Muscular dystrophy (MD) is a group of inherited genetic conditions that cause muscles to weaken gradually. The damaged muscles become progressively weaker and the phenomenon leads to an increasing level of disability.
There are different types of muscular dystrophy. The symptoms of the most common type of muscular dystrophy begin in childhood, most commonly in boys while in other types of muscular dystrophies, symptoms don’t surface until adulthood.
Muscular Distrophy Physical Therapy
The different forms of muscular dystrophy differ in terms of extent and distribution of muscle weakness, age of onset, pattern of inheritance and rate of progression. The different types of MD include:
All muscular dystrophies are associated with a distinct genetic mutation and are inherited. There are over hundreds of genes that produce proteins which protect muscle fiber from damage. When one of the genes responsible for making proteins becomes defective, muscular dystrophy occurs. The characteristic of a particular muscular dystrophy is determined by the nature of gene mutation, the location of gene on a particular chromosome and the way the gene is passed on from one generation to the next.
Duchenne and Becker muscular dystrophies are X-linked recessives i.e – the disease is passed on from women and commonly affects male children. Of the different types of muscular dystrophies, Duchenne is the most common and severe type. Duchenne MD is caused by a defective gene for dystrophin (a protein responsible for maintaining integrity of muscles). The mutated gene for dystrophin either fails to produce enough dystrophin or produces dystrophin that does not work properly. The onset for Duchenne muscular dystrophy is between 3-5 years and the disease progresses rapidly such that by age of 12, most boys are unable to walk and need a respirator to breathe.
The main feature of muscular dystrophy is progressive muscular weakness. Each of the different type of muscular dystrophy differs in terms of age at which signs and symptoms appear and the sequence in which muscles are affected.
Some of the common signs and symptoms of Muscular Dystrophies include:
Duchenne Muscular Dystrophy (DMD) – Signs and symptoms of DMD surface when the child begins to walk. The typical symptoms may include:
- Frequent falls
- Trouble getting up from lying or sitting position
- Difficulty running and jumping
- Difficulty breathing
- Enlarged calf muscles
- Waddling gait
- Learning disabilities
- Abnormal heart rhythm
- General fatigue
Becker Muscular Dystrophy – The signs and symptoms of Becker MD are similar to DMD but they progress slowly and are milder in nature. Onset of symptoms is generally in the teens but sometimes may even occur until mid – 20s or even later.
Symptoms of other forms of Muscular Dystrophies:
Myotonic – In this form of muscular dystrophy, there is inability to relax muscles at will. Often appearing in early adulthood, facial muscles are first to be affected.
Congenital – The muscular dystrophy is present at birth or shows symptoms before age 2. Some forms show mild disability while others may show severe impairments.
Limb-girdle – The muscles of hip and shoulder are first to be affected in this type of MD. Signs and symptoms in this type of MD may appear from early childhood to adulthood.
Fascioscapulohumeral (FSHD) – The onset of symptoms in this type is usually in teens or young adults. The most striking feature of this form is that the shoulder blades stick out like wings when the patient raises arms.
Oculopharyngeal – Drooping of eyelids is the first sign that appears in this type of MD. There is weakness of muscles of eye, face and throat along with difficulties in swallowing.
To diagnose Muscular dystrophy, following tests may be done along with history review and physical examination – Enzyme tests, Muscle Biopsy, Electromyography and Genetic testing.
Although there is no cure for any form of Muscular Dystrophy, a range of treatments are given to manage the physical disabilities and problems that may develop overtime. Medications including corticosteroids, physical therapy along with assisted devices, surgery to prevent contractures, scoliosis and heart problem are some of the treatments that are given to manage Muscular Dystrophies.
The main goal of physiotherapy for Muscular Dystrophy and Rehabilitation is to maintain function of the patient and prevent complications of the disease owing to progressive muscular weakness. At ORC associated clinics, our rehabilitation experts comprehensively evaluate strength and motor skills of the patient, recommend devices including neck supports, canes, walkers, wheelchairs and adaptive equipments and discuss methods of modifying activities to conserve energy for work simplification.
Despite advances in molecular biology and gene therapy, currently there is no cure for Muscular Dystrophy. However, Physical therapy and rehabilitation along with proper care and attention can help in giving patients a better quality of life.
OVERSEAS REHABILITATION CARE (ORC) is the most trusted provider of rehabilitation services in India which has been catering to the demands of numerous of clients coming for rehabilitation from across the globe in India. Our rehabilitation program for the treatment of Muscular Dystrophy is tailored to the specific needs of each patient. GRC’s constant endeavor is to assist patients to regain optimal neurological fitness and functional abilities.
Our Physical therapy and rehabilitation programs aim to reduce and delay symptoms of muscular dystrophies and maximize patient’s function. Our rehabilitation personnel provide specific exercises, stretches and activities that help in maintaining strength and function. Our therapists educate children the ways to conserve energy for executing their important tasks thereby maintaining function without getting overworked.
Physical therapy exercises and assistive devices can improve length and quality of life in persons with Muscular Dystrophy. These may include:
- Range of motion exercises to maintain joint range of motion and prevent contractures
- Stretching and mild strengthening exercises
- Providing mobility aids
- Breathing assistance
At ORC, we provide holistic rehabilitation to individuals with Muscular dystrophy through physical therapy that aims to:
- Avoid contractures
- Ensure flexibility of joints and tendons
- Assist in breathing through ventilator and breathing exercises
- Provide treatment for problems like scoliosis
- Make Individualized educational plans for patients with learning disabilities
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