People with DMD need access to different types of rehabilitation management throughout their lives. Much of this will be delivered by physiotherapists and occupational therapists, but other people may also need to help, including rehabilitation specialists, orthotists, providers of wheelchairs and other seating. Orthopaedic surgeons may also be involved.
Management of muscle extensibility and joint contractures is a key part of rehabilitation management.
The goal of stretching is to preserve function and maintain comfort. The program of stretching will be monitored by the physiotherapist but needs to become part of the family’s daily routine.
There are many factors in DMD that contribute to the tendency for joints to get tight or “contracted”. These include the muscle becoming less elastic due to limited use and positioning or because the muscles around a joint are out of balance (one stronger than another). Maintaining good range of movement and symmetry at different joints is important. This helps to maintain the best possible function, prevent the development of fixed deformities, and prevent pressure problems with the skin.
Information based on consensus statement (published in January 2010)