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Cao M, Katz SL, Hansen-Flaschen J. Roadmap for Advancing a New Subspecialty in Pulmonary Medicine Devoted to Chronic Respiratory Failure. Ann Am Thorac Soc 2024; 21:692-695. [PMID: 38445980 DOI: 10.1513/annalsats.202309-810ip] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 03/05/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Michelle Cao
- Pulmonary, Allergy, and Critical Care Division, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Sherri Lynne Katz
- Division of Respirology, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; and
| | - John Hansen-Flaschen
- Pulmonary, Allergy, and Critical Care Division, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Türken A, Çapar H, Kurt ME, Çakmak C. The challenges faced by patients with hereditary myopathy during the COVID-19 pandemic. Int J Palliat Nurs 2024; 30:12-19. [PMID: 38308604 DOI: 10.12968/ijpn.2024.30.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
BACKGROUND Neuromuscular diseases are inherited and the prevalance of neuromuscular disease is estimated to be around 1:2000. METHODS This cross-sectional research was conducted with a qualitative research model. Data were collected from patients with an online survey using the snowball sampling method. The study was conducted in accordance with the STROBE checklist methodology. Frequencies and percentages were used to analyse demographic data, and content analysis was used for qualitative opinions. RESULTS Most of the participants were men and their education levels were low. Participants reported experiencing physical and socio-economic barriers to accessing healthcare. Participants also stated that these barriers have worsened since COVID-19. CONCLUSIONS Patients with hereditary myopathy are stigmatised by society and face different problems depending on the type of disease and level of function. It is recommended that decision-makers enable patients with hereditary myopathy in exceptional situations to access healthcare services and take steps to resolve their problems.
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Affiliation(s)
- Askeri Türken
- Doctor, Gazi Yaşargil Training and Research Hospital, Department of Physical Medicine and Rehabilitation
| | - Haşim Çapar
- Assistant Professor, Dicle University, Turkey
| | | | - Cuma Çakmak
- Ph.D, Dicle University, Department of Health Management, Turkey
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Lombardo ME, Carraro E, Sancricca C, Armando M, Catteruccia M, Mazzone E, Ricci G, Salamino F, Santorelli FM, Filosto M. Management of motor rehabilitation in individuals with muscular dystrophies. 1 st Consensus Conference report from UILDM - Italian Muscular Dystrophy Association (Rome, January 25-26, 2019). ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2021; 40:72-87. [PMID: 34355124 PMCID: PMC8290512 DOI: 10.36185/2532-1900-046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/09/2021] [Indexed: 11/03/2022]
Abstract
Muscular dystrophy (MD) is a group of neuromuscular diseases characterized by progressive muscle weakness due to various mutations in several genes involved in muscle structure and function. The age at onset, evolution and severity of the different forms of MD can vary and there is often impairment of motor function and activities of daily living. Although there have been important scientific advances with regard to pharmacological therapies for many forms of MD, rehabilitation management remains central to ensuring the patient's psychophysical well-being. Here we report the results of an Italian consensus conference promoted by UILDM (Unione Italiana Lotta alla Distrofia Muscolare, the Italian Muscular Dystrophy Association) in order to establish general indications and agreed protocols for motor rehabilitation of the different forms of MD.
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Affiliation(s)
| | - Elena Carraro
- Neuromuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy
| | - Cristina Sancricca
- Centro di Riabilitazione UILDM Lazio ONLUS, Rome, Italy
- UOC Neurofisiopatologia, Dipartimento Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michela Armando
- Department of Rehabilitation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Michela Catteruccia
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Elena Mazzone
- Physioterapist and international trainer for therapeutic trials, Rome, Italy
| | - Giulia Ricci
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
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Filiz MB, Toraman NF, Kutluk MG, Filiz S, Doğan ŞK, Çakır T, Yaman A. Effects of lumbar lordosis increment on gait deteriorations in ambulant boys with Duchenne Muscular Dystrophy: A cross-sectional study. Braz J Phys Ther 2021; 25:749-755. [PMID: 34119442 DOI: 10.1016/j.bjpt.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/24/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Increment of lumbar lordosis, a frequent spinal finding in Duchenne Muscular Dystrophy (DMD), is a compensatory mechanism secondary to muscle weakness. However, excessive lumbar lordosis may change the position of the center of mass, and lead to balance and walking difficulties. OBJECTIVE To study the relationship between factors that may influence ambulatory function in boys with DMD and to investigate the effects of lumbar lordosis increment on gait and balance perturbations. METHODS Twenty-one ambulant patients with DMD and 10 healthy boys were included. Lumbar lordosis and thoracic kyphosis angles, dynamic and static balance tests, ambulatory function, muscle strength, and disease severity were assessed. Usage of steroids and orthotic devices were recorded. Scoliosis was assessed on radiographs. Receiver operator characteristic curves were formed and area under curve (AUC) measurements were performed to assess the ability of the tests to discriminate ambulatory status and optimal cut-off values were established according to the Youden index. RESULTS The amount of lumbar lordosis correlated strongly and negatively with quality of ambulation (r = -0.710) and moderately with performance on balance tests. The strength of both upper limbs and lower limbs muscles were not associated with any of the variables. According to the AUC analysis, patients with a lumbar lordosis higher than 36° had worse scores on gait and dynamic balance tests. CONCLUSION Ambulation and dynamic balance are negatively affected by the increment of lumbar lordosis with a cut-off point of 36°in boys with DMD.
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Affiliation(s)
- Meral Bilgilisoy Filiz
- Antalya Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Health Sciences University, Antalya, Turkey; Antalya Training and Research Hospital, Neuromuscular Disease Center, Health Sciences University, Antalya, Turkey.
| | - Naciye Füsun Toraman
- Antalya Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Health Sciences University, Antalya, Turkey; Antalya Training and Research Hospital, Neuromuscular Disease Center, Health Sciences University, Antalya, Turkey
| | - Muhammet Gültekin Kutluk
- Antalya Training and Research Hospital, Department of Pediatric Neurology, Health Sciences University, Antalya, Turkey; Antalya Training and Research Hospital, Neuromuscular Disease Center, Health Sciences University, Antalya, Turkey
| | - Serkan Filiz
- Antalya Training and Research Hospital, Department of Pediatric Allergy and Immunology, Health Sciences University, Antalya, Turkey; Antalya Training and Research Hospital, Neuromuscular Disease Center, Health Sciences University, Antalya, Turkey
| | - Şebnem Koldaş Doğan
- Antalya Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Health Sciences University, Antalya, Turkey
| | - Tuncay Çakır
- Department of Physical Medicine and Rehabilitation, Private ASV Life Hospital, Antalya, Turkey
| | - Aylin Yaman
- Antalya Training and Research Hospital, Department of Neurology, Health Sciences University, Antalya, Turkey; Antalya Training and Research Hospital, Neuromuscular Disease Center, Health Sciences University, Antalya, Turkey
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Buckner JL, Bowden SA, Mahan JD. Optimizing Bone Health in Duchenne Muscular Dystrophy. Int J Endocrinol 2015; 2015:928385. [PMID: 26124831 PMCID: PMC4466394 DOI: 10.1155/2015/928385] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 01/30/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serious sequelae adversely affect quality of life and can impact survival. The current clinical issues relating to bone health and bone health screening methods in DMD are presented in this review. Diagnostic studies, including biochemical markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry (DXA), as well as spinal imaging using densitometric lateral spinal imaging, and treatment to optimize bone health in patients with DMD are discussed. Treatment with bisphosphonates offers a method to increase bone mass in these children; oral and intravenous bisphosphonates have been used successfully although treatment is typically reserved for children with fractures and/or bone pain with low bone mass by DXA.
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Affiliation(s)
- Jason L. Buckner
- Division of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH 43205, USA
- *Jason L. Buckner:
| | - Sasigarn A. Bowden
- Division of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH 43205, USA
| | - John D. Mahan
- Division of Nephrology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH 43205, USA
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McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, Glanzman AM, Spiegel R, Barth J, Elfring G, Reha A, Peltz SW. The 6-minute walk test and other clinical endpoints in duchenne muscular dystrophy: reliability, concurrent validity, and minimal clinically important differences from a multicenter study. Muscle Nerve 2013; 48:357-68. [PMID: 23674289 PMCID: PMC3826053 DOI: 10.1002/mus.23905] [Citation(s) in RCA: 214] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2013] [Indexed: 11/10/2022]
Abstract
INTRODUCTION An international clinical trial enrolled 174 ambulatory males ≥5 years old with nonsense mutation Duchenne muscular dystrophy (nmDMD). Pretreatment data provide insight into reliability, concurrent validity, and minimal clinically important differences (MCIDs) of the 6-minute walk test (6MWT) and other endpoints. METHODS Screening and baseline evaluations included the 6-minute walk distance (6MWD), timed function tests (TFTs), quantitative strength by myometry, the PedsQL, heart rate-determined energy expenditure index, and other exploratory endpoints. RESULTS The 6MWT proved feasible and reliable in a multicenter context. Concurrent validity with other endpoints was excellent. The MCID for 6MWD was 28.5 and 31.7 meters based on 2 statistical distribution methods. CONCLUSIONS The ratio of MCID to baseline mean is lower for 6MWD than for other endpoints. The 6MWD is an optimal primary endpoint for Duchenne muscular dystrophy (DMD) clinical trials that are focused therapeutically on preservation of ambulation and slowing of disease progression.
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Affiliation(s)
- Craig M McDonald
- Department of Physical Medicine and Rehabilitation, Neuromuscular Medicine and Rehabilitation Research Center, University of California Davis School of Medicine, Davis, California, 95817, USA
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Henricson E, Abresch R, Han JJ, Nicorici A, Goude Keller E, de Bie E, McDonald CM. The 6-Minute Walk Test and Person-Reported Outcomes in Boys with Duchenne Muscular Dystrophy and Typically Developing Controls: Longitudinal Comparisons and Clinically-Meaningful Changes Over One Year. PLOS CURRENTS 2013; 5. [PMID: 23867975 PMCID: PMC3712467 DOI: 10.1371/currents.md.9e17658b007eb79fcd6f723089f79e06] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Data is currently lacking anchoring a 30-meter longitudinal change in walking ability by 6-minute walk test (6MWT) in Duchenne muscular dystrophy as a minimal clinically important difference and “clinically meaningful” person-reported outcomes (PROs) at differing levels of ambulatory ability.
Methods: We describe correlation between measures, 1-year change in measures, and correlation of 1-year changes between measures for the six-minute walk test (6MWT), 10-meter run/walk velocity, PedsQL and POSNA Pediatric Outcomes Data Collection Instrument (PODCI) in 24 4-12 year old. ambulatory DMD and 36 typical controls, and determine if minimal clinically important differences (MCID) of PROs contribute to different estimates of 6-minute walk distance (6MWD) change at differing levels of ability.
Results: PedsQL total and physical function and PODCI global, transfer/mobility and sports/physical function PROs demonstrated significant differences between DMD and controls (p<0.00001). In DMD, 6MWD and 10-meter run/walk velocity were correlated with PODCI domain scores, with the transfer/mobility scale showing the strongest relationship (r=0.79 and r=0.76). In DMD, 6MWD distance and 10-meter run/walk velocity weakly correlated with PedsQL domain scores. In DMD, 6MWD, 10-meter run/walk velocity, and PODCI global and transfer and basic mobility demonstrated significant one-year change and exceeded the amount of change representing MCID. In DMD, 6MWD change highly correlated with change in PODCI global and PODCI transfer/mobility scores (r=0.76 and r=0.93). PODCI global and PODCI transfer/mobility scales provided the best estimates of 6MWT performance. A “meaningful” 4.5 point change in a low PODCI transfer / basic mobility score of 30 to 34.5 was associated with a 5.6m 6MWD change from 150.3 to 155.9m. At PODCI levels closer to normative levels for healthy controls, the change in 6MWD distance associated with a “meaningful” change in PODCI scores was almost 46m.
Discussion: At lower levels of function, smaller increases in 6MWD result in meaningful change in quality of life (QoL) instrument scores. At higher levels of function, larger increases may be necessary to achieve the same QoL change score.
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Affiliation(s)
- Erik Henricson
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
| | - Richard Abresch
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
| | - Jay J Han
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
| | - Alina Nicorici
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
| | - Erica Goude Keller
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
| | - Evan de Bie
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
| | - Craig M McDonald
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
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