How Physical Therapy Helps Muscular Dystrophy

Muscular dystrophy (MD) refers to a group of genetic diseases that cause progressive weakness and loss of muscle mass. Many people with MD eventually lose the ability to walk and, sometimes, may need a respirator to breathe.
Although living with MD can be challenging, studies have identified treatments, including physical therapy, that can improve the quality of life for many.

How Does MD Affect the Body?

Scientists have identified over 30 types of MD caused by a genetic mutation that disrupts the normal development of the proteins that protect muscle fibers. Depending on the mutation, MD can affect the spine, heart, gastrointestinal system, endocrine glands, eyes, brain, and other organs. Doctors have diagnosed various forms of MD in infants up through middle age and older.

Duchenne muscular dystrophy (DMD) is the most common form of MD, accounting for about half of all cases. Although girls can inherit and pass on the gene, DMD primarily affects boys, with symptoms often beginning in early childhood.

The symptoms of Becker muscular dystrophy (BMD) are similar to those of Duchenne but may be milder and progress more slowly. Symptoms of BMD typically emerge during a person’s teens or 20s.

According to the Mayo Clinic, symptoms of DMD and BMD may include:

• Frequent falls
• Difficulty rising from a lying or sitting position
• Trouble running and jumping
• Waddling gait
• Walking on the toes
• Large calf muscles
• Muscle pain and stiffness
• Learning disabilities
• Delayed growth

Symptoms of facioscapulohumeral MD often begin in the teenage years. This type of MD causes progressive weakness in the face, arm, leg, chest, and shoulder muscles. The progression tends to be slower and may not be as disabling as other forms of MD.

Myotonic muscular dystrophy is the most common adult form of MD. Symptoms can include prolonged muscle spasms, cataracts, cardiac abnormalities, and endocrine disturbances. Those with myotonic MD may have long, thin faces, drooping eyelids, and a swan-like neck.

Although muscular dystrophy is a chronic progressive disease, studies find physical therapy may slow the course of the disease and improve the person’s quality of life.

How Physical Therapy Can Help Muscular Dystrophy

Physical therapists (PTs) are movement experts who work to improve or restore strength and functional mobility in their clients. Therapists often include low-impact exercises, gentle stretches, and resistance training in a PT program for those with MD. It is essential activities are not too intense, and that a licensed physical therapist supervises the program.

Studies have found aquatic physical therapy is effective for many with MD, reducing pain, improving functional ability, and improving physical and mental health.

Depending on the type of MD, your physical therapist-designed treatment plan may focus on the following areas:

Range of Motion and Flexibility

Many types of MD result in muscle pain, joint stiffness, and muscle contractions, causing discomfort, which can be severe and impede movement and mobility. Active and passive range of motion exercises can improve joint flexibility, tightness, and range of motion and prevent contractures of tendons and joints.

Active range of motion (AROM) – appropriate if you can initiate movements to contract, control, and move through a range, fully or even partially, without help. AROM helps strengthen muscles and joints, improve flexibility, prevent muscle atrophy, reduce pain, and improve function.

Passive range of motion (PROM) – your physical therapist moves the joint for you without your help. PROM is appropriate when you cannot or should not move the area yourself and helps loosen tight muscles, improve joint mobility, decrease muscle spasticity, and improve circulation.

Strengthening and Cardiovascular Exercises

The name “muscular dystrophy” means the wasting away of muscle tissue, so it’s easy to understand why muscle strengthening is a vital component of the treatment plan. Muscle weakness, body misalignment, spinal curvature, scoliosis, and obesity are all areas that may be related to MD. Low-impact exercises and resistance (weight) training can help improve areas of weakness.

• Improve muscle strength, including respiratory muscles
• Core strengthening to improve posture, balance, and stability
• Balance strengthening to reduce fall risk
• Weight management
• Improve cardiovascular health and endurance

Breathing and Speech

MD can weaken the muscles you use to breathe. Shallow breathing can lead to dangerously low blood oxygen levels, headaches, and confusion. Weak respiratory muscles compromise your breathing function. They may also impair your ability to cough, making you vulnerable to infection.

Weak facial and throat muscles impair your ability to close your eyes, smile, speak, chew, and swallow. If you have problems with chewing and swallowing, getting the nutrients you need to maintain health and muscle mass can be challenging. An impaired swallowing function increases the risk of aspiration or an obstruction in the airway or lungs.

Many physical therapists have advanced training in speech therapy. They can include exercises and activities to conserve breath, strengthen the diaphragm, facial, and throat muscles, and deepen breathing to increase the ability of the lungs to expand.

Developmental skills

Staying on target with motor and other developmental skills can be challenging for children with MD. Many physical therapists specialize in working with children and can design a fun program to help them attain age-related milestones related to crawling, jumping, climbing, eating, and more.

Use of Assistive Devices

Health professionals often prescribe assistive devices for children and adults with MD. Your physical therapist can help identify assistive devices to improve your mobility and quality of life and teach you how to use them safely.

Devices may include:

• Wheelchairs, walkers, or crutches
• Splints and braces
• Standing frames
• Overhead bars
• Night splints
• Adaptive eating utensils and two-handled cups
• Voice-controlled lights or computer software
• Adaptive keyboard
• Grooming and hygiene items like hairbrushes and toothbrushes

As challenging as muscular dystrophy can be, a quality physical therapy program can significantly increase mobility, reduce discomfort, and improve your quality of life.

Our team at Athletic Physical Therapy is committed to ensuring each client we see attains the highest level of function possible. Contact us today to learn how our proprietary program, the ARC Progression, can improve symptoms of muscular dystrophy and help you live a better life.