In boys living with Duchenne muscular dystrophy (DMD), the progressive weakening of muscles significantly impacts mobility. Orthotic devices (also called “orthoses”) such as leg braces and wrist splints help support weakened muscles and prevent muscle stiffness. Though there are several kinds of orthotic devices and different uses for them at different stages of the disease, they all help patients move more easily and for longer.
What kinds of orthotic devices are used in DMD?
Orthotic devices provide support for weakened muscles, but they also help delay contractures, where muscles and tendons shorten and become rigid. To ensure they provide the best support possible orthotic devices are typically custom-made to the wearer for an exact fit. The most common orthotic devices used by people living with DMD are:
Ankle-foot orthoses (AFOs): Also called “moon boots,” these are plastic splints that cover the ankle, foot and the leg below the knee, and help keep DMD patients walking for longer. They can be worn at night to stretch the Achilles tendon and prevent ankle stiffness. AFOs may also be worn during the day to help support the ankle and make walking easier.
Knee-ankle-foot orthoses (KAFOs): Similar to AFOs, these are customized splints that cover the ankle and foot, but unlike AFOs they also cover the knee joint. KAFOs may be made of metal, plastic or carbon fiber. They provide additional support to help with stability, joint alignment and reduce joint pain. Though KAFOs can prolong walking, many patients find them difficult to use.
Hand orthoses: Hand and wrist braces or splints can help support grasping items. Wearing hand orthoses at rest has shown benefit in maintaining joint mobility, reducing pain and improving function.
Learn more about DMD treatment and care
At what stage of Duchenne are orthoses used?
Orthotic devices are adapted to each stage of disease progression in DMD. While the exact timing of the stages of DMD vary from person to person, orthoses are first used at night in early childhood, and then worn more progressively by many patients as the muscles continue to weaken.
- Childhood: AFOs are often used at night to prevent contractures and stretch the calf muscles.
- Teens: Both AFOs and KAFOs are used to preserve walking function. Hand and wrist orthoses may be worn to help with carrying out daily activities.
- Late teens to early twenties: Wheelchair use often replaces the need for AFOs and KAFOs, but hand and wrist orthoses are still used to preserve hand function and joint mobility.
Braces and splints are an important aid in preserving mobility and function for as long as possible. Maintaining the ability to carry out daily activities and remain active are essential to preserving quality of life in people living with DMD.
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