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Advances in medical technology, perinatal care, and neonatal intensive care have greatly increased the rate of survival for neonates born with a variety of medical problems and very low birth weights. The majority survive relatively sequelae free, although evidence still indicates that they remain at higher than normal risk for physical, mental, and social development. As the number of medical complications increases and birthweight decreases, the expectations for normal development become less promising. The kinds of stimulation the early postnatal environment provides have been identified as important factors in the infant’s growth and development. The effects of providing patterned stimulation to infants in the neonatal intensive care unit have been investigated by many. Despite difficulties in comparing studies due to the variability of subjects used, and type, intensity, and duration of treatment, the overwhelming evidence indicates beneficial effects.

Due to increased metabolic demands during walking, ∼50% of children with myelomeningocele transition to wheelchair use during adolescence/early adulthood. The purpose of our pilot study involving children with myelomeningocele was to determine: (a) energy expenditure needs during acute use of common assistive devices and (b) if walking poles are a feasible assistive device. Oxygen uptake was recorded for eight (5–12 years old) children in four conditions: independent, walker, crutches, and poles. Acute pole use did not significantly differ from independent walking net energy consumption or cost. Participants consumed more energy while walking with the walker than independently. Our pilot results suggest that (a) acute use of common assistive devices while walking increases energy consumption and cost versus independent and (b) poles are feasible assistive devices, resulting in slightly increased energy requirements. Poles may have provided “just enough” support with minimal change in energy requirements for our participants and, with practice, may enable children with myelomeningocele to remain community ambulators.