Physical Therapy Exercises for Duchenne Muscular Dystrophy Management

Physical Therapy Exercises to Help Manage Duchenne Muscular Dystrophy

Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by progressive muscle degeneration and weakness. It primarily affects boys and causes muscles to become very weak by the early teen years. While there is no cure, physical therapy is extremely beneficial for preserving strength and function.

Physical therapists can recommend specific exercises that are safe and effective for managing DMD. Certain exercises can help maintain mobility, flexibility, posture, and independence for as long as possible. Here is an overview of the important role physical therapy plays in the treatment of Duchenne muscular dystrophy along with specific exercises that can help.

The Benefits of Physical Therapy for DMD

Every child with DMD can benefit greatly from seeing a physical therapist. A customized exercise program can help:

• Strengthen muscles and maintain mobility
• Prevent contractures that limit motion
• Improve balance and coordination
• Maintain good posture and spine health
• Keep lungs and heart healthy
• Promote overall fitness within limitations
• Enable participation in sports and activities
• Encourage independence in movement

A physical therapist will tailor exercises for the child's specific needs and stage of DMD. They can also provide assistive equipment to facilitate movement and function. Ongoing physical therapy is essential for optimizing quality of life with DMD.

Low-Impact Cardiovascular Exercises

Cardio exercise is extremely beneficial for maintaining heart and lung function with DMD. Low-impact activities like swimming and riding a stationary bike can improve cardiovascular fitness without overworking weakened muscles. Some examples include:

• Swimming and water aerobics
• Using arm crank machines
• Reclined cycling
• Adapted rowing
• Wheelchair aerobics

A physical therapist can provide guidance on appropriate cardio exercises and intensities based on the child's abilities. Regular cardio workouts help strengthen the heart and lungs which is vital for managing DMD.

Muscle Strengthening Exercises

Specific muscle strengthening exercises can help maintain mobility and function. The physical therapist will determine which muscle groups to focus on and which exercises are safe and effective. Some examples include:

• Modified push-ups against a wall
• Sit-to-stand from a chair
• Straight leg raises
• Heel raises
• Squats holding onto parallel bars
• Resistance band exercises

It's important to only do strengthening exercises recommended by the therapist to avoid injury. They will ensure the exercises suit the child's abilities and don't put excess strain on muscles.

Range of Motion and Stretching

DMD causes muscles to shorten and tighten over time leading to limited mobility. Daily stretching is extremely important for maintaining range of motion and preventing contractures. A physical therapist can recommend useful stretches such as:

• Hamstring stretches
• Calf stretches
• Shoulder stretches
• Neck stretches
• Wrist and finger stretches

The therapist may also use assisted stretches and recommend the use of splints to keep joints flexible. Stretching should become part of the daily routine to maintain range of motion needed for function.

Balance and Coordination

Exercises that improve balance, posture, and coordination help with sitting, standing, and walking. They also prevent falls which can cause serious injury. Examples include:

• Standing on one leg
• Walking heel-to-toe
• Reaching across the body in sitting
• Practicing transfers
• Balance exercises on a therapy ball

A physical therapist can provide adaptive equipment like therapy balls, balance boards, parallel bars and gait trainers to safely work on coordination skills.

Spine Strengthening and Posture

Having strong spine muscles and good posture is extremely important for managing DMD. Specific exercises that help include:

• Modified sit ups and crunches
• Prone press ups
• Supermans
• Planks
• Rowing exercises
• Chin tucks

Exercises that strengthen core and back muscles help keep the spine aligned and stable. A physical therapist can also recommend bracing if needed.

Aquatic Therapy

Doing exercises in a warm therapeutic pool brings many benefits for DMD. The water provides gentle resistance and support to enable movement while reducing strain on muscles and joints. Water therapy may include:

• Walking through water
• Jogging
• Leg kicks
• Arm movements
• Floating and gentle stretching

Aquatic exercises build strength with minimal impact and low risk of falls. Many children also find exercising in water fun and enjoyable.

Lifestyle and Functional Training

A physical therapist can advise on lifestyle habits and functional skills to maintain independence. This may involve:

• Learning safe methods for transfers, bed mobility and standing
• Using devices and equipment to facilitate self-care
• Practicing skills for participation in sports, recreation and social activities
• Adapting activities as abilities change
• Aiming for an active lifestyle within limitations

Functional training enables people with DMD to keep doing regular daily and social activities for as long as possible.

Starting a Physical Therapy Program

Here are some tips for starting effective physical therapy for DMD:

• Have the initial evaluation early, such as around the time of diagnosis.
• Find a physical therapist experienced in neuromuscular disorders.
• Expect to attend therapy 1-3 times per week initially.
• Be actively involved and learn how to do prescribed exercises properly.
• Make exercises part of the daily care routine at home.

Ongoing physical therapy helps optimize physical abilities and quality of life. Adaptive equipment and mobility aids may eventually become necessary. But maintaining movement and independence can be achieved with the right physical therapy program.

The Takeaway

Regular physical therapy is considered essential for the management of Duchenne muscular dystrophy. Specific exercises tailored to the child's needs and stage of DMD can build strength, maintain range of motion, improve posture and balance, encourage mobility and independence. Physical therapy also promotes overall fitness and active participation in life. Starting customized therapy early and keeping up with exercises provides the greatest benefits.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.