Non-ambulatory boys with Duchenne muscular dystrophy (DMD) have concerningly low levels of physical activity, according to a recently published study in Muscle and Nerve.
Physical activity refers to any movement performed by muscles that requires energy. The World Health Organization (WHO) recommends at least 60 minutes of physical activity per day to maintain health.
Evidence shows that moderate dynamic physical activity can also be beneficial for patients with DMD. “In the DMD population, there is reason to believe that physical activity may lead to the same positive health effects and, importantly, help prevent the adverse effects associated with corticosteroid treatment, including osteoporosis, diabetes, weight gain, and secondary disuse of still-functioning muscles,” the study’s authors wrote.
However, DMD can cause muscle weakness, fatigue and pain that create significant obstacles to engaging in physical activity. Due to the limited data on physical activity patterns in patients with DMD, the authors quantified physical activity in 28 patients with a mean age of 12 years old.
Read more about the prognosis of DMD
Methodology and results
The study utilized the ActiGraph GT3X+ accelerometer, which recorded the participants’ physical activity during wear time. The participants wore the device during waking hours for seven consecutive days. Additionally, researchers used a questionnaire to assess how the patients perceived their relationship to physical activity.
Results showed that, according to the accelerometer, 53% of the patients met WHO recommendations for daily physical activity. However, the authors observed that non-ambulatory boys (that is, boys who use wheelchairs or have lost the ability to walk) engaged in significantly less physical activity. Furthermore, sedentarism appeared to increase with age, with boys over the age of 8 showing notably lower activity levels. Participants were more sedentary on weekends than on weekdays, which increased with age; these findings were also seen in the healthy control group.
The primary barriers to physical activity, according to the questionnaires, included poor health and lack of interest. The majority of participants reported perceiving sports as “not fun” or “not fun at all.” However, wheelchair hockey and assisted cycling were relatively popular among the group.
Result analysis and comparison
This study reported higher levels of physical activity in patients with DMD compared to other similar studies. Researchers attributed the difference to the availability of sports facilities, provision of appropriate assistance, access to suitable wheelchair paths and cultural factors in Norway, where the study was conducted.
The authors noted that the decline in physical activity with age was also observed in healthy controls and therefore could not be attributed solely to disease progression. Increased screen time appeared to be a contributing factor.
“It is crucial to tailor PA [physical activity] while also considering social factors and creating inclusive environments to encourage and sustain PA participation among the DMD population, and barriers to engaging in PA should be addressed,” the authors concluded.
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