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Myelomeningocele is a neural tube defect caused by the failure of the neural tube to close in the caudal part. The exposed spinal cord in myelomeningocele usually causes neural damage. Children with myelomeningocele have varying degrees of disability depending on the level of lesion and the presence of CNS-related anomalies. Lower limb weakness, sensory loss or deformity, and impaired bowel and bladder function are common disabilities that need to be managed. Performing multiple tasks simultaneously is a necessity in the daily lives of both adults and children. Although the majority of children with myelomeningocele lack the ability to ambulate and spend most of the day sitting, they have to perform dual tasking while performing activities of daily living as in all children. In the literature, dual task performance has been evaluated in many studies in adult individuals with diseases such as Multiple sclerosis, Stroke, Parkinson's, etc. However, there are few studies in the pediatric population in the literature. Most of the studies conducted in children include children with cerebral palsy and there are almost no studies in children with myelomeningocele. Therefore, the aim of this study was to compare dual task and upper extremity performance in children with myelomeningocele to typically developing peers.
Within the scope of the study, socio-demographic information of the individuals will be recorded first. Afterwards, the Box Block Test and 9-hole peg test will be performed for single task assessment. The children will be seated on a chair with back support and before the test starts, all the details about the application will be explained to the person and the person will be given the opportunity to make a trial and if there are mistakes, they will be warned and then the actual evaluation will be started.
After the single task evaluation, the dual task performance will be evaluated. When testing dual task performance, participants will be asked to perform both tasks without prioritizing them and to do their best. However, they will also be instructed not to pause for reflection. A rest interval of at least 3 minutes will be given between all tests. Dual task complexity of the given upper limb functions will be measured by calculating the 'dual task effect' for both tasks. The formula used to calculate the dual task effect is as follows: Dual Task Effect=(Dual Task-Single Task/Single Task)x 100. If the result is positive, it is assumed that there is an improvement in the dual task conditions; if it is negative, it is assumed that there is a decrease in the dual task conditions. The results of children's performance will be recorded in the relevant table in the demographic data form
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Meningomyelocele Group | Individuals between the ages of 7-18 years with a diagnosis of meningomyelocele |
| |
| Typical Developing Group | Typically developing individuals between the ages of 7-18, who do not have any musculoskeletal system problems and who volunteer to participate in the study, who do not have a chronic neurological, cardiovascular or orthopedic disease |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Single Task (Box and Block Test) | Diagnostic Test | The test requires a wooden box divided into two compartments and 150 blocks (2.5 cm tall). When administering the test, the evaluator should be aware of whether the child's fingertips move from one compartment to the other. The number of blocks passed from one side of the box to the other in one minute determines the level of the skill. It is done separately for right and left hand. The number of cubes thrown in 1 minute gives the score. |
| Measure | Description | Time Frame |
|---|---|---|
| Dual Task (Box and Block Test-Motor Task) | The test requires a wooden box divided into two compartments and 150 blocks (2.5 cm tall). When administering the test, the evaluator should be aware of whether the child's fingertips move from one compartment to the other. The number of blocks passed from one side of the box to the other in one minute determines the level of the skill. It is done separately for right and left hand. The number of cubes thrown in 1 minute gives the score. For the Box Block Test-motor task assessment, the individual will be asked to keep a rhythm by tapping the table with the fingers on the other side while performing the test. The number of blocks passed from one side to the other side of the box divided into two in one minute will be determined and recorded. | through study completion, an average of 1 year |
| Dual Task (Box and Block Test-Kognitif Task) | The test requires a wooden box divided into two compartments and 150 blocks (2.5 cm tall). When administering the test, the evaluator should be aware of whether the child's fingertips move from one compartment to the other. The number of blocks passed from one side of the box to the other in one minute determines the level of the skill. It is done separately for right and left hand. The number of cubes thrown in 1 minute gives the score. Box Block Test-for the cognitive task assessment, the individual will be asked to count animal names while performing the test. | through study completion, an average of 1 year |
| Dual Task (Nine Hole Peg Test-Motor Task) | The Nine Hole Peg test is a standardized test that measures fine dexterity against time. It is simple to administer and is a valid and reliable method of assessment. Both hands are tested in the assessment. The child is first asked to place 9 sticks of 3.2 cm in length into the holes on the platform as quickly as possible with the dominant hand and the time from the start command until the last stick is placed is recorded. Then, with the same hand, he/she is asked to pick up the sticks in order and the time to remove all the sticks is recorded in seconds. The same procedure is repeated with the other hand. 9 Hole Peg Test-for motor task assessment, the individual will be asked to bend and unbend the other elbow while performing the test. |
| Measure | Description | Time Frame |
|---|---|---|
| Single Task (Box and Block Test) | The test requires a wooden box divided into two compartments and 150 blocks (2.5 cm tall). When administering the test, the evaluator should be aware of whether the child's fingertips move from one compartment to the other. The number of blocks passed from one side of the box to the other in one minute determines the level of the skill. It is done separately for right and left hand. The number of cubes thrown in 1 minute gives the score. |
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Inclusion Criteria:
For children with meningomyelocele
For children with typical developing
Exclusion Criteria:
For children with meningomyelocele
For children with typical developing
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Children diagnosed with meningomyelocele and typically developing peers who agreed to participate in the study and met the inclusion criteria.
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| Name | Affiliation | Role |
|---|---|---|
| Sezen Tezcan, Ph.D | Abant Izzet Baysal University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bolu abant Izzet Baysal University | Merkez | Bolu | 14030 | Turkey (Türkiye) |
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| Single Task (Nine Hole Peg Test) | Diagnostic Test | The 9-hole peg test is a standardized test that measures fine dexterity against time. It is simple to administer and is a valid and reliable method of assessment. Both hands are tested in the assessment. The child is first asked to place 9 sticks of 3.2 cm in length into the holes on the platform as quickly as possible with the dominant hand and the time from the start command until the last stick is placed is recorded. Then, with the same hand, he/she is asked to pick up the sticks in order and the time to remove all the sticks is recorded in seconds. The same procedure is repeated with the other hand. |
|
| Dual Task (Box and Block Test-Kognitif Task) | Diagnostic Test | Box Block Test-for the cognitive task assessment, the individual will be asked to count animal names while performing the test. |
|
| Dual Task (Nine Hole Peg Test-Kognitif Task) | Diagnostic Test | 9 Hole Peg Test-for the cognitive task assessment, the individual will be asked to count backwards from 20 one by one while performing the test |
|
| Dual Task (Box and Block Test-Motor Task) | Diagnostic Test | For the Box Block Test-motor task assessment, the individual will be asked to keep a rhythm by tapping the table with the fingers on the other side while performing the test. The number of blocks passed from one side to the other side of the box divided into two in one minute will be determined and recorded. |
|
| Dual Task (Nine Hole Peg Test-Motor Task) | Diagnostic Test | 9 Hole Peg Test-for motor task assessment, the individual will be asked to bend and unbend the other elbow while performing the test. |
|
| ABILHAND-Kids | Diagnostic Test | The Abilhand Kids Hand-Related Ability Scale will be used to assess the use of upper extremities in Activities of Daily Living (ADL). The scale includes 21 sub-items. Sub-items are scored as 0; cannot do, 1; has difficulty in doing and 2; can easily do. The questions are usually answered by the parent, but can also be answered by the child if the child is old enough and cognitive level is appropriate. |
|
| Functional Mobility Scale (FMS) | Diagnostic Test | The child's walking ability is assessed at 3 different distances (5 meters (home), 50 meters (school), 500 meters (community)). The assessment at all three distances is graded on a scale of 1-6, with wheelchair mobilization 1 and independent ambulation 6. It is indicated as (C) if the distance can be covered by crawling and (N) if the distance cannot be covered by any other means. The assessment is done through an interview with the family. The child is not observed. |
|
| Myelomeningocele Functional Classification System (MMFC) | Diagnostic Test | The Myelomeningocele Functional Classification System (MMFC) is a 4-level system that classifies individuals with myelomeningocele according to their functional capacity. The functional status of children in Level 1 is more inadequate than in other levels. Functional status improves as the level increases. |
|
| Modified Mini Mental Test (MMMT) | Diagnostic Test | The Modified Mini Mental Test (MMMT) is used to screen for cognitive dysfunctions in children, to assess the severity of impairments and to determine changes over time. It has been reported that the test is a suitable tool for examining cognitive functions in children from the age of 4 and can be easily included in general neurological examinations of children. The test, which takes 5 to 10 minutes to administer, assesses 5 cognitive domains, including orientation, memory, concentration, language function and measures of structural ability. The total score in this test reaches a plateau at approximately 9-10 years of age. In children over 10 years of age, scores below 27 out of a total of 35 points are indicative of mental retardation. |
|
| through study completion, an average of 1 year |
| Dual Task (Nine Hole Peg Test-Kognitif Task) | The Nine Hole Peg test is a standardized test that measures fine dexterity against time. It is simple to administer and is a valid and reliable method of assessment. Both hands are tested in the assessment. The child is first asked to place 9 sticks of 3.2 cm in length into the holes on the platform as quickly as possible with the dominant hand and the time from the start command until the last stick is placed is recorded. Then, with the same hand, he/she is asked to pick up the sticks in order and the time to remove all the sticks is recorded in seconds. The same procedure is repeated with the other hand. 9 Hole Peg Test-for the cognitive task assessment, the individual will be asked to count backwards from 20 one by one while performing the test | through study completion, an average of 1 year |
| through study completion, an average of 1 year |
| Single Task (Nine Hole Peg Test) | The Nine Hole Peg test is a standardized test that measures fine dexterity against time. It is simple to administer and is a valid and reliable method of assessment. Both hands are tested in the assessment. The child is first asked to place 9 sticks of 3.2 cm in length into the holes on the platform as quickly as possible with the dominant hand and the time from the start command until the last stick is placed is recorded. Then, with the same hand, he/she is asked to pick up the sticks in order and the time to remove all the sticks is recorded in seconds. The same procedure is repeated with the other hand. | through study completion, an average of 1 year |
| ABILHAND-Kids | The Abilhand Kids Hand-Related Ability Scale will be used to assess the use of upper extremities in Activities of Daily Living (ADL). The scale includes 21 sub-items. Sub-items are scored as 0; cannot do, 1; has difficulty in doing and 2; can easily do. The questions are usually answered by the parent, but can also be answered by the child if the child is old enough and cognitive level is appropriate. | through study completion, an average of 1 year |
| ID | Term |
|---|---|
| D008591 | Meningomyelocele |
| ID | Term |
|---|---|
| D009436 | Neural Tube Defects |
| D009421 | Nervous System Malformations |
| D009422 | Nervous System Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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