One common motor functional problem children and adults suffer from today is a condition called Spina Bifida. Spina Bifina is a physical condition people suffer from which, results in a failure of fusions of the caudial neural tube, which produces a malformation that losses motor functions in the human structure (Sival, Viles, Weerden, 2004, p. 427). Spina Bifida usually occurs in the human embryos, before the fourth week of conception. The factors that spina bifina is related to is gender, race, geographical location, and socioeconomic status (2004, p. 27). Spina Bifida is very rare in the United States, which rare occurred in only about 2 out of every 1,000 births or (2%) (p. 427).
However, spina bifida occurs more often in other countries such as Great Britain and Ireland, occurring 4 out of every 1,000 births (p. 427). Spina Bifida is a very genetic problem, and if a person’s first child has this condition, the child will be very likely the mother will pass the disease on to the second child. During the second pregnancy, the rate of spina bifida will increase greatly o about 1 in 20 or (5%) of the births if the first child has Spina Bifida (p. 427). Poverty is another relevant problem associated with spina bifida.
Families suffer greatly because income is not sufficient enough to provide treatment and care for this condition (p. 427). Lack of nutrition during pregnancy, may also harm the child, causing the embryo not to fully develop that may lead to spina bifida. Issue Causes In this section the researchers will discuss the effects folic acid can have on spina bifida.
It is recommended that folic acid be used before and during early pregnancy because inadequate intake of natural folate will decrease the child chances in developing spina bifida (Adzick, Melchionne, and Mitchell, 2004, pp. 1885-1886). Inadequate amount of folic acid during pregnancy can increase the risk of spina bifida and anencephaly (2004, p. 1886).
The studies done by the researcher’s shows that failure to consume folic acid supplements or folic acid-containing will increase the risk of having a child defected with spina bifida from two-fold to eight-fold (p. 886). If folic acid is disrupted in the two metabolic pathways it could harm the development of the embryo (p. 1886). “Disruption in folate metabolism can also result in raised homomocysteine concentrations, which are teratogenic to the neural tube in some animal models” (p. 1886).
The researchers did a study which involved Mexican-American women who reported having a three-fold, which increase the risk of neural tube defects occurring in the women’s off-spring (p. 1886). Drugs Another problem related to the increases in the number of people with spina bifida is drugs.
Drugs are considered to be a teratogen, which is a type of action or environment factor, which has a negative affect that will hinder the health of the embryo before birth. According to the researchers, Adzick, Melchoionne, and Mitchell, anticonvulsant drugs should not be used unless used for the treatment of epilepsy (eg, bipolar, disease, migraine, chronic pain are also related factors in having a child with spina bifida (Adzick, Melchionne, and Mitchell, 2004, pp. 1886-1887). The use of drug metabolism may have an adverse affect on the embryonic tissue causing it to be damaged (2004, p. 1886).
However, there has been some research to prove maternal use of folic acid might reduce some but not all risk factors related to drugs (p. 1886). Folic acid is still proven to be unknown by researchers as a drug-related birth defect; spina bifida can be prevented by folic acid. In this section the researchers Adzick, Melchioone, and Mitchell (2004) will make the claim for women who are obese, increasing their risk of having a child with spina bifina are greater than those women who are not obese.
The body mass index was used as an indication that meant women with a body mass index of about 29 has a 1. to 3. 5- times the higher risk than women with low body mass index (2004, p. 1887). “Data from one study suggest that the increase risk of spina bifida in the offspring of obese women might be attributable to hyperinsulinaemia might precede or coexist with obesity and diabetes this metabolic state provides a potential link between these two maternal risk factors” (2004) Surgery is a much more effective alternative for pregnant women because it decreases the risk of producing a child with spina bifida.
Gastric bypass surgery may be less effective because spina bifida could reduce the intake of nutrients which is essential for the development of the embryo (Adzick, Melchionne, and Mitchell, 2004, p. 1887). The researchers found sufficient evidence to support the negative risk factors associated with spina bifida, which include the use of saunas, hot tubs, and tanning beds (2004, p. 1887).
The national academy of science institute of medicine in the USA conducted a study on three subject men, the study concluded by saying men who were exposed to herbicide Agent Orange during the Vietnam War are at much higher risk of receiving spina bifida than men who did not serve in the Vietnam War (p. 1887). However, one can question the results of this study because the largest case of spina bifida only included three people, and a much larger sample is needed to make a conclusion on the risk factors which can have an adverse affect on people causing them to have spina bifida.
Genetics This next section will discuss reasons why genetics play such an important role with the on-set development of spina bifida. Researchers (Adzick, Melchionne, and Mitchell, 2004, p. 1887) suggest spina bifina is not a recurring problem within families; patterns are likely to be associated with the effects of a single genetic locus. However, spina bifida seems to be a more complex traits, which is determined by many gene and environment factors which makes spina bifida more susceptible for children with a family history of this genetic disorder (2004, p. 887). Some research has suggested that spina bifida has increasingly becoming more feasible with genes involved in folate-homocysteine metabolism.
Researchers (p. 1887) found some conclusive evidence in their research to make a claim that genes involved in folate-homocysteine metabolism and folate in genes causing the on-set of spina bifida. However, people must be aware of other factors such as the gene development in other metabolic pathways. Pregnant women who suffer from diabetes and obesity are at greater risk in producing a child with spina bifida.
Metabolic pathways involvement with the genes may involve metabolism of known teratogenic agents such as valproic acid which is essential for the embryonic development (p. 1888). However, only a few genes have been investigated as a potential risk factor for spina bifida, any link has not been associated with the major cause of this disorder (p. 1888). Implications In this section the researchers (Sival, Viles, and Weerden 2004, p. 428) at the University Hospital of Groningen tested 11 infants babies motor behavior on videotape during a period of several months The baby’s motor functions were assessed by an independent pediatric neurologist.
The pediatric neurologist used the babies motor behaviors to determine their related muscle contractions to associate with myotomes (2004, p. 428). During the study, leg reflexes were determined early postnatally, between week 1 and the third month (p. 428). After the third month, the baby’s behavior was determined by emotional responses being assessed on video-urodynamic evaluation (p. 428).
Research Results The results of this research showed an increase in knee tendon reflexion for the 18 infants tested, however, the results showed the level of the MMC did not show any level of statistical significance (Sival, Viles, & Weerden, 2004, p. 28). Only 50% of the baby’s assessments showed the coexistence between increase reflexes and reduced reflexes in myotomes caudal to the MMC during the first day (Sival, Viles, & Weerden, 2004). During the second day of this study, the research showed a correlationship between 6 of the 8 neonates, visible muscle contractions between both muscles (Sival, Viles, & Weerden, ). After the first week of this study, 7 out of the 10 infant’s leg movements and functions started to disappear merely because the loss of knee tendons or anal reflexes (Sival, Viles, & Weerden ).
However, assessment of leg movements and reflexes after the first week showed no additional decreases in the use of motor functions and tendon leg reflexes (Sival, Viles, & Weerden). The results for 1 infant with MMC showed areas of normalizing in both motor behavior and neurologic examination after three months (Sival, Viles, & Weerden). Six of out seven infant, flexion of the ankle disappeared after the first week, however, bladder functions indicated hyperactive during the infants first year of life. Exercise/Activity
In this section the researchers (Hodnett, Patrick, & Roussos, 2000) will present research which shows the positive impact exercise and physical activity can have on that suffer from spina bifida. Can a reciprocal walking program can be affective long-term for patients who suffer greatly from functional disorders? Many studies advocate many up-sides for reciprocal walking for patients with spina bifida. Researchers Carroll, Menelaus, and Rose make the claim that reciprocal walking will led to improvements in urinary drainage, bowel function and peripheral circulation.
Mazur et al. research results have showed the different between patients whom walk at an early age than patients whom did not walk at an early age. Patients will trouble walking are twice as likely to fractures many bones and five times as likely to suffer pressure sores than a matched group using an appropriate orthosis. The use of albulators also played a huge role with spina bifida patients because the patient’s level of independences increases by three times when moble within the community when they reach teenagers (Hodnett, Patrick, & Roussos, 2000).
Research started in 1973 and ending in 1984, which tested 28 spina bifida subjects; the research at the time was an original prescription for subject with the multi-disciplinary team providing on-going treatment for the patients (Hodnett, Patrick, & Roussos, 2000). The patients were monitoring on a regular bases to ensure the data was the most accurate, and the patients performance was preformed regularly (Hodnett, Patrick, & Roussos).
Exercise and activity is also benfical to the patient’s family because with more exercise will equal to less hospital visits for the patient and will result in a lower medical cost for the patient and his/her family. Patients whom exercise daily will create better opportunities to participate in leisure activity without relaying on caregivers (Hodnett, Patrick, and Roussos). The reciprocal walking system will be a tremendous for spina bifida because exercise will decrease the severity of this disorder, and walking would booster a patient’s confidence with tremendous motivation.
Patients as young as 1 to 2 year-old would use a swivel walker to familiarize the body in an upright posture; this intervention allows patients to make a much smoother transition when battling spina bifida. In order for patients to participate in an effective reciprocal walking problem the patient must develop good upper limb co-codination so more surfaces and situations can be used as an accommodation for these patients young as 4 to 5 years-of-age (Hodnett, Patrick, and Roussos).
The results reflectthat 15 patients suffering from thoracic lesions, 11 suffering from high lumbar lesions, and 2 suffering from mid lumbar lesions (Hodnett, Patrick, and Roussos). From this research one can examine why the reciprocal walking system is such an effective tools from exercise and treatment from the following figures found throughout (Hodnett, Patrick, and Roussos) Take out bullets and put this into a paragraph please! • 93% of patients used the device at special Schools for the physically impaired. • 90% of patients used the device at home.