Physiotherapy

Physiotherapy About Duchenne Muscular Dystrophy About Becker Muscular Dystrophy Learning and Behaviour Siblings Respiratory Care Steroid Protocols and Studies Cardiac Information Multidisciplinary Care  Management of Scoliosis Workshop - 2005

Boys with Duchenne should commence physiotherapy from a very early age. The physiotherapy management is very different to what is expected in other conditions where rehabilitation and restoration of muscle power and function would be the main aim. This will not be possible for boys with  Duchenne as it is a progressive muscle wasting condition. In Duchenne the therapists will advise on the types of active exercise to maintain health and well being, and develop sensorimotor skills and from the very beginning boys will begin a daily programme of stretches to prevent known the secondary complications of contractures (permanent tightening and limitation of joint movement) Physiotherapists will also monitor the boys breathing and provide suitable programmes to maintain their respiratory function and help them clear the lungs of secretions when they have colds and chest infections. Physiotherapists will be able to give advice on suitable exercise and activities, which are less likely to cause injury, while having a positive affect of maintaining muscle strength. It is not recommended that boys try to strengthen weakening muscles but rather enjoy the activities that they are able to participate in with plenty of rest breaks. Read more about what scientists can tell us about physical activity and Duchenne. Exercise done in the water is especially beneficial. Older boys and young men, who use a power chair full time, find that they are able to move more easily in the pool and they also appreciate their hydrotherapy sessions for relaxation and social interaction with friends. Riding bicycles is also good non-weight bearing exercise in the early years. It is recommended that the boys never become tired by their activities and that transport is provided for them if long distances are to be travelled. They should never be required to push themselves in a manual wheel chair but rather use a power chair or scooter part time. The daily stretching regime is necessary to keep the joints as free from permanent restrictions in range of movement. Many boys have their stretches done at home while others have aides at school who provide this part of their program under the supervision of the physiotherapist. The following 7 minute tutorial is taken from our "Giving a Face to Duchenne" DVD set.   Most boys will wear orthotics or splints on their feet, either in the night or day (or both) to maintain the range in their feet. Another important part of the care provided by the therapist is to monitor posture and seating for comfort and to ensure that symmetry is maintained to prevent the development of spinal curvatures. Scoliosis (a permanent curvature in the spinal column) is a common secondary complication of this condition. The likelihood of it developing can be reduced if boys are provided with good supportive seating and an electronic tilting mechanism on their chair, which will permit them to rest and recline when they are tired. Boys with Duchenne muscular dystrophy really enjoy being able to participate with their friends in all forms of recreation. Physiotherapists are able to provide suggestions for adapting activities so that they can be included. It is however often the case that they themselves or their lateral thinking friends come up with the solutions which enable them to enjoy as rich and as fulfilling life style as possible. Prepared by Helen Posselt PT Montrose Access, Brisbane Helen also volunteers her time as Parent Project Australia’s Educational Advisor   Boys can stretch their achillies tendons themselves while they are ambulatory.   Ankle Foot Othosis (AFO) -worn nightly to prevent heel cord contractions. The boys call them 'moon boots'.  Holistic clinician, Helen Posselt reads to her client during a regular clinical assessment.