Effects of a balance exercise programme in myotonic dystrophy type 1: A pilot study

Abstract

This pilot study aimed to evaluate the effects of balance exercises in adults with classical myotonic dystrophy type 1 (DM1) directly after intervention and at follow-up after 12 weeks. Eleven outpatients (median age 49 years, range 36–60 years) with balance difficulties participating in a 10 week intervention were assessed before, after and at follow-up. The primary outcome measure was balance confidence, measured with the Activities-specific Balance Confidence (ABC) scale. Secondary outcome measures were the Step Test, Timed Up and Go test, Timed 10 m Walk at maximum pace, isometric muscle force in legs and number of falls. The most important findings directly after the intervention were that nine of the 11 patients scored higher on the ABC scale (p = 0.02), and that the number of steps in the Step Test increased in nine of 10 participants. The increased number of steps remained increased at follow-up, but the increased confidence was not maintained for all patients. Timed Up and Go was unchanged but the time to walk 10 m increased. The knee extensor force and number of falls did not show any statistically significant changes. Unexpectedly, all patients deteriorated in the ankle dorsiflexor force (mean –17%) after intervention. The study showed that self-assessed balance confidence is likely to increase following an individualized balance exercise programme in outpatients with DM1.