F-2-08-04
DEVELOPMENTAL CHANGES OF POSTURES OF NORMAL, AT-RISK AND LOW BIRTH WEIGHT INFANTS WITH GOOD PROGNOSIS BASED ON NDT ASSESSMENT SCALES
Masavuki Aoyama, kyoko Hirasawa, Kiyoshi Kano (Omiya Municipal General Center for the Physically, Mentally and Auditorily Disabled, Omiya, Saitama, Japan)
It has been fourteen years since the early detection system of developmental disabilities in Omiya began. In 1988, we analyzed the growth changes of 130 normal infants, and in 1986, of 143 at-risk infants, in order to obtain information about the characteristics of their neurological development. In 1993, we estimated developmental changes of postures of low birth weight (LBW) infants with good prognosis. Now, we wanted to determine the differences of developmental changes of postures between the lines of normal, at-risk and LBW infants [Purpose]. Using NDT assessment scales, we followed up infants and checked their postural changes every two months for over six months [Method]. We found out the developmental line of LBW infants crossed over the theoretically normal 45 degree line at the age of 6.27 months in sitting position, 8.37 months in prone position, 8.57 months in supine position and 8.97 months in standing position. The developmental lines of LBW infants were quite similar to those of at-risk infants [Results].
F-2-08-05
AMPUTATION IN ADULTS WITH SPINA BIFIDA: THREE CASE STUDIES
J.P. Jacob (Mediplex Rehabilitation Hospital/Mediplex Subacute Center, United States)
E. Marlowe, D. Wu
Adults with spina bifida are at increased risk for lower extremity amputation (1, 2), though the precise incidence has not yet been defined. Patients with nonplantigrade position, or foot rigidity due to arthrodesis are susceptible to develop neuropathic skin changes (3). Other factors that predispose to skin breakdown, osteomyelitis, cellulitis, and amputation include lack of aggressive follow-up into adulthood (4), the presence of abnormal plantar sensation (2, 5), and conceivably decline in cognition due to hydrocephalus. Three cases of adult amputees with spina bifida were reviewed. One amputation was due to extensive gas gangrene that necessitated a trans-femoral approach. While management of children in special clinics has been successful, we find that many of these patients are lost to follow-up once they reach adulthood. Subsequently, we hypothesize, these adults are at greater danger of becoming amputees. Areas for future investigation include the exact incidences of various levels of amputation in relation to the level of cord lesion, (educational achievement), and socioeconomic status. While Kaufman et al illustrate the need for a multidisciplinary approach headed by a single coordinator, we suggest this may best be achieved in an interdisciplinary rehabilitation setting.
