Doctors use physical therapy to treat Duchenne muscular dystrophy. It can help maintain muscle function, boost quality of life, and prevent complications. A physical therapist will tailor your treatment according to your needs.
Muscular dystrophy describes a group of genetic conditions that cause muscle weakness and decline in function that worsen over time. Duchenne muscular dystrophy (DMD) is the
The effects of DMD decrease mobility and make it more difficult to do daily tasks. Physical therapy is an important part of managing DMD, as it can help improve movement and flexibility and prevent certain DMD complications.
Continue reading for more information about how physical therapy may help individuals with DMD.
Physical therapy benefits people with DMD in several ways.
Progressive weakening of muscles is a characteristic of DMD. A physical therapist can help maintain muscle function by using exercises that target muscle strength and flexibility.
However, all people with DMD will lose muscle function over time. Along with other members of the care team, a physical therapist can monitor your level of muscle function and can work to help you adapt to any loss of function.
DMD may cause a type of complication called contractures. If you have contractures, your muscles, tendons, or other soft tissues become short, causing your joints to become stiff and deformed.
Working with a physical therapist to maintain flexibility can help reduce the risk of having contractures.
There are several components to physical therapy for DMD. These components include:
Assessments
Physical therapists can use various standardized tests and measures to test your muscle function and mobility. This helps them to monitor your condition and adapt your therapy accordingly.
Experts recommend that you take these tests
Exercise
Regular exercise can help boost overall health and maintain muscle strength for as long as possible. The types of exercise used during physical therapy for DMD are typically those that are gentler on your body,
- aquatic exercise
- bicycle training
- body weight-supported walking
A physical therapist will often supervise exercise to ensure that you don’t overexert yourself or experience an injury.
Stretches
Stretching can help prevent contractures in people with DMD. It involves stretching areas of the body most likely to be impacted by contractures.
- hips
- legs, ankles, and feet
- arms, wrists, and fingers
- neck
Generally speaking, experts recommend daily at-home stretching
Orthotics
A physical therapist may also recommend orthotics. These have several benefits, including:
- supporting weakened muscles
- keeping muscles and tendons flexible by providing a maintained stretch
- boosting mobility
Some examples of orthotics used for DMD include:
- ankle-foot orthotics
- wrist or hand splints
- knee-ankle-foot orthotics
If you receive a diagnosis of DMD, you’ll need physical therapy throughout your lifetime. Having said that, the exact type of therapy that you receive will change as your condition progresses.
For example, early in the disease course, physical therapy
As DMD progresses, muscle weakness becomes more severe and an individual is eventually unable to walk on their own. In these later stages, the focus of physical therapy shifts to:
- providing comfort
- improving posture
- reducing pain
- preventing the worsening of existing contractures or new ones from forming in the upper body
- using assistive devices like wheelchairs and standing devices to help with mobility
Physical therapy for DMD has many benefits. However, there are also some risks to be aware of.
Exercise that’s too strenuous can damage muscles, worsening the effects of DMD. This is why physical therapists may prescribe lower-intensity exercises, such as aquatic exercise.
DMD affects not only mobility but also balance. Muscle weakening can make it harder to react quickly to changes in walking surfaces or in direction. As such, individuals with DMD are at a higher risk of falls, including during exercise.
Your physical therapist will often supervise your physical therapy exercises directly. They will help to make sure that you’re using the appropriate technique and intensity, reducing the risk of an injury or a fall.
There’s evidence that various types of exercise are safe and effective for people with DMD. For example:
- A 2013 study found that assisted bicycle training was safe and delayed worsening of function in people with DMD.
- According to a
2022 study , a mild to moderate intensity resistance exercise program improved leg strength in people with DMD and showed no signs of muscle damage. - A
2023 study observed that hydrokinesitherapy, a type of aquatic therapy, was safe for people with DMD and improved results on various standardized tests of movement or function.
But it’s important to point out that these studies have small numbers of participants. Overall, we need larger studies.
A
Other studies have noted that stretching alone is
It’s important to note that there’s currently no cure for DMD. The condition is progressive, meaning that it gets worse as time passes.
While physical therapy may help to slow some of the effects of DMD and improve quality of life, muscle weakness will continue to worsen over time. Because everyone with DMD is different, the rate at which this occurs can vary by individual.
What types of professionals are a part of the rehabilitation team for Duchenne muscular dystrophy?
In addition to physical therapists, other members of your rehabilitation team for DMD may include:
What are other treatments for Duchenne muscular dystrophy?
Other treatments for DMD include:
- corticosteroids
- drugs like eteplirsen (Exondys 51), golodirsen (Vyondys 53), and casimersen (Amondys 45) that people with DMD can use who have specific gene variants
- elevidys, the
first gene therapy for DMD , which doctors use to treat children with DMD who have a specific gene variant - Angiotensin-converting enzyme inhibitors or beta-blockers to treat cardiomyopathy that can happen in DMD
- surgery to treat contractures or scoliosis
- calcium and vitamin D supplementation to prevent osteoporosis due to corticosteroid use
- assisted ventilation for respiratory muscle weakness
How common is Duchenne muscular dystrophy?
DMD is estimated to occur in
Physical therapy is an important component of DMD treatment. It can have several benefits including maintaining muscle strength and function, helping with mobility, and preventing complications like contractures.
A physical therapist will work with you to develop a treatment plan appropriate to your needs. They’ll also supervise your therapy to monitor your condition and ensure you’re not at risk of injury.
While physical therapy is beneficial, it doesn’t stop the progression of DMD. Every individual with DMD is different. Each person will have a different disease course and response to physical therapy.
