Physiotherapists, also called “physical therapists”, are an essential part of your healthcare team if you’re living with muscular dystrophy (MD).

Make sure your physiotherapist specialises in MD and has experience in your type of dystrophy as strenuous exercise may damage already weakened muscles even further. Aim to start with a physiotherapy programme as soon as possible after you’ve been diagnosed and before joint or muscle contractures occur.

Reduce the costs of physiotherapy by asking your doctor to give you a prescription for physiotherapy.

Remember to also check with your health insurance about the limits for physiotherapy appointments and treatments.

How does physiotherapy help?

We all know that regular exercise maintains good overall health. When you have MD, physiotherapy and regular moderate exercise can help maximise range of motion, delay contractures, increase mobility and maintain muscle strength and flexibility.

If you have MD, a physiotherapy exercise programme will focus on:

• Slowing progression of the complications
• Improving your quality of life
• Prolonging independence
• Ensuring your ability to function safely at a high level for as long as possible

Role of the physiotherapist

A physiotherapist specialises in programmes that involve gross motor movement, i.e. activities that use your major muscle groups (examples include walking, getting in and out of bed, and standing up from a chair).

He/she will teach you exercises and techniques to prevent, treat and rehabilitate areas of the body affected by MD through every stage of the illness.

After an initial consultation – which may include various assessments – your physiotherapist will develop an appropriate exercise programme based on your needs, capabilities and specific type of dystrophy. If necessary, the PT may also recommend other adaptive devices and assistive mobility equipment such as walkers, wheelchairs and leg braces.

What a physiotherapy programme may include

Since exercise can increase blood pressure and cause shortness of breath, you should always first consult a cardiologist to do tests on your heart and breathing functions before you start a physiotherapy exercise programme.

Your physiotherapy programme may include any or all of the following components:
• Passive stretching
• Postural correction
• Breathing exercises
• Strengthening exercises
• Manual therapy treatment (e.g. massage, manipulations and heat to reduce pain and stiffness)

The physiotherapy will probably start you off on supervised exercises for several weeks or months before giving you an exercise routine to do at home, if appropriate.

Passive stretching: Stretching exercises can help to prevent contractures and increase flexibility in your joints. For example, motion exercises involve the physiotherapy gently taking each joint and moving it through its range of normal positions to help reduce premature shortening of muscle tendons. Passive stretching isn’t painful when done correctly.

Caution: If you’re doing these exercises unsupervised, make sure you know how to do them correctly as using the wrong technique may do more harm than good.

Postural correction focuses on offsetting contractures, muscle weakness and spinal problems that hamper people living with MD. Your physiotherapist will show you how to sit upright with your feet at a 90-degree angle to the floor. Aids such as foam wedges and pillows may be recommended to help you sit upright, straighten your legs and distribute your weight evenly. The physiotherapy will also make sure that chair armrests are at the proper height to provide support and prevent you from leaning.

Strengthening other muscles to compensate for weakness in affected muscles may be beneficial, especially in the earlier stages of milder MD. These exercises are designed to keep your body as strong and upright as possible.

Breathing exercises are useful if you have a weakened diaphragm. Your physiotherapist will teach you coughing and deep breathing exercises to keep your lungs fully expanded.

Sources:
1. http://muscle.ca/living-with-muscular-dystrophy
2. http://www.ninds.nih.gov/disorders/md/detail_md.htmPHYSIOTHERAPIST
3. www.physiotherapy.ca
4. mda.org/publications

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