Muscular Dystrophy (MD)

What special care we provide for muscular dystrophy condition?

Our Rehabilitation program is for the patients to maintain available function in limbs and attain maximum possible improvement in associated disabilities. We help patients attain a socially functional status so that he or she can function in their surroundings on their own accord, thus bringing about a sense of independence. Combined with proper and timely medications and our rehabilitation program patients actively manage symptoms and slow the course of disease. Therapy also helps prevent or reduce problems in joints and spine, allowing people with muscular dystrophy to remain mobile for as long as possible.

Our specialists will create a customized treatment plan that will incorporate a multi disciplinary approach including exercises, yoga, nutrition consultation, aqua therapy, music and dance therapy, speech therapy, occupational therapy and psychological counseling.

Our 12 week comprehensive Rehabilitation program for Muscular Dystrophy includes:

Patient Counseling on how the patient may expect his or her condition to progress over the course of disease. Parents/guardians/caretaker are educated about the progressive and degrading condition of the disease and the fatality of the condition, if applicable. They are made aware of the necessity of physiotherapy regime that needs to be followed back at home and what to expect from the sessions under our therapist’s supervision. In conjunction with other rehabilitation professionals, the therapist may also recommend the use of orthoses and wheelchairs for patient use.

Electrotherapy to address complains of musculoskeletal pains at various sites. Electrotherapeutic modalities like paraffin wax bath over fractured limb, TENS, IFT, Ultrasonic therapy for tender points and Contrast Bath are typically used to relieve such pains.

Passive movements are a technique involving movement of limbs, in all ranges, to maintain joint and muscle integrity. Long-term immobilization- due to weakness of muscles- can render the muscle fibrotic and lead to stiff joints. To avoid the development of these co morbidities one needs to maintain the integrity of structures through passive movements.

Active assisted movements as MD patients have limited muscle power. With maximum effort they can attain only a limited range by active contraction of their muscle. To maintain this power, maximum amount of activity up to the fatigue threshold is encouraged in these patients. While the patient maintains muscle force, the physiotherapist assists in completion of movement in the normal biomechanical pattern. This helps maintain joint proprioception i.e. the sense of joint position in space.

Stretching maneuvers as often due to immobility and poor power of muscles, patient’s muscles shorten in length. The joints adapt a gravity-assisted position and internal muscular forces cannot work against this external gravitational force. As a result of this, joint contractures develop. To open up these joints and retain the normal muscle length, stretching is done. A sustained long duration stretch with crepe bandages or taping is given initially and this can be toned down a bit in later stages to short duration stretches with greater repetitions given manually.

Joint mobilization is important as joints often get displaced from their normal anatomical position due to imbalance of muscular forces. To ensure proper weight bearing can be done on the joints without any harm to associated structures, our physiotherapist will passively mobilize the bones of each joint to bring them in place.

Balance and Gait training for muscular imbalances are so profound in MD patients, affective basic sitting and standing postures. As balance improves, patients are able to function better by themselves. With gradual degradation of power in lower extremities, gait is affected. Gait training involving proper training in parallel bars, progressing from supported to unsupported walking is done under the supervision of our physiotherapist.

Aqua Therapy or Hydrotherapy or aquatic exercises are an essential part of physiotherapy rehabilitation protocol for MD. Activities are performed in water at a warmer temperature than body. This helps in the following manner:

  • Buoyancy of water protects and braces weak joints.
  • In water a person can feel very little of his/her own weight so this makes activities of partial weight bearing possible.
  • Adding floatation devices can assist movements while adding high pressure water jet can help in performing mild resistance training in better muscle groups.
  • Warm water helps in maintaining good thermo-stasis in the body and keeps the active muscle warm and at ease.

Cardiac Pacing and Breathing Exercises as chest and cardiac congestion is seen in the patients with MD due to weakness in muscles of heart and respiratory system. To avoid the deleterious effects of an insufficient cardiopulmonary system, our therapists

  • Give passive chest manipulations to clear airway
  • Teach patient huffing and coughing to aid him in spitting out chest secretions
  • Teach deep breathing exercises to condition general cardiorespiratory performance and build endurance.

Aerobic Exercise including walking and swimming are undertaken to maintain strength, mobility and general health.

Nutrition Counseling as proper nutrition is essential for MD patients as limited mobility may contribute to obesity, dehydration and constipation. People with MD are given age-appropriate dietary therapy. Obesity is especially harmful to patients with muscular dystrophy as it places additional strain on their weak muscles.

Psychological Counseling to help you cope in the face of challenges faced by you or your caregiver. A prime part of counseling involves Genetic Counseling.

Occupational Therapy helps train patients in a manner that he or she can attain a good level of independence in daily activities. Besides this, modified workplace and home designs as per the patients´ ergonomic requirements and designing of assistive devices like long handled spoons, scooting chairs etc. are suggested by our occupational therapist.

Speech Therapy under the supervision of our speech therapist can help train patients to recruit accessory muscles for speech articulation. In muscular dystrophies like Occulopharyngeal and Facio-scapulo-humeral dystrophy, speech articulation can be affected.

Yoga Therapy helps in improving flexibility and posture and promotes relaxation.

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