Perception of secondary conditions in adults with spina bifida and impact on daily life

Robert Wagner, M.D.Ronna Linroth, O.T., Ph.D., Candice Gangl, O.T.D., O.T.R/L., Nancy Mitchell, M.A., O.T.R/L., Michelle Hall, C.P.O., .A.A.O.P.,Rhonda Cady, Ph.D., R.N.,Matthew Christenson, B.S.
Disability and Health Journal, October 2015 Volume 8, Issue 4, Pages 492–498


Spina bifida is a congenital defect of the neural tube resulting in motor and sensory disruption. Persons with spina bifida can also experience executive function impairments. Secondary conditions are physical, medical, cognitive, emotional, or psychosocial consequences to which persons with disabilities are more susceptible. Our experience suggested clinicians underappreciate the presence and impact of secondary conditions in adults with spina bifida because they do not specifically ask for this information.


Describe the presence and impact of secondary conditions on daily life, as perceived by adults with spina bifida.


A clinic-based sample was recruited from the active patient population of an adult specialty center for spina bifida-related care. All subjects were verbally administered a survey developed through literature review and clinical experience of the researchers. The survey measured the presence and perceived impact of secondary conditions. Recruitment and survey data collection occurred over a 6-month period to maximize age representation. Survey data were stratified by age, gender and lesion level for analysis.


Seventy-two respondents completed the survey. Pain was commonly reported, along with pressure ulcers, bowel & bladder concerns, depression, sleep disturbance, and limited social and community participation. No significant relationships were found between the presence or perceived impact of secondary conditions and age, gender or level of lesion.


Secondary conditions in spina bifida are present by early adulthood. Identifying these conditions during clinical encounters requires specific rather than general questions. Future study should evaluate earlier initiation of preventative measures by pediatric providers.