The Relationship Between Lower Limb Muscle Strength and Gross Motor Skills Including Ambulation in Children with Spina Bifida.

Aim: Children with spina bifida demonstrate impairments in walking; however, little is known about gross motor skill development and its association with lower limb muscle strength. This study aims to investigate the relationship between lower limb strength and gross motor skills in children with spina bifida.

Methods: Lower limb strength and level of lesion were determined by manual muscle test (MMT). Eighteen key gross motor skill items from the Gross Motor Function Measure (GMFM) were assessed, and level of ambulation classified according to a modified Hoffer's classification. Spearman's correlations were used to establish a relationship between muscle strength, level of lesion and gross motor skills.

Results: Participants included 42 children with spina bifida aged 4-16 years (median 8.1 years). Strong positive correlations were demonstrated between lower limb muscles and key gross motor items. While quadriceps strength demonstrates a relationship with supported weight bearing activities, hip extension, and abduction strength demonstrate strong relationships with independent standing, walking, and more complex gross motor skills.

Conclusion: Understanding the relationship between lower limb strength and motor skill attainment may assist in educating parents on functional potential and guiding goal setting for physiotherapy interventions.