S.P.44 Evaluation of a balance exercise programme in DM 1: A single-subject experimental study with 11 participants

Abstract

The aim of this study was to evaluate the effects of an individualised balance exercise programme in patients with myotonic dystrophy type 1 (DM1). A single-subject experimental design was used: baseline, intervention and second baseline (ABA) with repeated assessments. Eleven DM1 patients with subjective or objective balance difficulties (outpatients) participated in a balance exercise programme with individualised exercises at the hospital-based physiotherapy department. The balance exercise programme was attended during 10 weeks (two sessions/week). Primary outcome measure was self-assessed balance confidence in three self-chosen activities, in which the balance was a problem. Secondary outcome measures were the Activities-specific Balance Confidence (ABC) scale, dynamic balance performance assessed with Step test and Timed Up and Go, together with Timed 10 m walk at maximum pace, isometric muscle force in leg muscles and number of falls. The most important findings were: 7/11 patients experienced a significant increase in balance confidence (>+2SD) in at least one self-selected activity, 9/11 scored a higher overall balance confidence in ABC scale (mean +13%, p = 0.014), and increased balance performance in Step test (mean +18%, p = 0.008). All patients deteriorated in the ankle dorsiflexor force (mean −17%, p = 0.003). The knee extensor force remained unchanged. The study showed that self-assessed balance confidence, as well as balance performance measured with Step test, is likely to increase following an individualised balance exercise programme in persons with DM1. It is important to note that distal muscles in DM1 patients are at risk of exhaustion during exercise, these patients therefore require close supervision when participating in these training sessions.