Physical Therapy Goals in Muscular Dystrophy

Muscular dystrophy is a genetic disorder. In this condition, muscle degeneration manifests as dystrophy, which refers to abnormal growth. Muscular dystrophy shows symptoms like difficulty in breathing, progressive muscle weakness initially involve legs only however, in later stages it involves neck, shoulder, arms and even changes spinal curvature, speech difficulty, difficulty in walking and stairs climbing. There are many different types of muscular dystrophy, but the most common is Duchenne muscular dystrophy. Duchenne muscular dystrophy (DMD) often starts in early childhood, and its symptoms can be treated by a physical therapist.

Stages of Duchenne Muscular Dystrophy

Stages of DMD represent the sequence of disease that occurs. DMD has no cure, but through physical therapy we can maintain or delay the condition severity according to the stage that decides the physical therapy plan. The four stages of DMD are;

At diagnosis
Early ambulatory
Early non-ambulatory
Late non-ambulatory

Goals of Physical Therapy in Muscular Dystrophy

Optimise Respiratory Functions: Respiratory functions become difficult in the case of muscular dystrophy. Physiotherapists set goals using Breathing exercises and other advanced strategies that help maintain respiratory function, strengthen respiratory muscles, and perform chest clearance techniques.
Prevent Stiffness of the Muscle: When joints get stiff, they become very fragile and restrict the movement of the joints. Physiotherapists set goals to maintain the range of motion of every joint in the body and try to increase this range of motion through stretching exercises, using braces, positioning and all the possible strategies.
Prevent deformity: Physiotherapists set goals to prevent deformity, which is very common in DMD. Physiotherapy, which includes focused exercises, stretching, and posture management, helps retain muscular function, range of motion, and mobility. Foot deformity is common due to foot drop, which is a common occurrence in DMD, so a brace is recommended to avoid injuries or deformity.
Maintain Functional Positional and Optimise Movement: Physiotherapy goals are to provide excellent support and correct position. Physiotherapists will monitor the child's positions or postures when sitting, lying, and standing. They can advise parents on how to assist their kid sit, stand, and lie in the best possible postures utilising cushions or splints.
Education to Avoid Fatigue: The educational goals include teaching patients skills for energy conservation, joint protection, and the prevention of overuse fatigue.
Improve mobility and Ambulation: Physical therapists are qualified mobility specialists who may assist patients with DMD in developing movement programs to enhance their daily mobility. Physical therapists may assist clients in securely getting up and down from chairs and rising from the floor, as well as providing instruction in walking and climbing stairs. They can help patients with DMD in adjusting specific actions to make them more straightforward and more bearable as their condition progresses.
Improve Balance and Coordination: Balance training enhances mobility, coordination, and reduces the fear of falling. This included regular physical activity and exercise routines. Exercises involve movement and doing mental tasks, such as walking and carrying things.
Main Spinal Curvature: Spine issues are very prevalent in males with DMD. As they age, the spine progressively curves. This curve might be side to side (scoliosis) (kyphosis). Setting goals should be made to avoid it. A physical therapist can provide guidance on sitting and sleeping postures, as well as exercises to maintain a straight back. Providing sufficient back support in one's wheelchair is an excellent technique to reduce or prevent scoliosis.
Guide the use of Assistive Devices/Mechanical Aids: Assistive devices, such as canes, braces, and wheelchairs, are frequently provided to enable safe movement and independence in patients with DMD. Helping patients to use canes, walkers, wheelchairs, and other mobility equipment can help individuals maintain their independence and safety while moving around. Mobility gadgets allow individuals to fulfil their social tasks and improve their quality of life.

Importance of Physical Therapy in Muscular Dystrophy

Physical therapy is a crucial component of DMD treatment, offering a range of benefits, including preserving muscular strength and function, enhancing mobility, and alleviating issues such as contractures. The physical therapist will create a personalised plan based on the individual's current mobility status, specific requirements, and overall health. DMD causes gradual muscular weakening and wasting of muscles; therefore, the condition will vary over time.

The physical therapist monitored all exercise and rehabilitation programs. They may personalise rehab programs and ensure that exercises are completed safely, reducing the intensity as the disease progresses. Physical therapists guide the proper use of orthotics and assistive equipment, such as braces, night splints, and wheelchairs. The gradual introduction of exercise progression, beginning slowly and increasing gradually to develop strength and endurance without causing harm. As the condition progresses, it is critical to monitor and act accordingly.

Conclusion

Physical therapy is an essential component in treating muscular dystrophy. It can improve mobility, keep muscles strong and functional, and avoid issues like contractures. However, physical therapy cannot stop the progression of MD but can slow down the progression since each individual with the disease is unique, and their disease history and response to physical therapy will differ.