PHYSICAL THERAPY FOR MUSCULAR DYSTROPHY

What is Muscular Dystrophy?

Muscular dystrophy is a collection of over 30 inherited disorders that impact how your muscles work. These conditions, known as myopathies, specifically affect the skeletal muscles responsible for movement. The symptoms tend to get worse over time, making it harder to perform everyday tasks like moving and other basic activities. Depending on the type of muscular dystrophy, it can also impact muscles involved in essential functions such as heart health and breathing. In more severe cases, this can lead to complications with heart function and respiratory issues.

There are over 30 different types of muscular dystrophy, with some being more common than others. Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are two of the most frequently seen forms.

Duchenne Muscular Dystrophy (DMD) is the most prevalent type, primarily affecting children assigned male at birth. It can also affect children assigned females at birth, though their symptoms tend to be milder. DMD typically shows up in early childhood, leading to progressive muscle weakness. Over time, the disease impacts not only mobility but also the muscles that support critical functions such as heart and lung activity, making it a life-threatening condition as it advances.

Becker Muscular Dystrophy (BMD) is the second most common form. The symptoms of BMD usually emerge later, sometimes between ages 5 and 60, although most people begin to notice signs in their teenage years. The severity of Becker muscular dystrophy varies widely, with some individuals experiencing slower progression and others facing more pronounced muscle weakness, but it often still impacts the heart and respiratory muscles as the disease progresses.

Signs & Symptoms

The signs and symptoms of muscular dystrophy can vary greatly depending on the specific type, but the primary sign is muscle weakness, along with other muscle-related issues. Different types of muscular dystrophy target different muscle groups and parts of the body, with symptoms generally worsening as the condition progresses.

When it comes to movement and muscles, common symptoms include:

  • Muscle atrophy, or the shrinking of muscles over time.
  • Difficulty walking, climbing stairs, or running.
  • An abnormal walking pattern, such as waddling or toe-walking.
  • Stiff or overly flexible joints.
  • Contractures, which are permanent tightening of the muscles, tendons, or skin
  • Muscle spasticity, or involuntary muscle stiffness.
  • Muscle pain or discomfort.

Beyond muscle issues, other symptoms may develop, including:

  • Persistent fatigue, making daily tasks more challenging.
  • Difficulty swallowing (dysphagia), which can affect nutrition and safety when eating.
  • Heart-related problems like irregular heartbeats (arrhythmias) or heart failure (cardiomyopathy).
  • Spinal deformities like scoliosis (curved spine).
  • Respiratory issues due to weakening of the muscles that help with breathing.
  • Intellectual disabilities or learning challenges.

The severity of muscular dystrophy varies from person to person. In some cases, the symptoms are mild and progress slowly, leading to gradual muscle weakening as you age. In more severe forms, the disease progresses rapidly, leading to significant muscle loss and physical disability at a much younger age.

Causes of Muscular Dystrophy

Muscular dystrophy is caused by mutations, or changes, in specific genes responsible for maintaining healthy muscle structure and function. These genetic mutations prevent the muscle cells from performing their usual role in keeping muscles strong and functional.

There are many different genes involved in muscle health and a variety of possible mutations that can affect them. This is why there are so many different types of muscular dystrophy, each with its own set of symptoms and progression patterns.

In most cases, muscular dystrophy is inherited, meaning the genetic mutation is passed down from one or both biological parents. Depending on the type, the disorder can be inherited in different patterns, such as X-linked (related to the X chromosome) or autosomal (related to non-sex chromosomes). In rare instances, the mutation can occur spontaneously, without a family history of the condition.

Prevention Methods

Since muscular dystrophy is a genetic condition, there is currently no way to prevent it. If you’re concerned about the possibility of passing on muscular dystrophy or other genetic conditions to your future children, it’s a good idea to speak with your healthcare provider about genetic counseling. They can help assess your risk and discuss options.

If you already have muscular dystrophy, there are steps you can take to help reduce complications and improve your overall quality of life. Maintaining a balanced, healthy diet is important to prevent malnutrition, and staying hydrated by drinking plenty of water can help avoid issues like dehydration and constipation. Regular exercise, as recommended by your healthcare team, can help keep muscles as strong and flexible as possible. It’s also crucial to maintain a healthy weight, quit smoking to protect your heart and lungs, and ensure you’re up to date with vaccinations to reduce the risk of infections that could further compromise your health.

Treatment Options

While there is no cure for muscular dystrophy, treatment can help improve quality of life and slow the progression of certain forms of the disease. These treatments focus on preserving mobility, strengthening heart and lung muscles, and addressing complications as they arise. Monitoring and ongoing care are essential, and individuals with muscular dystrophy often require a team of specialists, including neurologists, physical therapists, cardiologists, and other healthcare professionals.

Non-Surgical – Corticosteroids like prednisone and deflazacort (Emflaza) are often prescribed to boost muscle strength and delay muscle deterioration. Long-term use of these drugs can lead to side effects such as weight gain and brittle bones, which increase the risk of fractures. Newer medications like eteplirsen (Exondys 51) and golodirsen (Vyondys 53), specifically approved for treating Duchenne muscular dystrophy with certain genetic mutations, offer additional options. In cases where muscular dystrophy affects heart function, doctors may prescribe heart medications like ACE inhibitors or beta blockers to protect the heart.

Surgical – Surgeries may be performed to correct contractures, which are permanent tightening of muscles, or to address spinal curvature that can affect breathing. In cases of heart complications, a pacemaker or other cardiac device may be implanted to regulate heart function and improve quality of life. As respiratory muscles weaken, breathing assistance devices like ventilators may be required to aid lung function and ensure proper oxygen levels.

Physical Therapy – Range of motion and stretching exercises help keep joints flexible, as the disease can cause joints to stiffen and lock. Low impact aerobic exercises, such as walking and swimming, are recommended to maintain muscle strength and overall health. Strengthening exercises may also be beneficial, though it’s important to consult with a doctor to avoid exercises that could cause harm. Assistive devices, such as braces, help keep muscles and tendons stretched, slow contracture progression, and provide additional support for weakened muscles. Canes, walkers, and wheelchairs may also be needed to maintain independence and mobility.

Exercises for Muscular Dystrophy

Aerobic Exercise: Activities like walking, cycling, swimming, or using a wheelchair to boost heart rate and breathing, improving heart health, circulation, and lung function while preventing chronic disease.

Stretching: Exercises like yoga, Pilates, or Tai Chi to reduce muscle stiffness and improve flexibility. Start with beginner poses and hold for 10–30 seconds with controlled breathing.

Light Resistance Training: After aerobic exercise, try light weightlifting (5–10 pounds) to gently build muscle strength.

Massage Therapy: Helps relax tight muscles, reduce pain, and improve flexibility by easing muscle tension.

For more information about tennis Muscular Dystrophy in Long Island, contact Hicksville Physical Therapy today.

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