Muscular Dystrophy and The Role of Physical Therapist

Most children who come to physical therapy require strengthening to be a core component to their rehabilitation.  It is critically important for both therapists and families to understand the difference in the rehabilitation approach for children with muscular dystrophy.

Muscular dystrophy is a group of diseases that causes progressive muscle weakness.  The role of physical therapy for children and adults with muscular dystrophy will change over time.  The first, and very important role of the physical therapist, is to teach families how to incorporate a daily stretching program.  Since there is a predictable pattern of muscle weakness, families can be proactive in maintaining their child’s range of motion.  

Over time physical therapists have a role in recommending orthotics, such as night splints, to maintain ankle flexibility.  They also work with families to recommend adaptive equipment. When walking creates too much of an energy demand and becomes a safety concern, power mobility can give back the freedom of movement.  The child or adult can return to keeping up with others in school and in the community and they can save their energy for learning, etc.

As mentioned above, there is a significant differentiation in the rehabilitation care for a person with muscular dystrophy.  Strengthening exercises can be harmful because they can accelerate the breakdown process of the muscles.  Physical therapists want to encourage activity, but not to encourage maximum effort against resistance.

In addition to mobility and equipment, activities such breathing games can be helpful to maximize respiratory abilities.  Breathing exercises within the context of yoga and meditation are beneficial as well.

Physical therapists in the schools have a very important role in educating the staff on what a child can and can’t do.  They should teach others about the negative effects of working too hard and the benefits of saving energy for learning.  Therapists and families need to help school staff understand muscular dystrophy, how it impacts the student, and how to best help the student have success.

Additional resources include:

Duchenne Therapy Network http://duchennetherapynetwork.com/

Parent Project Muscular Dystrophy:  http://www.parentprojectmd.org

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