Spina Bifida: Understanding, Managing and Improving Health and Function

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Spina bifida is a lifelong neurological condition that affects the spine and spinal cord. It occurs when the neural tube does not develop properly during early pregnancy, leading to varying degrees of physical and neurological impairment. The severity of spina bifida can differ significantly between individuals, ranging from mild functional limitations to more complex physical disabilities.

While spina bifida cannot be cured, individuals can lead active and fulfilling lives with the right support and management strategies. Through targeted exercise, rehabilitation, and multidisciplinary care, individuals can improve mobility, independence, and overall quality of life. Accredited Exercise Physiologists play an important role in delivering safe, individualised, and evidence-based programs that support functional capacity and long-term health.

Spina bifida affects how the brain communicates with the body below the level of the spinal lesion. This can lead to muscle weakness, reduced sensation, and impaired motor control. In many cases, secondary complications such as reduced mobility, muscle imbalances, and decreased cardiovascular fitness may also develop over time.

These physiological changes can affect:

• Muscle strength and coordination
• Balance and postural control
• Mobility and gait efficiency
• Bladder and bowel function
• Overall physical independence

Types of Spina Bifida

Spina Bifida Occulta
The mildest and most common form. Often has no visible symptoms and may go undiagnosed. Minimal or no functional impairment.

Meningocele
The protective membranes around the spinal cord protrude through the spine. May cause mild to moderate functional limitations.

Myelomeningocele
The most severe form. The spinal cord and nerves protrude through an opening in the spine. Often associated with significant physical disability, including paralysis and loss of sensation below the lesion level.

Common Signs and Symptoms

The presentation of spina bifida varies depending on the severity and level of the lesion. Common features may include:

• Muscle weakness or paralysis (typically in the lower limbs)
• Reduced or absent sensation
• Difficulty with walking or mobility
• Balance impairments
• Orthopaedic complications such as scoliosis and joint deformities
• Fatigue with physical activity

Risk Factors

Non-modifiable:

• Genetic predisposition
• Family history
• Neural tube development during pregnancy

Modifiable (prenatal considerations):

• Low folate intake during pregnancy
• Maternal health conditions
• Certain medications during pregnancy

How Exercise Helps

Exercise is a key component in the management of spina bifida. A structured and individualised exercise program can improve strength, mobility, cardiovascular fitness, and overall functional independence.

Strength training helps improve muscle activation and joint stability, particularly in individuals with partial muscle function. Aerobic exercise supports cardiovascular health, which is often reduced due to limited mobility. Balance and coordination exercises can enhance postural control and reduce falls risk.

Exercise also plays a vital role in preventing secondary complications such as obesity, deconditioning, and reduced bone density. Additionally, regular physical activity can improve mental health, confidence, and participation in daily activities.

Key Exercise Findings:

• Strength training improves functional mobility and independence
• Aerobic exercise enhances cardiovascular health and reduces fatigue
• Regular movement reduces the risk of secondary complications
• Individualised programs are essential due to varying levels of ability

The Importance of a Holistic Approach

Managing spina bifida requires a comprehensive and multidisciplinary approach. This includes:

Social and community participation

Individualised exercise and rehabilitation programs

Assistive devices and mobility support

Ongoing medical and allied health care

Education and self-management strategies

With consistent and structured intervention, individuals with spina bifida can significantly improve their physical function, independence, and overall quality of life.