The spina bifida population has a high risk of which condition that affects orthotic and wheelchair fit, independence, transfers, mobility, and self-care activities?

• A. Obesity
• B. Diabetes
• C. Anemia
• D. Hypertension

Answer: (A)

Obesity in the spina bifida population most directly affects how devices fit and how independently a person can move and take care of themselves. Excess weight changes body dimensions and the forces acting on seating and braces, making wheelchair components—such as seat depth and width, back height, cushion type, and leg support—less optimal, increasing the risk of skin breakdown and reducing stability and propulsion efficiency. For orthoses, increased thigh or calf girth can prevent proper alignment and comfort, leading to poor fit and reduced function. Fatigue and higher energy needs associated with carrying extra weight further complicate transfers, standing and mobility tasks, and self-care activities like dressing and bathing. All of this can limit independence and overall participation in daily activities. While diabetes, anemia, and hypertension are important health concerns, obesity has the most direct impact on device fit and functional independence in this context.