{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:24:47Z","timestamp":1775129087130,"version":"3.50.1"},"reference-count":19,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2004,3,1]],"date-time":"2004-03-01T00:00:00Z","timestamp":1078099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Rehabil"],"published-print":{"date-parts":[[2004,3]]},"abstract":"<jats:p> Objective: To investigate functional outcome in two groups of children with sacral level paralysis: myelomeningocele (MMC) versus lipomyelomeningocele (LMMC). Additionally both groups were compared with each other and when possible with reference values. <\/jats:p><jats:p> Design: Cross-sectional study by means of (1) clinical assessment, and (2) disability measurement. <\/jats:p><jats:p> Setting: Spina bifida outpatient clinic at a university hospital in the Netherlands. <\/jats:p><jats:p> Subjects: Sample of 30 children with MMC and 14 with LMMC. Mean age (SD) 6.0 (4.9) and 8.4 (4.9) years respectively. <\/jats:p><jats:p> Main measures: Muscle strength, ambulation level, motor performance (Bayley Scales of Infant Development (BSID) and Movement Assessment Battery for Children), and the Pediatric Evaluation of Disability Inventory (PEDI). <\/jats:p><jats:p> Results: The majority of patients in both groups were normal ambulant, 14\/21 (67%) in MMC and 9\/14 (64%) in LMMC. Ambulation was strongly associated with muscle strength of hip abductors (odds ratio (OR): 13.5, 95% condfidence interval (CI) 2.5\u201373.7), and ankle dorsal-flexor muscles (OR: 110, 95% CI 8.9\u2013135.9). No significant differences were found in lesion and ambulation level. Muscle strength and motor performance were significantly lower in the MMC group than in the LMMC group ( p &lt;0.05). PEDI scores were comparable in both groups. Most problems were noted in mobility skills and caregiver assistance in self-care, especially regarding bladder and bowel management. <\/jats:p><jats:p> Conclusions: Gross motor and functional problems were seen in both groups. The MMC group showed more muscle weakness and motor problems. However, in both groups caregiver assistance was needed for a prolonged period, especially regarding bladder and bowel management. These dindings need special attention, particularly in children who attend regular schools. <\/jats:p>","DOI":"10.1191\/0269215504cr718oa","type":"journal-article","created":{"date-parts":[[2004,3,8]],"date-time":"2004-03-08T22:38:55Z","timestamp":1078785535000},"page":"178-185","source":"Crossref","is-referenced-by-count":41,"title":["Spina bifida at the sacral level: more than minor gait disturbances"],"prefix":"10.1177","volume":"18","author":[{"given":"M AGC","family":"Schoenmakers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V AM","family":"Gulmans","sequence":"additional","affiliation":[{"name":"Department of Paediatric Physiotherapy, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R HJM","family":"Gooskens","sequence":"additional","affiliation":[{"name":"Rudolf Magnus Institute of Neuroscience, Department of Neurology and Neurosurgery, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P JM","family":"Helders","sequence":"additional","affiliation":[{"name":"Department of Paediatric Physiotherapy, Wilhelmina Children's Hospital, University Medical Centre, Ultrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2004,3,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199409000-00003"},{"key":"atypb2","first-page":"12","volume":"4","author":"Wolf LS","year":"1992","journal-title":"Pediatr Phys Ther"},{"key":"atypb3","first-page":"12","volume":"43","author":"Ong LC","year":"2002","journal-title":"Singapore Med J"},{"key":"atypb4","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/s003810050090","volume":"13","author":"Pierre-Kahn A","year":"1997","journal-title":"Nerv Syst"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1007\/s003810050433"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/20.6.817"},{"key":"atypb7","volume-title":"Daniel's and Worthingham's muscle testing;techniques of manual examination","author":"Hislop HJ","year":"1995"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/72.2.115"},{"key":"atypb9","first-page":"1063","volume":"73","author":"Schwarz S","year":"1992","journal-title":"Arch Phys Med Rehabil"},{"key":"atypb10","first-page":"855","volume":"67","author":"McDonald CM","year":"1986","journal-title":"Arch Phys Med Rehabil"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197355010-00014"},{"key":"atypb12","volume-title":"\u2018Bayley Ont wikkelings schaal\u2019, Dutch translated and adapted version of the Bayley Scales of Infant Development","author":"Meulen BF van der","year":"1983"},{"key":"atypb13","volume-title":"Movement Assessment Battery for Children","author":"Henderson SE","year":"1992"},{"key":"atypb14","volume-title":"\u2018Pediatric Evaluation of Disability Inventory\u2019 (PEDI). Development, standardization and administration manual","author":"Hayley SM","year":"1992"},{"key":"atypb15","unstructured":"Custers JWH. Pediatric Evaluation of Disability Inventory, the Dutch adaptation. PhD thesis, University of Utrecht, The Netherlands, 2001."},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198365030-00009"},{"key":"atypb17","first-page":"512","volume":"68","author":"Findley TW","year":"1987","journal-title":"Arch Phys Med Rehabil"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1991.tb14913.x"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-001-0531-6"}],"container-title":["Clinical Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1191\/0269215504cr718oa","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1191\/0269215504cr718oa","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T05:52:12Z","timestamp":1741067532000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1191\/0269215504cr718oa"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,3]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2004,3]]}},"alternative-id":["10.1191\/0269215504cr718oa"],"URL":"https:\/\/doi.org\/10.1191\/0269215504cr718oa","relation":{},"ISSN":["0269-2155","1477-0873"],"issn-type":[{"value":"0269-2155","type":"print"},{"value":"1477-0873","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,3]]}}}