Spina bifida is a developmental defect of the spinal column where the vertebrae do not fuse, leaving a gap in the spinal column. This space can affect the signals the brain sends to the body, and vice versa. Spina bifida can affect range of motion and coordination, but those with the condition can still typically perform various physical activities. Swimming is an excellent exercise, as it strengthens upper and lower body muscles with no impact on joints.
Spina Bifida Basics
According to the Spina Bifida Association of America, spina bifida occurs in seven out of every 10,000 live births in the U.S. Because the disorder affects the spinal column, it can also impact the spinal cord; the vertebrae provide protection and support to the spinal cord, a critical nerve and message center for the entire body. Spina bifida can cause mix-ups in nerve signaling, leading to lack of feeling and movement in the legs and arms and the inability to control muscles and organs like the bladder. The spine may curve and range of motion is often affected. Children with spina bifida can also have hydrocephalus, where the circulation of fluid around the brain is blocked. Hydrocephalus is managed with a shunt that diverts the fluid to another part of the body, usually the abdomen.
Importance of Exercise
Physical activity keeps you strong, forcing you to use muscles and strengthen your lungs and heart. The Children's Hospital at Westmead in Sydney, Australia recommends that children with spina bifida participate in activities, like swimming, that strengthen upper body muscles. Upper body strength helps with balance and will help your child move herself from her wheelchair, propel the wheelchair or use walking equipment if needed. Exercise and sports also maintain muscle length, promote friendships, independence and self-esteem and prevent obesity. Swimming can be performed by almost anyone, regardless of physical limits. The buoyancy of water creates a more equalized "playing field" for children with less mobility, who can learn to swim with the help of a coach or flotation devices.
Swimming and Spina Bifida
A child with spina bifida can find enjoyment in the water, which allows him freedom of movement in a lower gravity environment. He may need support in the water, however, from you, a trained physical therapist or a flotation device. If your child has spina bifida, he may have difficulty maintaining a relatively horizontal position when floating, gliding, or swimming because of the difference in relative density of the upper and lower trunk. Adding weight to the lighter areas can help even out his body density. Have your child sit upright on a floating mat, play while draped over a fun noodle and tread water in an upright position. Maintaining body alignment may also help with the development of postural alignment on dry land.
Proper Precautions
Although swimming is an enjoyable activity, managing certain elements of the experience will help keep your child safe. Spina bifida often decreases the sensitivity of your child's skin, and she can easily cut or scrape herself in and around the pool on the concrete. Use care when transferring her, and teach her to use caution as she becomes strong enough to manage herself. Water also increases the risk for slipping when getting in or out of a wheelchair. If you child has a device for bladder or bowel elimination or a feeding tube, talk to your doctor about how to secure it properly while she is swimming.
