Learn The BasicsThere is currently no cure for Duchenne muscular dystrophy (DMD). However, there are several options available for patients to manage the complications of the disease and ensure they live their best possible lives.
Physical therapy
DMD affects muscle strength and function, and patients gradually lose the ability to perform daily activities that were previously doable due to muscle weakness and wasting.
Patients with DMD should be seen by a physical therapist every four to six months from the time of diagnosis to monitor their physical function and offer support to maintain this function for as long as possible.
Physical therapy plays important roles in improving several aspects of a patient’s life, such as minimizing contractures, preventing and managing pain, recommending the right mobility device and other equipment and offering rehabilitation following an injury or fracture.
A physical therapist may prescribe and guide exercises to improve blood flow to the muscles, increase the ability of muscle stretching and decrease muscle stiffness.
Occupational therapy
As the disease progresses, patients with DMD may start to experience difficulties performing everyday tasks.
An occupational therapist can work with patients and their families to ensure that they have the accommodations they need. An occupational therapist can help patients build new skills, make changes to their daily activities or environment to make these more suitable for their abilities and provide guidance about specialized equipment or aids to make everyday living more comfortable.
Occupational therapy can ensure patients can fulfill everyday tasks, school- and work-related activities and social activities.
An occupational therapist can assess patients’ range of motion and conduct a wheelchair evaluation to make sure that all parts of the wheelchair fit the patient properly to avoid deformities.
The occupational therapist can also educate patients about the proper use of the wheelchair and provide other equipment such as splints to help with joint mobility, grip strength and motor function in the fingers.
Speech therapy
DMD may also affect cognitive function, and some patients may have a particular pattern of speech deficits.
A speech therapist can evaluate and treat these speech deficits in patients with DMD. They may prescribe exercises for the muscles that play a role in speech and help with articulation.
In the later stages of the disease, a speech therapist can suggest voice exercises, speech amplification devices and compensatory approaches.
Respiratory therapy
As the disease progresses, patients with DMD may start to experience respiratory insufficiency as they begin to lose strength in their respiratory muscles.
The respiratory function of the patients should be tested routinely and include a medical history, physical examination, lung function tests and sleep-disordered breathing evaluation.
Respiratory therapy may include airway clearance with assisted cough techniques to prevent pneumonia and lung collapse. This can be done via manual or mechanical techniques or mucus mobilization devices.
Respiratory therapy may also include respiratory muscle training, though the benefits of this approach remain limited.
Patients with DMD may benefit from noninvasive night-time ventilation to decrease the risk of sleep apnea and low oxygen concentration in the blood. As the disease progresses further, patients usually also require non-invasive ventilation during the day and eventually continuous invasive ventilation via tracheostomy.