Bone health management

Bone health is important in both the ambulatory and non-ambulatory phases of DMD. Boys with DMD at all ages have weak bones, especially if they are taking steroids. They have a lower bone mineral density and are at increased risk of fractures (broken bones) compared to the general population.

Underlying factors for poor bone health are

  • Decreased mobility
  • Muscle weakness
  • Steroid therapy

Possible interventions

  • Vitamin D – needed if there is a real deficiency, supplement should be considered in children.
  • Calcium – intake is best in the diet, but supplementation should be considered if diet is not adequate with advice from a dietician.
  • Bisphosphonates – IV bisphosphates recommended for vertebral fractures.

Information based on consensus statement (published in January 2010)