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Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy

Duchenne muscular dystrophy (DMD) is one of the most common forms of hereditary muscular dystrophies in childhood and is characterized by steady progression and early disability. It is known that physical therapy can slow down the rate of progression of the disease. According to global recommendatio...

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Autores principales: Suslov, V. M., Lieberman, L. N., Carlier, P. G., Ponomarenko, G. N., Ivanov, D. O., Rudenko, D. I., Suslova, G. A., Adulas, E. I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410449/
https://www.ncbi.nlm.nih.gov/pubmed/37564736
http://dx.doi.org/10.3389/fneur.2023.1230770
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author Suslov, V. M.
Lieberman, L. N.
Carlier, P. G.
Ponomarenko, G. N.
Ivanov, D. O.
Rudenko, D. I.
Suslova, G. A.
Adulas, E. I.
author_facet Suslov, V. M.
Lieberman, L. N.
Carlier, P. G.
Ponomarenko, G. N.
Ivanov, D. O.
Rudenko, D. I.
Suslova, G. A.
Adulas, E. I.
author_sort Suslov, V. M.
collection PubMed
description Duchenne muscular dystrophy (DMD) is one of the most common forms of hereditary muscular dystrophies in childhood and is characterized by steady progression and early disability. It is known that physical therapy can slow down the rate of progression of the disease. According to global recommendations, pool exercises, along with stretching, are preferable for children with DMD, as these types of activities have a balanced effect on skeletal muscles and allow simultaneous breathing exercises. The present study aimed to evaluate the effectiveness of regular pool exercises in patients with Duchenne muscular dystrophy who are capable of independent movement during 4 months of training. 28 patients with genetically confirmed Duchenne muscular dystrophy, who were aged 6.9 ± 0.2 years, were examined. A 6-min distance walking test and timed tests, namely, rising from the floor, 10-meter running, and stair climbing and descending, muscle strength of the upper and lower extremities were assessed on the baseline and during dynamic observation at 2 and 4 months. Hydrorehabilitation course lasted 4 months and was divided into two stages: preparatory and training (depend on individual functional heart reserve (IFHR)). Set of exercises included pool dynamic aerobic exercises. Quantitative muscle MRI of the pelvic girdle and thigh was performed six times: before training (further BT) and after training (further AT) during all course. According to the results of the study, a statistically significant improvement was identified in a 6-min walking test, with 462.7 ± 6.2 m on the baseline and 492.0 ± 6.4 m after 4 months (p < 0.001). The results from the timed functional tests were as follows: rising from the floor test, 4.5 ± 0.3 s on the baseline and 3.8 ± 0.2 s after 4 months (p < 0.001); 10 meter distance running test, 4.9 ± 0.1 s on the baseline and 4.3 ± 0.1 s after 4 months (p < 0.001); 4-stair climbing test, 3.7 ± 0.2 s on the baseline and 3.2 ± 0.2 s after 4 months (p < 0.001); and 4-stair descent test, 3.9 ± 0.1 s on the baseline and 3.2 ± 0.1 s after 4 months (p < 0.001). Skeletal muscle quantitative MRI was performed in the pelvis and the thighs in order to assess the impact of the procedures on the muscle structure. Muscle water T2, a biomarker of disease activity, did not show any change during the training period, suggesting the absence of deleterious effects and negative impact on disease activity. Thus, a set of dynamic aerobic exercises in water can be regarded as effective and safe for patients with DMD.
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spelling pubmed-104104492023-08-10 Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy Suslov, V. M. Lieberman, L. N. Carlier, P. G. Ponomarenko, G. N. Ivanov, D. O. Rudenko, D. I. Suslova, G. A. Adulas, E. I. Front Neurol Neurology Duchenne muscular dystrophy (DMD) is one of the most common forms of hereditary muscular dystrophies in childhood and is characterized by steady progression and early disability. It is known that physical therapy can slow down the rate of progression of the disease. According to global recommendations, pool exercises, along with stretching, are preferable for children with DMD, as these types of activities have a balanced effect on skeletal muscles and allow simultaneous breathing exercises. The present study aimed to evaluate the effectiveness of regular pool exercises in patients with Duchenne muscular dystrophy who are capable of independent movement during 4 months of training. 28 patients with genetically confirmed Duchenne muscular dystrophy, who were aged 6.9 ± 0.2 years, were examined. A 6-min distance walking test and timed tests, namely, rising from the floor, 10-meter running, and stair climbing and descending, muscle strength of the upper and lower extremities were assessed on the baseline and during dynamic observation at 2 and 4 months. Hydrorehabilitation course lasted 4 months and was divided into two stages: preparatory and training (depend on individual functional heart reserve (IFHR)). Set of exercises included pool dynamic aerobic exercises. Quantitative muscle MRI of the pelvic girdle and thigh was performed six times: before training (further BT) and after training (further AT) during all course. According to the results of the study, a statistically significant improvement was identified in a 6-min walking test, with 462.7 ± 6.2 m on the baseline and 492.0 ± 6.4 m after 4 months (p < 0.001). The results from the timed functional tests were as follows: rising from the floor test, 4.5 ± 0.3 s on the baseline and 3.8 ± 0.2 s after 4 months (p < 0.001); 10 meter distance running test, 4.9 ± 0.1 s on the baseline and 4.3 ± 0.1 s after 4 months (p < 0.001); 4-stair climbing test, 3.7 ± 0.2 s on the baseline and 3.2 ± 0.2 s after 4 months (p < 0.001); and 4-stair descent test, 3.9 ± 0.1 s on the baseline and 3.2 ± 0.1 s after 4 months (p < 0.001). Skeletal muscle quantitative MRI was performed in the pelvis and the thighs in order to assess the impact of the procedures on the muscle structure. Muscle water T2, a biomarker of disease activity, did not show any change during the training period, suggesting the absence of deleterious effects and negative impact on disease activity. Thus, a set of dynamic aerobic exercises in water can be regarded as effective and safe for patients with DMD. Frontiers Media S.A. 2023-07-26 /pmc/articles/PMC10410449/ /pubmed/37564736 http://dx.doi.org/10.3389/fneur.2023.1230770 Text en Copyright © 2023 Suslov, Lieberman, Carlier, Ponomarenko, Ivanov, Rudenko, Suslova and Adulas. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Suslov, V. M.
Lieberman, L. N.
Carlier, P. G.
Ponomarenko, G. N.
Ivanov, D. O.
Rudenko, D. I.
Suslova, G. A.
Adulas, E. I.
Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
title Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
title_full Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
title_fullStr Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
title_full_unstemmed Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
title_short Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
title_sort efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410449/
https://www.ncbi.nlm.nih.gov/pubmed/37564736
http://dx.doi.org/10.3389/fneur.2023.1230770
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