The relevance of trunk evaluation in Duchenne muscular dystrophy: the segmental assessment of trunk control

Sá, Cristina dos Santos Cardoso de; Fagundes, Iara Kristine; Araújo, Talita Bastos; Oliveira, Acary Souza Bullé; Fávero, Francis Meire

doi:10.1590/0004-282x20160124

Cited by 23 publications

(26 citation statements)

References 13 publications

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“…The percentage of trunk muscle capacity used when sitting upright was already two times higher in patients with Brooke scale 1 compared to HC and this normalized activity level is even higher when performing tasks. This indicates early trunk muscle weakness in relation to motor function, which contrasts with previous studies indicating that trunk function is good in the ambulatory phase [5, 6]. When a higher percentage of the maximum muscle capacity is used, this leads to faster development of fatigue and possibly to overloading of the muscles [20].…”

Section: Discussionmentioning

confidence: 66%

“…Trunk weakness seems to occur in later disease stages. Trunk function seems relatively good and stable in the ambulatory phase, but starts to decrease when boys become non-ambulant [5, 6]. However, both measures used (Segmental Assessment of Trunk Control [5] and Motor Function Measure [6]) are influenced by upper extremity function too and therefore might not completely represent trunk function alone.…”

Section: Introductionmentioning

confidence: 99%

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Don’t forget the trunk in Duchenne muscular dystrophy patients: more muscle weakness and compensation than expected

Peeters¹,

Kingma

Dieën

et al. 2019

J NeuroEngineering Rehabil

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Background Performing daily activities independently becomes more difficult in time for patients with Duchenne muscular dystrophy (DMD) due to muscle weakness. When performing seated daily activities, the trunk plays an indispensable role besides the upper extremities. However, knowledge is lacking on the interaction between trunk and upper extremities. Therefore the aim was to investigate whether patients with DMD use trunk movement to compensate for reduced arm function when performing seated tasks, and whether this is related to increased muscle activity. Methods Eighteen boys with DMD and twenty-five healthy controls (HC) performed several tasks when sitting unsupported, like reaching (and placing) forward and sideward, drinking and displacing a dinner plate. Maximum joint torque and maximum surface electromyography (sEMG) were measured during maximum voluntary isometric contractions. Three-dimensional movements and normalized sEMG when performing tasks were analyzed. Results Significantly decreased maximum joint torque was found in DMD patients compared to HC. Trunk and shoulder torques were already decreased in early disease stages. However, only maximum trunk rotation and shoulder abduction torque showed a significant association with Brooke scale. In all reaching and daily tasks, the range of motion in lateral bending and/or flexion-extension was significantly larger in DMD patients compared to HC. The trunk movements did not significantly increase with task difficulty (e.g. increasing object weight) or Brooke scale. Normalized muscle activity was significantly higher in DMD patients for all tasks and muscles. Conclusions Boys with DMD use increased trunk movements to compensate for reduced arm function, even when performing relatively simple tasks. This was combined with significantly increased normalized muscle activity. Clinicians should take the trunk into account when assessing function and for intervention development, because DMD patients may appear to have a good trunk function, but percentage of muscle capacity used to perform tasks is increased. Electronic supplementary material The online version of this article (10.1186/s12984-019-0515-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Don’t forget the trunk in Duchenne muscular dystrophy patients: more muscle weakness and compensation than expected

Peeters¹,

Kingma

Dieën

et al. 2019

J NeuroEngineering Rehabil

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“…Alguns estudos sugerem que o uso da fisioterapia para retardar a perda da função motora e atrasar as complicações cardiorrespiratórias tem aumentado o tempo de sobrevivência em pelo menos dez anos. 24 A hidroterapia é mais um recurso dentro do programa de reabilitação, pois os exercícios são de baixo impacto e a água oferece suporte e apoio durante a marcha, 25 mas sabemos que é importante compreender as alterações funcionais observadas em pacientes com DMD durante o seu desenvolvimento, pois nos direciona no momento de formular a intervenção terapêutica para essa população que apresenta característica clínica variável dependendo do estágio da doença. 26,27 Diversos aspectos devem ser considerados durante a marcha subaquática para a recuperação funcional, como nível de imersão, que é fator determinante acerca das forças que agem durante a marcha, e a posição dos membros superiores que podem causar alterações nos valores das forças atuantes na água.…”

Section: Discussionunclassified

Análise do gasto energético em crianças Hígidas e com Distrofia Muscular de Duchenne nos ambientes aquático e terrestre.

Silva

Cecconi²,

Hengles³

et al. 2017

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Introdução: A Distrofia Muscular de Duchenne é uma doença progressiva, que leva a um progressivo comprometimento funcional. Metodologia: para avaliação do Índice de Gasto Energético dos pacientes com Distrofia Muscular de Duchenne e indivíduos hígidos foi aplicado o Teste de Caminhada de 6 Minutos no solo e na água. Participaram do estudo 28 crianças do sexo masculino, sendo 20 do grupo controle e 8 crianças com Distrofia Muscular de Duchenne. Resultados: no solo o grupo controle andou uma distância maior comparado ao grupo com Duchenne (p = 0,001). Os grupos apresentaram a média muito próxima da distância percorrida na água, grupo controle (128,3±17,9) e grupo com Duchenne (126,1±9,1). Sendo assim, não houve diferença significativa na distância percorrida entre os dois grupos na água (p=0,837). Na análise intragrupos, houve diferença significante entre os ambientes (p=0,001), tanto para distância quanto para o índice de gasto energético para ambos os grupos. Discussão: notamos que a distância na água é sempre menor do que no solo. Já o índice de gasto energético ocorre o inverso, ou seja, os valores na água são sempre maiores do que no solo (p=0,001). Conclusão: A marcha na água e solo diferem, pois na água a distância percorrida é menor e o índice de gasto energético é maior em ambos os grupos. Os pacientes com Duchenne no solo percorreram uma distância menor, e na água apresentaram um Índice de Gasto Energético maior.

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“…This muscle weakness is evident, as the child finds it difficult to run, get off the floor, go up and down the stairs, and frequent falls, 1 , 2 progressing to trunk, and upper (UL) and lower limb (LL) musculature. 1 , 2 , 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Responsiveness of Upper Limb Scales and Trunk Control for the Evolution of Patients With Duchenne Muscular Dystrophy

Maciel

Santos

Sá

2021

Rev. paul. pediatr.

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Objective: To verify the interval of responsiveness to the scales Segmental Assessment of Trunk Control (SATCo-BR), Performance of Upper Limbs (PUL), and Jebsen Taylor Test (JTT) in patients with Duchenne Muscular Dystrophy (DMD). Methods: We assessed patients with DMD aged 6 to 19 years old and with mini-mental (MMSE) score above 10 points. The assessments were performed individually, in a single session. The upper limb function was performed by PUL and JTT, and trunk control by SATCo-BR. Assessments were repeated six and 12 months after the initial assessment. The repeated-measures analysis of variance model and Bonferroni’s multiple comparison method were employed as post hoc analysis; when the ANOVA assumptions were not met, the Friedman test was applied. Results: The sample consisted of 28 patients evaluated in three moments (initial, and six and 12 months after the beginning). There was a time effect for the Upper Limb function performance in the total JTT, and for the subtests, except for subtests 1 and 6, which did not show a difference between the different moments. There was also a time effect for the score of total PUL, proximal PUL, intermediate PUL, and distal PUL. In the SATCo-BR, this effect was observed between the initial and 6 months, and between the initial and 12 months. Conclusions: The JTT, PUL, and SATCo-BR scales can detect changes over time, and they showed responsiveness to detect the evolution of the disease in the 6-month interval.

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The relevance of trunk evaluation in Duchenne muscular dystrophy: the segmental assessment of trunk control

Cited by 23 publications

References 13 publications

Don’t forget the trunk in Duchenne muscular dystrophy patients: more muscle weakness and compensation than expected

Don’t forget the trunk in Duchenne muscular dystrophy patients: more muscle weakness and compensation than expected

Análise do gasto energético em crianças Hígidas e com Distrofia Muscular de Duchenne nos ambientes aquático e terrestre.

Responsiveness of Upper Limb Scales and Trunk Control for the Evolution of Patients With Duchenne Muscular Dystrophy

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