In managing stage 4 spina bifida, which goal is emphasized?

• A. Reduce mobility options
• B. Maximize independent mobility options
• C. Balance
• D. Gait on various terrains

Answer: (B)

The main thing being aimed for is maximizing independent mobility options. In advanced spina bifida, the priority is to enable the person to move and participate in daily life with as much independence as possible, using whatever combination of devices or strategies works best for them. This might mean braces or assistive devices, manual or powered wheelchairs, and environmental adaptations, all chosen to preserve safety, energy efficiency, and participation in home, school, and community activities. Reducing mobility options would limit independence and participation, which is less desirable than supporting functional, self-directed movement. While balance and gait on different terrains can be important components of care, they are means to the end of independent mobility rather than the sole focus.