making muscle wasting history

Physical therapy can help prevent deformities, improve movement, and keep muscles as flexible and strong as possible. Options include passive stretching, postural correction, and exercise. A program is developed to meet the individual patient’s needs. Therapy should begin as soon as possible following diagnosis, before there is joint or muscle tightness.

Passive stretching can increase joint flexibility and prevent contractures that restrict movement and cause loss of function. When done correctly, passive stretching is not painful. The therapist or other trained health professional slowly moves the joint as far as possible and maintains the position for about 30 seconds. The movement is repeated several times during the session. Passive stretching on children may be easier following a warm bath or shower.
Regular, moderate exercise can help MD patients maintain range of motion and muscle strength, prevent muscle atrophy, and delay the development of contractures. Persons with a weakened diaphragm can learn coughing and deep breathing exercises that are designed to keep the lungs fully expanded.
Postural correction is used to counter the muscle weakness, contractures, and spinal irregularities that force MD patients into uncomfortable positions. When possible, patients should sit upright, with feet at a 90-degree angle to the floor. Pillows and foam wedges can help keep the person upright, distribute weight evenly, and cause the legs to straighten. Armrests should be at the proper height to provide support and prevent leaning.
Support aids such as wheelchairs, splints and braces, other orthopedic appliances, and overhead bed bars (trapezes) can help maintain mobility. Braces are used to help stretch muscles and provide support while keeping the patient ambulatory. Spinal supports can help delay scoliosis. Night splints, when used in conjunction with passive stretching, can delay contractures. Orthotic devices such as standing frames and swivel walkers help patients remain standing or walking for as long as possible, which promotes better circulation and improves calcium retention in bones.
Repeated low-frequency bursts of electrical stimulation to the thigh muscles can produce a slight increase in strength in boys with Duchenne MD.
Speech therapy may help patients whose facial and throat muscles have weakened. Patients can learn to use special communication devices, such as a computer with voice synthesizer.
Special exercises, or a special diet and feeding techniques, can help MD patients who have a swallowing disorder. Some patients may find it difficult to pass food or liquid from the mouth to the stomach, which can lead to poor nutrition and increased susceptibility to infection.