Muscular Dystrophy and Rehabilitation Interventions with Regenerative Treatment

Abstract

This paper reviews the enhanced therapeutic effects of rehabilitation and regenerative medicine toward Duchenne muscular dystrophy. Duchenne muscular dystrophy (DMD) is one of the most severe forms of muscle disorders. Muscle in DMD patients is extremely fragile and can be damaged even during normal daily activity. There is little in the way of treatment for the disease and no cure. Some investigators have been developing cell therapies for DMD by generating muscle stem cells from human-induced pluripotent stem (iPS) cells and other progenitor/stem cells. Although reports have shown dystrophin protein restoration following cell transplantation in DMD models, improvement in motor function has not been achieved, and optimal methods that maximize the efficacy of the transplantation are still needed. Recently, some studies have reported that exercise with controlled load (treadmill running, voluntary running on a running wheel, swimming, etc.) improves the pathology of DMD. Thus, exercise is expected to enhance the effect of cell therapy for DMD, acting as a form of “regenerative rehabilitation.” Consistently, optimized muscle contraction training programs enhance the effect of cell transplantation therapy. Cell transplantation therapy in combination with rehabilitation, which focuses on exercise therapy, may provide an effective radical treatment for DMD patients. This combination is described as regenerative rehabilitation.