Objective:To determine the responsiveness of the domain climbing up and going down stairs of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD-D3) in a one-year follow-up study.Method:The study included 26 patients with DMD. Effect Size (ES) and Standardized Response Mean (SRM) described the scale’s responsiveness.Results:For climbing up stairs, ES showed that responsiveness was low in the three-month assessments (0.26; 0.35; 0.13; 0.17), low to moderate in the six-month assessments (0.58; 0.48; 0.33), moderate in the nine-month assessments (0.70; 0.68), and high in the 12-month assessment (0.88). SRM showed that responsiveness was low in the three-month assessments (0.29; 0.38; 0.18; and 0.19), low to moderate in the six-month assessments (0.59; 0.51; 0.36), moderate in the nine-month assessments (0.74 and 0.70), and high in the 12-month assessment (0.89). For going down stairs, ES showed that responsiveness was low in the three- and six-month assessments (0.16; 0.25; 0.09; 0.08 and 0.48; 0.35; 0.18, respectively), low to moderate in the nine-month assessments (0.59; 0.44), and moderate in the 12-month assessment (0.71). SRM showed that responsiveness was low in the three- and six-month assessments (0.25; 0.35; 0.12; 0.09 and 0.47; 0.38; 0.21, respectively), low to moderate in the nine-month assessment (0.62; 0.49), and moderate in the 12-month assessment (0.74).Conclusion:Climbing up stairs should be assessed at intervals of nine months or longer, when responsiveness is moderate to high. Going down stairs should be assessed annually because moderate responsiveness was observed in this period.
Objective: To evaluate effects of the isostretching exercise training on flexibility and muscle strength. Method: Thirty-one healthy subjects (27 women), aged between 18 and 28 years, divided into two groups: Group A, isostretching, which has undergone a program of exercises based on the isostretching technique, and Group B, standard, which was subjected to the same exercises using the general technical principles of traditional stretching. The training went on for 12 weeks, twice per week, one hour per session. Flexibility was evaluated through photogrammetry in pre- and post-test, evaluating the wrist-floor distance and classifying posture according to the categories of muscle shortening described by Kendall, while muscle strength was assessed using a handgrip dynamometer. Results: There was no statistically significant difference between the results for each group in the flexibility test. Analysis of clinical significance and improvement by the Reliable Change Index (RCI) showed an improvement in flexibility affecting 14 subjects from both groups. Analysis of body contour in group A showed attenuation in the curvatures of the cervical, thoracic, and lumbar spine, as well as the hip flexion angle, and group B showed attenuation in the curvature of the cervical spine and hip flexion angle. Group A showed statistically significant differences in some specific muscle groups, but with no clinical significance. Conclusion: Both interventions affected flexibility in a statistically similar way, but had a different impact on the curvatures of the spine. Isostretching training clinically changed the flexibility of healthy individuals, with evidence that more intense or longer workouts can affect muscle strength
Background: With the progressive increase of muscle weakness in patients with DMD, new compensatory movements are employed to maintain the performance of functional activities. Objective: To describe the evolution of compensatory movements observed in sitting and rising from a chair in children with DMD. Compare and correlate the evolution of timed performance of these activities and the number of compensatory movements in one year. To analyze the responsiveness of timed performance in six-month and one year intervals. Method: Twenty-three ambulatory children with DMD, aged 5 to 12 years, were followed during one year. Sitting and rising from a chair were evaluated in three moments (initial assessment, after six and after twelve months) with the Functional Assessment Scale for DMD, domain 1 (FES-DMD-D1). Analyses of variance (ANOVA) compared the timed performances and numbers of compensatory movements (scores on the phases and subphases of FES-DMD-D1). Post hoc Tukey tests were used when a significant main effect was identified and the Spearman test was used to correlate these variables. Responsiveness of the timed performance was described by the effect size (ES) and the standardized response mean (SRM). Results: The progression of sitting and rising from a chair in one year resulted in a significant increase in FES-DMD-D1 scores and timed performance. Only rising from a chair showed moderate to strong correlation with timed performance. Timed performance was responsive in six months and one year reassessments. Conclusion: There was a progressive increase in the number of compensatory movements and timed performance of sitting and rising from a chair. Only rising from a chair showed correlation between compensatory movements and timed performance. For a more accurate assessment of DMD progression, we suggest monitoring the timed performance of rising from a chair and, whenever possible, scoring the compensatory movements.
BACKGROUND: The progressive weakness of Duchenne muscular dystrophy (DMD) interferes with performance. This study investigated the sensitivity to change and the responsiveness of sitting and standing from the ground in patients with DMD. AIM: The aim was to assess the sensitivity to change and the responsiveness of lowering to/ rising from the ground, in three, six, nine, and twelve month-evaluation intervals and to define the most suitable reevaluation intervals for ambulatory patients with DMD. METHOD: This is an observational, longitudinal study. Recordings of 28 patients performing lowering to/ rising from the ground were analyzed. Sensitivity to change was assessed using effect sizes and standardized response means. Responsiveness was assessed using minimal detectable changes (MDC) and minimal clinically important differences (MCID). RESULTS: In the lowering to the ground, significant sensitivity to change was found in higher than 6 months reassessment intervals. In the rising from the ground, significant sensitivity to change was observed in higher than 9 reassessment intervals. MDC and MCID varied from 1.0 to 1.6 points and from 0.5 to 2.5 seconds when lowering to the ground and from 1.3 to 2.6 points and from 5.0 to 28.0 seconds when rising from the ground. CONCLUSION: Patients should be reassessed after nine months from the lowering to and rising from the ground. Increments of 2.0 points and/or 2.5 seconds (or higher) in the score of lowering to the ground assessment denote clinically relevant changes. Increments of 3 points (or higher) in rising from the ground assessment are clinically relevant.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.