Purpose:
The purpose of this study was to assess the fitness and body fat in adolescents and young adults with meningomyelocele (MMC). The authors also attempted to determine if the level of everyday physical activity was related to body fat and fitness in the participant group.

Participants:
Participants were required to be wheelchair users. The presence of any other disabililities or health conditions that could affect their activities of daily living was the exclusion criterion for the study.

Method:
The ambulatory status of the 14 participants was divided into four categories according to the classification of Hoffer, et al. Thickness of four skinfolds was measured with a harpenden caliper for body fat measures. Fitness was measured in a progressive maximal aerobic test on an electronically braked arm or cycle ergometer, depending on the mode of ambulation. A 3-minute warm-up was followed by a 5-minute rest period, and then a test was performed for 8 to 12 minutes. During the test, resistance was increased every 2 minutes and subjects were asked to maintain 60 rpm. Heart rate and RER were used as objective criteria for maximal exercise. Fitness was defined in terms of VO2 peak. Activity monitors were used during two randomly selected consecutive weekdays to assess levels of everyday physical activity.

Results:
Based on the cut-off points for obesity, four participants were classified as obese. The duration of day (expressed as percentage of the measurement of the day) spent on dynamic activities was 7.3 (2.3%) for ambulators and 5.2 (1.6%), p=0.08. A significant correlation coefficient was found between time spent on dynamic activities and fitness. Percentage of body fat was inversely correlated with fitness (rs -0.58, p=0.04).

Discussion:
The study concludes that both ambulatory and the non-ambulatory young adults with MMC are at risk for developing obesity and their fitness is subnormal. Also, it shows that young adults with MMC (non-ambulatory) are considerably hypoactive when compared with healthy peers.

The study, even though conducted with a limited sample size, has clinical significance as it shows a pre-disposition of young adults with MMC towards obesity. This suggests that regular physical activity, diet counseling, and physical activity patterns must be taught to this group as early as possible. Appropriate exercise programs would help these young adults improve their physical fitness and daily functioning.