AMBULATION IN CHILDREN AND ADOLESCENTS WITH SPINAL-CORD INJURIES

The ambulatory status of 76 children and adolescents with spinal cord injuries was studied to delineate the natural history of ambulation an d to identify factors predictive of successful ambulation. The type of orthotic used and the degree and duration of ambulation depended on a ge, completeness and level of the neurologic deficit, and lower extrem ity contractures. Younger age, L3 or better neurologic levels, incompl ete lesions with motor preservation, and absence of lower extremity co ntractures were associated with functional walking. The psychological advantages of ambulation must be weighed against the cost of orthotics and associated training and the nonfunctional nature of ambulation in the vast majority of individuals with spinal cord injuries. In additi on, the developmental aspects of pediatric spinal cord injuries requir e changing therapeutic goals at different developmental stages.