Rehabilitation for Spina Bifida in Children

A team of specialists at Rusk Rehabilitation provides a range of rehabilitative treatments for children with spina bifida. Physical, occupational, and speech therapy are often an integral part of care. They can help children improve muscle coordination and balance, build strength, and overcome language delays. Our neuromuscular experts also help children learn to function independently, build social skills, and gain confidence.

Doctors at Hassenfeld Children’s Hospital at NYU Langone determine the best rehabilitative treatment approach depending on the type of spina bifida, the location of the opening in the spinal column, and the severity of nerve damage. Children with spina bifida in the lower spine tend to have milder symptoms, while those with a lesion higher in the back may have significant disabilities.

Our experts offer family-centered care in a warm, welcoming environment. Doctors provide treatment tailored to each stage of a child’s development, starting with a physical assessment of overall muscular function in the days after your baby is born.

As a child grows, a physiatrist—a doctor who specializes in rehabilitation medicine—coordinates all aspects of your child’s care. He or she works closely with physical, occupation, and speech therapists, as well as with specialists in orthopedics, neurology, psychology, and social work.

This centralized approach makes scheduling treatment simpler for parents and caregivers, and ensures that information about your child’s treatment is shared among experts and can be easily explained. It also allows the physiatrist to monitor how each type of treatment benefits your child’s total development, and to adjust therapies as needed to ensure that your child receives care that meets his or her evolving needs.

Physical Therapy

Physical therapy involves exercises and other techniques to improve gait, muscle coordination, and balance. It can also help maintain range of motion in joints, build strength in weak muscles, and improve flexibility in stiff muscles. After performing a muscular assessment, our therapists create a treatment plan to help your child attain age-appropriate milestones, such as sitting up, crawling, and walking.

Our therapists may use specialized therapeutic equipment, such as the Lokomat^®, LiteGait^®, and Motomed^®. These are robotic devices that help children learn natural walking patterns. Our therapists may also use child-friendly technologies, such as the Nintendo Wii^®, to encourage children to participate in therapy.

Physical therapy may begin when a child is 18 months to 2 years old. For children with mild symptoms, doctors usually recommend outpatient therapy at Rusk Rehabilitation two to four times a week.

For children with more severe muscular dysfunction, our doctors may recommend inpatient physical therapy, which is performed while your child is the hospital. This approach allows your child to receive two hours of intensive physical therapy every day, six days a week. There is no set timeframe for when physical therapy must end. In some instances, a child works with a physical therapist until he or she is an adult.

Our physical therapists, along with other members of the rehabilitation team, work closely with each family to help them reinforce the skills learned in therapy and practice therapeutic movements at home.

Occupational Therapy

Occupational therapists help improve your child’s ability to perform everyday activities. Their goal is to teach children important practical skills, such as bathing, dressing, and using the bathroom. Occupational therapists may also help children learn to put on and take off braces or orthotics and care for these devices.

Occupational therapists may also help older children and teenagers develop skills required to navigate social spaces, adjust to environmental changes, and take care of themselves independently. They may include how to prepare meals, use home appliances, or use a computer.

Speech Therapy

Some children with spina bifida may have difficulty forming words and speaking clearly. This inability to communicate is often frustrating for a child. Speech pathologists increase a child’s oral motor skills and communication acumen by using exercises that train the brain to pronounce, understand, and interpret individual words, sounds, numbers, and gestures.

Our speech-language pathologists are experienced in working with children who have neuromuscular disorders. They can design a speech therapy plan tailored to your child’s needs.

Assistive Devices

Physical therapists offer a wide range of assistive devices to help children with spina bifida move independently. These include crutches, which reduce the amount of weight put on the hips and legs; orthotics, custom-made devices that can be worn on the legs or feet and help guide movement; braces, plastic devices that help immobilize or stabilize the legs; and wheelchairs, which can be controlled manually or with a motorized button.

Our therapists work closely with orthopedic doctors to provide the appropriate device for your child, depending on his or her level of mobility. For instance, braces, which are worn on the legs or feet, can stabilize weak muscles. Some types of orthotics, which can be custom-fit to your child’s needs, correct the shape or position of the foot and ankle, providing stability and relieving pain. Other devices, such as crutches, redistribute body weight, making it easier to walk.

For children whose legs have little or no sensation, a wheelchair provides independence and mobility. Our therapists and doctors recognize that walking is not an appropriate goal for many children with spina bifida. They care for each child in ways that help him or her reach realistic goals.

Positioning Techniques

Doctors may recommend one orthotic or brace for use during the day, when a child is likely to be more mobile, and a second device, called a positioning device, to wear overnight. Nighttime bracing helps keep certain parts of the body, such as the foot, in the correct position and prevents a deformity from progressing.

In some instances, a doctor may recommend a positioning technique called serial casting, in which plaster casts are applied to a baby’s feet every week. Over time, they correct the position of the bones.