Bracing for Ambulation in Childhood Progressive Muscular Dystrophy

Abstract

1. Fifteen of seventeen patients with childhood muscular dystrophy who had ceased walking because of muscle weakness were able to walk independently again after correction of contractures and fitting of long lower-extremity braces. 2. The criterion for bracing is recent loss of the ability to walk independently or the ability to walk only with assistance in a patient who stands less than half an hour a day. 3. Contrary to previous opinion, there is enough residual muscle power for walking in braces when muscle weakness prevents independent walking. 4. When braces are needed to continue walking, the patient with muscular dystrophy has lost 60 per cent of his muscle mass. 5. It is usually necessary to correct heel-cord and iliotibial-band contractures surgically before application of braces. 6. The additional energy requirements for walking with braces have not caused any significant cardiovascular complications as far as can be determined through clinical observation aided by serial electrocardiograms and cardiac roentgenograms.