Sensory Hand Function of the Child with Spina Bifida Myelomeningocele

Abstract

Hand dysfunction has seen reported to be present in myelomeningocele children, yet the type, extent and cause of such dysfunction has remained unclear. This study was undertaken to discover if sensory abnormality was present in the hands of myelomeningocele children. Twenty-two children with myelomeningocele lesions below the vertebral level T4 were chosen for assessment and constituted the experimental group. This group was compared with a control group of 22 normal children, each individually matched with the myelomeningocele children for age, sex and hand dominance. Sensory function of the hands for both experimental and control groups was assessed using clinically accepted tests of sensation. Statistical analysis of the results indicated that significant differences were present between myelomeningocele and normal children with myelomeningocele children having significantly poorer sensory function of the hands for light touch (p<0.004), fine joint sense (p<0.0007), position sense (p<0.00009), two-point discrimination (p<0.015), stereognosis (p<0.03) and graphaesthesia (p<0.02). The effects of widespread sensory impairment on the developing child with myelomeningocele are discussed, with particular reference to the development of higher neurological functions in these children. The extent of sensory impairment discovered may be the prime cause of hand dysfunction and clumsy hand use found in previous research.