Secondary Logo

Institutional members access full text with Ovid®

Progression of Ankle Plantarflexion Contractures and Functional Decline in Duchenne Muscular Dystrophy

Implications for Physical Therapy Management

Kiefer, Michael, PT, DPT; Bonarrigo, Kelly, PT, DPT; Quatman-Yates, Catherine, PT, DPT, PhD; Fowler, Amanda, PT, DPT, PCS; Horn, Paul S., PhD; Wong, Brenda L., MD

doi: 10.1097/PEP.0000000000000553
RESEARCH REPORTS
Buy
SDC

Purpose: This study characterizes the progressive loss of ankle dorsiflexion range of motion in boys with Duchenne muscular dystrophy (DMD), the relationship to functional decline, and the implications for physical therapy management.

Methods: Longitudinal data for 332 boys with DMD were extracted from medical records and analyzed. Summary statistics for age, number of visits, ankle dorsiflexion measures, and North Star Ambulatory Assessment (NSAA) scores were computed.

Results: Ankle dorsiflexion motion ranged from −32.5 to 25 degrees. Progression of ankle contractures is demonstrated by a trend line: slope −1.43 per year. NSAA score was estimated to decline approximately 0.23 points per 1 degree of ankle dorsiflexion lost.

Conclusions: The results of this study describe the progression of ankle contractures and functional decline in DMD. The findings may help inform decisions regarding interventions to support participants with DMD and their families.

This study characterizes the progressive loss of ankle dorsiflexion range of motion in boys with Duchenne muscular dystrophy, the relationship to functional decline, and the implications for physical therapy management.

Department of Pediatrics (Drs Kiefer and Wong), University of Massachusetts Medical School, Worcester, Massachusetts; Division of Occupational Therapy and Physical Therapy (Drs Kiefer, Bonarrigo, Quatman-Yates, and Fowler) and Division of Neurology (Drs Kiefer, Bonarrigo, Fowler, Horn, and Wong), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (Dr Horn), University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Physical Therapy (Dr Quatman-Yates), The Ohio State University, Columbus, Ohio.

Correspondence: Michael Kiefer, PT, DPT, University of Massachusetts Medical School, Department of Pediatrics, 55 North Lake Avenue, Worcester, MA 01655 (Michael.Kiefer@umassmed.edu).

The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association