Don't forget the trunk in Duchenne muscular dystrophy patients: more muscle weakness and compensation than expected.
L H C Peeters, I Kingma, J H van Dieën and 1 others
PMID 30917845WHAT IT FOUND
Boys with Duchenne muscular dystrophy lean their trunk heavily to move their arms, using nearly all their back muscle strength just to sit.
This compensatory trunk movement is essential for daily tasks and should not be restricted by seating or therapy.
Key findings
01Trunk muscle activity is already doubled in DMD patients compared to healthy controls during simple upright sitting.
02DMD patients use significantly more trunk range of motion than healthy controls during all reaching and daily tasks.
03Restricting compensatory trunk movements could prevent patients from accomplishing tasks independently.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small, particularly when subcategorizing by Brooke scale, which reduced statistical power. The control group was not matched for gender, although no significant differences were found between boys and girls in the control group. Maximum muscle activity estimates were based on seated contractions, which may not reflect true maximum capacity, potentially overestimating the percentage of muscle used. Only patients with relatively good arm function could perform the more difficult tasks, introducing a selection bias in the heavier weight conditions.
Declared interests
The study was funded by the Netherlands Organization for Scientific Research (Stichting voor de Technische Wetenschappen). No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not conclude that compensatory trunk movements increase significantly more with task difficulty in DMD patients than in healthy controls. The study found no significant difference in the change of trunk movement between groups as weight increased, likely due to low statistical power and the inability of weaker patients to complete the tasks.