Which of the following is a secondary impairment involving the knee or leg in spina bifida?

• A. Knee flex contracture
• B. Spine scoliosis
• C. Cognitive impairment
• D. Obesity

Answer: (A)

Secondary impairments in spina bifida develop over time as mobility changes and muscles become imbalanced. A knee flexion contracture is a classic example in the knee/leg region: tight or imbalanced muscles around the knee lead to shortening of soft tissues, making it hard to fully straighten the knee. This limits standing and walking and can cause compensatory gait changes. Other options touch on areas not specific to the knee or leg—spine scoliosis involves the spine, cognitive impairment relates to brain function, and obesity is a general health issue that isn’t a knee/leg impairment by itself. So knee flexion contracture is the typical secondary knee/leg problem in spina bifida.