Quantification of muscle strength and motor ability in patients with Duchenne muscular dystrophy on steroid therapy

Parreira, Samara Lamounier Santana; Resende, Maria Bernadete Dutra de; Peduto, Marília Della Corte; Marie, Suely Kazue Nagahashi; Carvalho, Mary S.; Reed, Umbertina Conti

doi:10.1590/s0004-282x2007000200011

Cited by 18 publications

(12 citation statements)

References 22 publications

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“…Our aim was to demonstrate the advantages for the use of MFM as a tool for monitoring the functional outcome of patients with DMD on steroid therapy; the purpose was not to evaluate the beneficial effects of medication on disease progression, which have been well recognized during the last two decades 2,[15][16][17][18][19][20] . In previous studies, several methods have been used to assess and monitor motor function in patients on steroid therapy 3,9,11,12 , and the search for the ideal instrument remains an objective in several centers for neuromuscular diseases 9,21 . The MFM has been applied successfully in some studies of treated DMD patients 13,14,22 .…”

Section: Discussionmentioning

confidence: 99%

“…Its treatment remains palliative and relies mainly on steroids and physiotherapy, both in order to slow the loss of motor function [2][3][4] . Several tests have been reported in the literature to assess muscle strength and functional ability, to monitor the progression of the disease, and to evaluate the results of drug interventions and rehabilitation [4][5][6][7][8][9][10][11][12] . However, most instruments involve ambulant patients, making adjustments and/or additional assessments necessary when the disease progresses 8,9 .…”

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confidence: 99%

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Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy

Silva

Machado

Resende

et al. 2012

Arq. Neuro-Psiquiatr.

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OBJECTIVE: To assess the evolution of motor function in patients with Duchenne muscular dystrophy (DMD) treated with steroids (prednisolone or deflazacort) through the Motor Function Measure (MFM), which evaluates three dimensions of motor performance (D1, D2, D3). METHODS: Thirty-three patients with DMD (22 ambulant, 6 non-ambulant and 5 who lost the capacity to walk during the period of the study) were assessed using the MFM scale six times over a period of 18 months. RESULTS: All the motor functions remained stable for 14 months in all patients, except D1 for those who lost their walking ability. In ambulant patients, D2 (axial and proximal motor capacities) motor functions improved during six months; an improvement in D3 (distal motor capacity) was noted during the total follow-up. D1 (standing posture and transfers) and total score were useful to predict the loss of the ability to walk. CONCLUSIONS: The use of the MFM in DMD patients confirms the benefits of the steroid treatment for slowing the progression of the disease.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy

Silva

Machado

Resende

et al. 2012

Arq. Neuro-Psiquiatr.

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“…Due to the inherent characteristics of DMD, we can consider that the classification adopted for improvement or maintenance of the data obtained indicates positive responses, since any worsening does not necessarily mean a negative effect, if this is slower than the one described in the natural evolution of the disease. 9 According to the literature, a progressive decline in pulmonary function almost always begins after the restriction to a wheelchair, with the association of increasing respiratory insufficiency and the inefficiency of the cough.…”

Section: Discussionmentioning

confidence: 99%

The impact of aquatic therapy on the agility of a non-ambulatory patient with Duchenne muscular dystrophy

et al. 2012

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Duchenne Muscular Dystrophy (DMD) is a progressive disease. The inability to walk is common in early adolescence, and with the restriction to a wheelchair at this stage of the disease, the wheelchair becomes the patient's only form of locomotion. Their agility in the wheelchair is a key factor for the functional independence of these individuals. Objective: The objective of this study was to verify the impact of aquatic therapy on non-ambulatory children with DMD. Method: This study has a prospective, interventional, clinical character. The patient underwent ten sessions of aquatic therapy as an intervention, using the following assessment tools: EgenKlassifikation scale, zigzag agility test, oxygen saturation (SatO 2 ), respiratory rate (RR), forced vital capacity (FVC), tidal volume (TV), minute volume (MV), peak cough flow (PCF), and maximal inspiratory (PImax) and maximal expiratory (PEmax) pressures. The intervention protocol of aquatic therapy was defined focusing on the agility in maneuvering the wheelchair. Results: Improvement in agility was observed in moving wheelchair, maintenance of the EK scale score, and a decrease in TV, MV, and PCF. Conclusion: The results showed that for this patient, aquatic therapy may intervene positively in his mobile agility in the wheelchair.

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“…Anti-inflammatory corticosteroids have been widely used as an attempt to reduce the disease progress; however, their side effects are severe (Muntoni et al, 2002, Parreira et al, 2007, Radley et al, 2007, Manzur et al, 2004. Alternative pharmacological strategies such as the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have become an option, since these drugs cause less severe side effects.…”

Section: Discussionmentioning

confidence: 99%

Effect of Citrus aurantium L. Essential Oil on Muscle Regeneration in Mdx Mice

Souza¹,

Marques

Hiruma-Lima³

et al. 2011

Int. J. Morphol.

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SUMMARY:Duchenne muscular dystrophy (DMD) is a severe X-linked recessive disorder characterized by the progressive loss of muscular strength. Mdx mutant mice show a marked deficiency in dystrophin, which was related to muscle membrane stability. The aim of this study was to verify the possible protective anti-inflammatory effect of citrus oil on mdx muscle fibers. Thus, adult male and female mdx mice (014/06-CEEA) were divided into control and citrus-treated. After 60 days of treatment, one ml of blood was collected for creatine kinase (CK) test. Diaphragm, sternomastoideus, anterior tibial and gastrocnemius muscles were removed and processed according to histological routine methods. The observed alterations indicate a direct effect of citrus. Recent studies have improved the diagnosis of muscular diseases but with no definitions of efficient treatments. Intervention with several therapies is important to many patients presenting muscular dystrophy, which enables them to live longer and be more active, while there is no development of gene therapies.

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Quantification of muscle strength and motor ability in patients with Duchenne muscular dystrophy on steroid therapy

Abstract: We conclude that a swift and objective assessment may be performed using the MRC scale for lower limbs and trunk, the Hammersmith motor ability score, timed nine-meter walk and weight lifts.

Cited by 18 publications

References 22 publications

Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy

Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy

The impact of aquatic therapy on the agility of a non-ambulatory patient with Duchenne muscular dystrophy

Effect of Citrus aurantium L. Essential Oil on Muscle Regeneration in Mdx Mice

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