Treatment Options For Muscular Dystrophy

August 19, 2023

Muscular dystrophy is the term for a group of diseases that progressively increase an individual's weakness and decrease their muscle mass. There are several different types of muscular dystrophy, and the symptoms, treatment, and outlook will vary depending on the type involved. Muscular dystrophy is caused by gene mutations that impede the proteins necessary for healthy muscle development.

The most common type of muscular dystrophy shows symptoms early in childhood, but there are adult-onset types as well. The unifying symptom of muscular dystrophy is muscle weakness that progresses. The age of onset, severity, and muscles affected all vary depending on the type of dystrophy. While muscular dystrophy doesn't have a cure, there are treatment options to slow the disease's progression and help with symptom management.

Certain Medications And Corticosteroids

Certain medications and corticosteroids, such as prednisone, can help patients manage symptoms of muscular dystrophy, and some might also slow the disease's progression. Corticosteroids are manufactured drugs that mimic the hormone cortisol, which is released by the adrenal gland and is an important part of multiple physical processes including bone formation, blood pressure regulation, inflammation, and metabolism. Corticosteroids can help increase or maintain muscle strength, delaying disease progression for some kinds of muscular dystrophy. They are generally not recommended for long term use, as this can lead to weakened bones and weight gain.

If the muscular dystrophy causes heart damage, beta-blockers or ACE inhibitors may help promote heart health. For Duchenne muscular dystrophy patients, the most common type, eteplirsen is the first medicine specifically FDA-approved for their condition. While this medicine isn't a cure, and it's new enough to need further data to establish effectiveness, it is possible it can increase muscle strength. It works by targeting the gene variants that are found in one out of every seven patients with Duchenne muscular dystrophy.

Use Of Walkers And Wheelchairs

The use of walkers and wheelchairs can help with muscular dystrophy. The type of mobility aid that works best for a patient will vary depending on their symptoms. Some individuals use multiple different mobility aids. Even when the disease affects the legs, many patients can walk to some degree for years. An affected individual might use a walker or a cane when they're walking short distances, but they may switch to a wheelchair for longer ones.

Many muscular dystrophy patients who use a wheelchair can walk or stand in some capacity, though this does not negate the need for a wheelchair. Mobility devices won't necessarily slow the disease's progression, and they may not reduce the presence of symptoms. But using mobility aids allows muscular dystrophy patients to maintain a greater level of independence. Mobility aids have a direct and significant impact on a patient's quality of life and general satisfaction with life.

Physical Therapy

Many muscular dystrophy patients can benefit from physical therapy. As with other treatments, the exercises, frequency of therapy, and targeted muscles will vary depending on the progression of the disease. As the muscles become progressively weaker and more atrophied, the mobility of an individual's joints can be affected. Joints move because they are attached to tendons, muscles, and ligaments. The muscle weakness can make an affected individual too weak to move their joints. Some patients have limbs that become drawn inward and paralyzed.

One of the most common types of physical therapy is range-of-motion exercises, which help improve joint mobility and keep the joints flexible. Spending too long without moving a joint can increase its likelihood of paralysis. A physical therapist can also help with painful contractures that occur as a result of the disease. If the muscular dystrophy patient needs to use mobility aids, a physical therapist or occupational therapist will often be the one to teach them how to use them. Physical therapists will generally work alongside the patient's other healthcare providers to make sure everyone is on the same page regarding treatment.

Wearing Braces

One thing that might help patients with muscular dystrophy is wearing braces. Braces are a type of assistive device, but they're different from typical mobility aids. Unlike other mobility aids, braces confer health benefits including a slowed progression of the disease. The goal of the braces is to keep the tendons and muscles flexible and stretched, rather than letting them curl inward and lose their range of movement.

At the same time, the braces support the muscles that have become weakened, which can improve muscle function and overall mobility. When wearing braces, an individual may find they're able to walk or stand for longer than they could unassisted. The braces might be paired with a cane or walker. Many different kinds of braces can help with different kinds of muscular dystrophy. Some are worn during the day, while others are worn while the patient sleeps, and some braces can even be worn around the clock. In addition to leg braces, arm braces are also available.

Regular Low-Impact Exercise

Exercise is almost always necessary to good physical health, the exception being when medical conditions cause exercise intolerance. In muscular dystrophy patients, exercise is imperative to maintaining muscle mass and function, though it's important to do the right kinds of exercise. High-impact exercises like running and jumping jacks can be exhausting and damaging to the body. Thus, many health professionals recommend regular low-impact exercise for patients with muscular dystrophy.

Swimming and walking cause little stress to the joints, but they can help keep muscles strong and mobile. Certain muscle strengthening exercises may also be helpful. Patients, however, should talk to their doctor before making any changes to their exercise routine. The wrong type of exercise can cause more damage than if the individual in question never exercised at all. If a certain exercise feels extremely painful or wrong, it's best to stop it and talk to a doctor.

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