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 and to identify factors predictive of successful ambulation. The type of orthotic used and the degree and duration of ambulation depended on age, completeness and level of the neurologic deficit, and lower extremity contractures. Younger age, L3 or better neurologic levels, incomplete lesions with motor preservation, and absence of lower extremity contractures 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 addition, the developmental aspects of pediatric spinal cord injuries require changing therapeutic goals at different developmental stages.