Patients with Duchenne Muscular Dystrophy (DMD) have gait disorders. Therefore, specific gait assessment tools are needed.
The aim of this study was to develop a gait assessment instrument for DMD ...patients (DMD-GAS), and investigate its validity and reliability.
The scale was developed considering the expert opinions which included 10 physiotherapists who had experience in the management of patients with DMD, and the Content Validity Index (CVI) was calculated. The final version of the DMD-GAS that was agreed upon the experts consisted of 10 items, and each item scored between 0 and 2. The intra-rater reliability was established by the video analysis of children with a 1-month interval and inter-rater reliability was determined by the scores of 3 physiotherapists.
The study included 56 patients with DMD.
The criterion validity was determined by investigating the relationship between the total score of the DMD-GAS and Motor Function Measure (MFM), 6 Minute Walk Test (6MWT), and the data obtained from GAITRite.
The CVI of the DMD-GAS was 0.90 (p < 0.05). The construct validity and internal consistency of the DMD-GAS were excellent as well as the intra- and inter-rater reliability (>0.90). Moderate-to-very strong correlations were found between the total score of the DMD-GAS and the MFM-total score (r = 0.78), 6MWT (r = 0.71), gait speed (r = 0.50), stride length (r = 0.56), and base of support (r = −0.70) (p < 0.01).
The results indicated that DMD-GAS was a reliable and valid instrument to determine gait characteristics of the patients with DMD in clinical settings.
NCT05244395.
•This study presents a new scale that can assess the kinetic properties of each part of the body during walking and the spatio-temporal characteristics of gait in a disease-specific manner.•DMD-GAS was a reliable, valid and practical assessment instrument for gait deviations.•DMD-GAS promises a practical assessment of gait deviations of children with DMD.
Abstract The aim of this study was to investigate the relationship between neck flexor muscle strength and functional performance in children with DMD. A total of 70 children with DMD between Level 1 ...and 3 according to Brooke Lower Extremity Functional Classification (BLEFC) were included in the study. Children were divided into 2 groups according to neck flexor strength measured by Medical Research Council Scale as Group 1 (3⁻ and below) and Group 2 (3 and above). Functional performance was assessed by 6 Minute Walk Distance (6MWD) and timed performance tests, and ambulatory status by North Star Ambulatory Assessment (NSAA). Correlations between neck flexor strength and performance tests were analyzed by using Spearman’s correlation coefficient in non-parametric conditions. Thirty-six and 34 children were included in Group 1 and 2, respectively. No statistically significant difference was found in BLEFC between groups (z=-1.225, p>0.05). 6MWD (z=-2.574, p=0.01) was found to be longer and NSAA (z=-2.565, p=0.01) was higher in Group 2. Positive, moderate, statistically significant correlations were determined between neck flexor muscle strength and 6MWD (p<0.01, r=0.374); NSAA (p<0.01, r=0.399) while a negative, weak correlation between neck flexor muscle strength and the duration for standing from supine position (p=0.02, r=-0.290). The results indicate the relationship of neck flexor muscle strength and functional performance in DMD children. It is thought that the approaches to maintain neck flexor muscle strength from the early stages of disease process may support functional activities of daily life with less compensation and effort in DMD.
Background
Although the gait and balance disturbances of Duchenne muscular dystrophy (DMD) patients were evaluated by using different methods in literature, the impact of the foot and body posture on ...gait and balance has not been clearly described yet in DMD.
Aim
The aim of this study was to examine the relationship between foot-body posture and gait and balance in patients with DMD.
Methods
Ambulatory patients with DMD who had > 90° range of motion at ankle joint were included in the study. Foot and body posture were evaluated with the Foot Posture Index (FPI-6) and the New York Posture Rating (NYPR). The limitation degree at the ankle joint (ALD) was recorded. Gait characteristics and balance were evaluated objectively by using the GAITRite system and the Bertec Balance Check Screener
™
force platform system, respectively.
Results
A total of 38 ambulatory patients with DMD (age: 92.44 ± 17.91 months) were recruited. Both the right and left foot FPI-6 scores were correlated with GAITRite parameters such as ambulation time, gait speed, number of steps, and left and right stride lengths (
p
< 0.05). A relationship was determined between right foot FPI-6 score and anterior–posterior limits of stability (LoS) obtained by force platform (
p
< 0.05). NYPR score was also correlated with the postural control parameters such as left and right base of support and anterior posterior LoS (
p
< 0.05).
Conclusion
The current findings indicate a contribution of foot and body posture to gait and balance disorders of children with DMD.
Clinical Trial Number
NCT04353167, Date of registration: April 16, 2020.
This study aims to investigate the feasibility and safety of short-term functional electrical stimulation (FES) training of the quadriceps femoris muscles in a child with facioscapulohumeral muscular ...dystrophy (FSHD).
A 7-year-old child with FSHD received treatment due to a decrease in functional performance and difficulty climbing stairs. The child was followed up with a home-based exercise program. FES was applied twice a week during stair climbing for six weeks. Muscle activation of the quadriceps femoris was measured using superficial electromyography, muscle strength was measured with a hand-held dynamometer, and functional performance was assessed with the 6-Minute Walk and the Stair Climb Tests before and after the treatment period.
At the end of the treatment, there was an improvement in muscle activation. While muscle strength increased in the quadriceps femoris muscle of the non-dominant side, it remained constant on the dominant side. Functional performance test results also improved.
FES was a feasible and safe tool to use in our case, a child with FSHD.
This study was aimed to investigate the acute effects of kinesiology taping (KT) on physical performance, gait characteristics, and balance in early-stage Duchenne Muscular Dystrophy (DMD).
...Forty-five children at early functional level of DMD were included. 6-minute walk test (6MWT), and timed performance tests were performed; gait characteristics, and balance were assessed before and one hour after taping. KT was applied to bilateral quadriceps and tibialis anterior muscles. The comparison of assessments was performed by using Wilcoxon Signed Ranks test.
Significant increase in the distance of 6MWT, decrease in the duration of descending 4 steps, and 10 m walk timed performance tests, improvements in all of the gait characteristics, and balance were determined after taping (p < .05).
KT has positive acute effects on performance and gait of children with DMD at early functional level which encourages therapists to use KT as a complementary approach in rehabilitation programs.
ABSTRACT
Introduction
We investigated and compared the effects of 2 different types of upper extremity exercise training on upper extremity function, strength, endurance, and ambulation in patients ...with early‐stage Duchenne muscular dystrophy (DMD).
Methods
The study group (n = 12) exercised with an arm ergometer under the supervision of a physiotherapist, whereas the control group (n = 12) underwent a strengthening range‐of‐motion (ROM) exercise program under the supervision of their families at home for 8 weeks. Upper extremity functional performance, strength, endurance, and ambulatory status were assessed before and after the training.
Results
Ambulation scores, endurance, and arm functions, as well as proximal muscle strength, were improved after the training in the study group (P < 0.05).
Conclusions
These results demonstrate that upper extremity training with an arm ergometer is more effective in preserving and improving the functional level of early‐stage DMD patients compared to ROM exercises alone. Muscle Nerve 51:697–705, 2015
Abstract. Purpose The purpose of this study was to compare patients with low back and neck pain with respect to kinesiophobia, pain, and quality of life. Subjects and Methods Three-hundred patients ...with low back (mean age 43.2+-11 years) and 300 with neck pain (mean age 42.8+-10.2 years) were included in this study. Pain severity was evaluated by using the Short-Form McGill Pain Questionnaire, which includes a Visual Analogue Scale, quality of life by the Nottingham Health Profile, and kinesiophobia by the Tampa Scale for Kinesiophobia. Results Pain severity was similar in both groups, with a Visual Analogue Scale score of 6.7+-2 in the low back pain and 6.8+-2 in the neck pain group. Nottingham Health Profile pain z=-4.132 and physical activity scores z=-5.640 in the low back pain group were significantly higher. Kinesiophobia was also more severe in the low back pain group, with a mean 42.05+-5.91 versus 39.7+-6.0 Tampa Scale for Kinesiophobia score z=-4.732. Conclusion Patients with low back pain developed more severe kinesiophobia, regardless of the pain severity, and had greater pain perception and lower physical activity levels. Kinesiophobia adversely affects the quality of life and requires effective management of low back pain.
A sedentary lifestyle has negative effects on many aspects of life.
The aim of this study was to determine the effects of physical activity on sleep quality, job satisfaction, and quality of life in ...office workers.
A convenience sample of office workers from administrative staff of a university was included. There were two groups; Group I did regular physical activity for at least eight weeks, and Group II did no regular physical activity. Sleep quality, job satisfaction, and quality of life were assessed using the Pittsburgh Sleep Quality Index, the Minnesota Job Satisfaction Scale, and the World Health Organization Quality-of-Life-Scale (WHOQOL-BREF), respectively.
Group I included 59 individuals and Group II 50 individuals. No significant differences were found between groups in terms of age, height, weight, and the period of time worked (p > 0.05). Although no significant difference was found in terms of sleep quality (p = 0.52), the overall job satisfaction of Group I was higher than Group II (p = 0.03). All subscales of the WHOQOL-BREF for Group I was higher than Group II (p < 0.05).
Regular physical activity could increase job satisfaction and quality of life for office workers. Further studies investigating the effect of physical activity in terms of its type, duration should be performed.
To investigate validity and reliability of the Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10) in children with Duchenne Muscular Dystrophy (DMD), to compare the motor imagery (MI) ability ...with age-matched controls, and to examine the relationship between MI ability and cognitive status.
The research involved 38 children who were diagnosed with DMD, as well as 20 healthy controls aged between 7 and 18 years. The KVIQ-10 was assessed for its test-retest reliability, internal consistency, construct and concurrent validity. The Motor Imagery Questionnaire for Children (MIQ-C) was selected as the gold standard test for concurrent validity. Cognitive function was assessed using the Modified Mini Mental Test (MMMT) and Montreal Cognitive Assessment (MoCA).
KVIQ-10 showed excellent test-retest reliability (ICC>0.90) and high internal consistency (Cronbach's alpha>0.70). A moderate-to-strong association was found between KVIQ-10 and MIQ-C subscales (p < 0.001). KVIQ-10 and MIQ-C subscores were statistically lower in the DMD group (p ≤ 0.05). A correlation was found between MoCA and KVIQ-10 in children with DMD (p ≤ 0.05).
The KVIQ-10 is a reliable and valid measure to assess the MI ability of children with DMD whose imagery ability was determined to be impaired.
NCT05559710 (https://classic.clinicaltrials.gov/ct2/show/NCT05559710?term=NCT05559710&draw=2&rank=1)
•KVIQ-10 is valid and reliable tool for evaluating MI.•Individuals with DMD were found to have more impaired MI ability and cognitive function than healthy controls.•The MI ability is related to the cognitive status of children with DMD.•Researchers and clinicians are recommended to use the KVIQ-10 to assess MI ability prior to MI training in DMD.
