[The efficacy and safety of kinesytherapy in Becker muscular dystrophy].

Abstract

Becker muscular dystrophy (BMD) is inherited X-linked neuromuscular disease characterized by progressive fatigue, atrophy, hypotonia and muscle weakness, that is predominantly located in muscles of pelvic girdle, femurs and lower leg. There are only singular studies at present showing the efficacy of different training programs for patients with muscular dystrophy, and there are no recommendations allowing to detect the optimal motor regimen, that is effective and safe for such patients.

Objective: To evaluate the efficacy of regular dynamic aerobic exercises in children with BMD, who are able to self-sustained movement.

Material and methods: The number of patients equal 13 with genetically confirmed BMD at the age from 8.9 to 15.9 years were examined. All patients took the course of exercise therapy for 4 months. The course was divided into 2 stages: the preparative (51-60% of the individual functional reserve of the heart (IFRH) with 6-8 repetitions of every exercise) and the training (61-70% of the IFRH with 10-12 repetitions of every exercise). The training duration was 60 min. The motor capabilities of patients were assessed by the 6-minute walk test, timed up & go test, MFM scale (sections D1, D2, D3) at the initial stage and during dynamic observation after 2 and 4 months.

Results: Statistically significant positive dynamics of indicators was revealed. The average distance in the 6-minute walk test at the initial stage was 526.9±12.7 m, after 4 months was 545.2±13.0 m (p<0.05). The average uplift time at the initial stage was 3.9±0.2 s, after 2 months was 3.5±0.2 s (p<0.05). The average running time for the distance of 10 m initially was 4.3±0.1 s, after 2 months was 3.8±0.1 s (p<0.05), after 4 months was 3.8±0.1 s (p<0.05). There was some positive dynamics in the evaluation of uplift and movement capabilities (D1) by the MFM scale: initially the indicator was 87.7±1.5%, after 2 months - 93.4±1.4% (p<0.001), after 4 months - 94.5±1.3% (p<0.001). Clinically significant adverse effects were not registered during the training courses.

Conclusion: Aerobic trainings without weight combined with exercises on a cycle machine for 4 months allow to improve movement capabilities and are not characterized by clinically significant adverse effects in children with BMD.