Gait training on varied terrains is a management focus for which stage of spina bifida?

• A. Stage 4 spina bifida
• B. Stage 5 spina bifida
• C. Both stage 4 and stage 5
• D. None of the above

Answer: (A)

Gait training on varied terrains targets real-world ambulation, where surfaces and conditions change and successful walking depends on balance, foot placement, and energy efficiency. In spina bifida rehab, Stage 4 describes individuals who can ambulate with external supports (like braces or crutches) but still require assistance for a safe, functional gait. At this stage, the therapist focuses on translating flat-surface walking into navigating uneven surfaces, slopes, and different textures. This builds adaptability, improves stability, and helps optimize use of orthoses and footwear for real-life environments. In Stage 5, ambulation is typically more limited, so the emphasis shifts away from gait on varied terrains toward wheelchair skills and other mobility goals. Hence, varied-terrain gait training is most appropriate for Stage 4.