G.P.243: Orthosis usage and ambulation levels in different clinical types of SMA

Abstract

In Spinal muscular atrophy (SMA), patients show different symptoms and need special management according to clinical type of the disease. The aim of this study was to describe ambulation levels and orthoses usage in different SMA types. Eighty-one patients (44 boys, 37 girls) diagnosed with Spinal Muscular Atrophy were analyzed. The group was consisted of 47 SMA Type 2, 24 SMA Type 3, 7 SMA Type 1 and 3 SMA Intermediate Type patients. Orthoses use and ambulation levels were recorded. None of the SMA Type 1 patients used orthoses and they were all nonambulant. 21 of SMA Type 2 patients (44,6%) were using different orthoses [10 Ankle Foot Orthoses (AFO), 10 Knee-Ankle–Foot-Orthoses (KAFO), 5 trunk support, 2 standing frame). Three (14.2%) of 21 SMA Type 2 patients were ambulatory independently, 8 (38%) ambulatory with orthoses, 7 (33.3%) with wheelchair and 3 (14.2%) non-ambulant. In SMA Type 3 group, 10 (41.6%) were using orthoses (7 AFO, 2 KAFO, 3 insoles, 1 body support, 1 sitting device), and 14 (58.3%) patients were not using any device for ambulation. Eighteen (75%) SMA Type 3 patients were ambulatory independently, 3 (12.5%) were ambulatory with support, 2 (8.3%) were ambulatory with wheelchair and 1 (4.1%) was nonambulatory. In SMA intermediate Type group, 2 (66.6%) of the patients were using orthoses (2 AFO, 1 insole). They were ambulatory independently. Clinical type is determinative for orthoses need in SMA. In this study, it is concluded that the SMA type 2 patients rehabilitating in sitting level have more orthoses need and orthoses variety than other types.