Proprioception and Children with Duchenne Muscular Dystrophy

Child Development and Neurology published research on 40 makes with Duchenne muscular dystrophy (DMD) to examine tactile perception and manual dexterity, with or without visual feedback.

The participants were assessed for tactile perception using two-point discrimination and stereognosis tests, and manual dexterity using the Pick-Up test with the eyes either open or closed.

The results indicated the following:
1. males with DMD exhibited no impairment in tactile perception, as measured by the two-point discrimination test and the number of objects correctly named in the stereognosis test.

2. manipulation during stereognosis was statistically slower with both hands

3. manual dexterity was much worse in males with DMD when there was no visual feedback

The researchers concluded that males with DMD exhibited difficulties with manipulation during stereognosis and dexterity tests. Hand control was highly dependent on visual information rather than on tactile perception.

The researchers hypothesize that motor dysfunction in males with DMD, therefore, might be related to altered neural control.

Reference: Troise, D et al. The influence of visual and tactile perception on hand control in children with Duchenne muscular dystrophy. Developmental Medicine & Child Neurology
Volume 56, Issue 9, pages 882–887, September 2014

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Serial Casting and Duchenne Muscular Dystrophy

Pediatric Physical Therapy published a medical records review following serial casting in 9 boys with Duchenne Muscular Dystrophy and ankle contractures. The results indicated improvements in range of motion (12 degrees on the right, 11.6 degrees on left with knee extended and 7.8 degrees on right and 8.7 degrees on the left with knee flexed). In addition, the boys were assessed on a timed 10 meter run, ability to climb four stairs and transfers from floor to standing. These scores were unchanged following the serial casting. The researchers concluded that serial casting increases range of motion in the ankle with no loss of function or speed in boys with Duchenne Muscular Dystrophy.

Reference: Glanzman, Allan M. et al. Serial Casting for the Management of Ankle Contracture in Duchenne Muscular Dystrophy. Pediatric Physical Therapy:
Fall 2011 - Volume 23 - Issue 3 - p 275–279 doi: 10.1097/PEP.0b013e318227c4e3

Gait Assessment and Duchenne Muscular Dystrophy

Journal of Child Neurology published research on the gait assessments of children with Duchenne Muscular Dystrophy with long distance walking. Overall, the children with Duchenne muscular dystrophy exhibited significantly lower stride velocity and a less smooth trunk movement. When comparing the children with milder symptoms of Duchenne's to children with more moderate symptoms, the milder symptom group showed significantly higher values for cadence and stride velocity. Trunk smoothness was also better in the mild group versus the moderate group.

Reference: Raluca Ganea, MSc et al. Gait Assessment in Children With Duchenne Muscular Dystrophy During Long-Distance Walking. Published online before print July 15, 2011, doi: 10.1177/0883073811413581 J Child Neurol July 15, 2011 0883073811413581