Abstract

In this case study a 9-year old ambulatory symptomatic girl with Duchenne muscular dystrophy participated in a dynamic training. Since the role of exercise is far from clear in both boys and girls with DMD, a recently developed assisted bicycle training was evaluated for its feasibility and effectiveness in this girl. The girl trained at home, 15 min with her arms followed by her legs, 5 times a week, for 24 weeks. The primary outcomes were the Motor Function Measure, and the Assisted Six-Minute Cycling Test. Secondary outcomes were the Vignos and Brooke scale for lower and upper extremity functioning, timed tests (time to rise from a floor, to rise from a chair, to climb 3 stairs and to walk 10 m), the Medical Research Scale scale for muscle strength, and quantitative muscle ultrasound to determine the echo intensity of the biceps brachii muscle, the forearm flexors, the rectus femoris muscle and the tibialis anterior muscle. This case study showed that the assisted bicycle training was feasible and safe. Additionally, we found that no physical deterioration occurred during the training period: she remained stable on the Motor Function Measure and the Assisted Six-Minute Cycling Test. Slight improvements in quantitative muscle ultrasound intensity were found, indicating less fatty infiltration in the muscles. Since there are several indications from this case study that physical training could be beneficial in this population, we recommend further research on the effects of dynamic training in girls with DMD and its relation to the level of dystrophin.

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