For stage 3 spina bifida management, which strengthening targets are emphasized?

• A. Head and neck
• B. Entire trunk only
• C. Upper and lower extremities
• D. Hands and wrists

Answer: (C)

For stage 3 spina bifida management, strengthening targets that directly support movement are emphasized—the upper and lower extremities. Building strength in both arms and legs enhances transfers, standing balance, wheelchair propulsion, and gait with assistive devices, which are central to functional independence at this stage. Strengthening only the trunk or focusing on the hands and wrists alone would not provide the full functional gains needed for mobility and daily activities. While trunk stability and hand function matter, the most impactful improvement comes from a coordinated increase in strength across the limbs that drive movement.