Physical therapy interventions for children and adolescents with myelomeningocele: A systematic review

Myelomeningocele (MMC) is the most common and severe form of spina bifida. Children and adolescents with MMC may experience challenges with movement, muscle strength, walking or using a wheelchair, bladder and bowel function, and independence in everyday activities. Physical therapy is an important part of care, but it is not yet clear which treatments are most effective. This systematic review examined research on physical therapy interventions for children and adolescents with MMC up to 18 years of age. We identified 36 studies involving 532 participants. The interventions included electrical stimulation, treadmill training, whole-body vibration, serial casting, strength training, standing programs, aquatic therapy, wheelchair training, virtual reality, and other approaches. Some interventions showed promising results. Electrical stimulation may improve bladder function, treadmill training may support walking ability and endurance, serial casting may increase joint range of motion, and laser therapy may promote wound healing. However, these findings should be interpreted cautiously. Many studies included only a small number of participants, used different treatment approaches, or had limitations in their design. As a result, the current evidence is not strong enough to determine which physical therapy interventions work best or to make firm recommendations about specific treatments.