The influence of abductor weakness on gait in spina bifida

This study aimed to determine which features of the characteristic gait of children with spina bifida are most responsible for increasing energy cost of walking. We studied 27 children with spina bifida, nine of whom had L4 level lesions, nine L5 and nine S1, using gait analysis and oxygen consumption studies. We found a positive correlation between oxygen cost (ml/kg/m) of walking and level of lesion (r = 0.35, P < 0.05) range of pelvic rotation (r = 0.5, P < 0.05), pelvic obliquity (r = 0.3, P < 0.05) and hip ab/adduction (r = 0.3, P < 0.05). We found no correlation between oxygen cost and maximum hip and knee extension during stance, nor did we find that hip and knee extension during stance correlated with the neurological level. We concluded that hip and knee flexion in stance are tolerated well by children with low level spina bifida. Control of pelvic rotation and obliquity and hip ab/adduction by functioning hip abductors appear to be the most important determinants of efficient ambulation in spina bifida.