Which of the following best describes our management role in Stage 1 spina bifida?

• A. ROM only
• B. Get a baseline of LE function; ROM; Positioning; Adjustments to normalizing auditory, visual, and vestibular environment
• C. Surgical planning
• D. Discharge planning only

Answer: (B)

Early rehabilitation in Stage 1 spina bifida focuses on establishing a functional starting point and preventing secondary problems. This means getting a baseline of lower-extremity function to know what the child can do, assessing range of motion to identify and prevent contractures, and using positioning strategies to protect joints, skin, and alignment. Equally important is adjusting the child’s environment to support sensory development—providing appropriate auditory, visual, and vestibular input so the nervous system can organize and respond efficiently. This broad, proactive approach supports growth and development from the start.

Surgical planning isn’t the immediate rehab focus in Stage 1, as operative decisions occur based on medical needs and later planning, not the initial rehabilitation assessment. Discharge planning is also a later step after stabilization and ongoing therapy needs are established. Focusing only on ROM misses the essential elements of baseline assessment, preventive positioning, and sensory-environment adjustments that together drive early functional progress.