22 who showed a decrease in total walking between the ages of ten and 15, the beginning of the decline was associated with a period of immobilization, demonstrating the potentially adverse effects of immobilization in these children. The ability to walk outdoors independently and to use a wheelchair by age seven predicted ambulation as an adolescent correctly for 87% of the children. In contrast, neurologic level predicted adolescent mobility correctly for only 71%.
出生记录显示，1966年至1970年在明尼苏达州出生的患有脊髓脊膜膨出的儿童有192名。1981年，通过查阅病历和问卷调查，对80名存活儿童中的77名确定了其当时的行走能力、神经平面以及早期运动成就。在这77名儿童中，20名完全不能行走，1名仅在治疗时行走，其余56名能够在社区行走（其中16名偶尔使用轮椅）。该组中，每日实际行走距离从100米到5000米不等，其中19名能在社区行走的儿童从未走过一个街区那么远。5名儿童从未行走，16名在1981年之前就停止了行走，另外6名虽然仍在行走，但行走能力不如以前。在10岁至15岁期间总行走能力下降的22名儿童中，有20名行走能力下降开始时伴有一段固定期，这表明固定对这些儿童可能产生不利影响。7岁时能够独立在户外行走和使用轮椅的能力，对87%的儿童正确预测了其青少年时期的行走能力。相比之下，神经平面仅对71%的儿童正确预测了青少年时期的活动能力。
