Factors Affecting Loss of Ambulatory Ability in Patients with Duchenne Muscular Dystrophy

Abstract

The purpose of this study was to investigate several factors related to loss of ambulatory ability in Duchenne muscular dystrophy (DMD) patients. Fourteen patients were divided into two groups according to the age at the time of losing ambulatory ability; young group: <10 years old (n=7), old group: ≧10 years old (n=7). We measured muscle strength, range of motion (ROM), height, weight and body mass index (BMI) before and after losing ambulatory ability for each patient. The interval of these paired tests was within 1 year (mean 9.2 months, range 4 to 12 months).
All 5 items were better in young group than those in old group before getting non-ambulatory. The mean ROM was worse in young group than in old group after getting non-ambulatory. Change in ROM was greater than the other 4 items in 6 out of 7 patients in young group, while all 5 items declined equally in old group. Furthermore, the difference in ROM between right and left lower extremity became significantly greater after getting non-ambulatory than before getting non-ambulatory in young group, but not in old group. These results indicate that loss of ambulatory ability was related to the decline and asymmetry of ROM in young group, and to the decline of multiple factors in old group. These facts imply the importance of ROM exercise, especially in the younger age of the patients with DMD to keep their ambulatory ability.