Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy

Frontiers in Neurology

Neurology

D. O. Ivanov¹  D. I. Rudenko¹  L. N. Lieberman¹  V. M. Suslov¹  E. I. Adulas¹  G. A. Suslova¹  G. N. Ponomarenko²  P. G. Carlier³ 

[1] Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia;Federal State Budgetary Institution Federal Scientific Center of the Rehabilitation of the Disabled Named After G. A.Albrecht of the Ministry of Labour and Social Protection of the Russian Federation, Saint Petersburg, Russia;University Paris-Saclay, CEA, Frédéric Joliot Institute for Life Sciences, SHFJ, Orsay, France;

关键词: Duchenne muscular dystrophy;    rehabilitation;    physical therapy;    hydrokinesis therapy;    muscle MRI;   

DOI  :  10.3389/fneur.2023.1230770

 received in 2023-05-29, accepted in 2023-07-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

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Copyright © 2023 Suslov, Lieberman, Carlier, Ponomarenko, Ivanov, Rudenko, Suslova and Adulas.