PTOTPilotPediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association2016

Supported Standing in Boys With Duchenne Muscular Dystrophy.

Elise L Townsend, Christine Bibeau, Tara M Holmes

PMID 27008581

WHAT IT FOUND

Supported standing was safe for four boys with Duchenne muscular dystrophy.

It improved hip and knee flexibility in some, but did not increase bone density. Adherence was difficult, and boys with severe ankle contractures could not tolerate upright standing.

Key findings

01The standing program was safe, with no injuries or adverse events reported.

02Hip and knee flexor muscle length improved in some participants, but ankle plantar flexor length did not improve in any.

03Bone mineral density did not increase in any participant, and decreased significantly in three of the four boys.

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 study included only four boys, making it impossible to draw general conclusions about efficacy. The boys were heterogeneous in their functional status; one lost the ability to walk during the study, which confounded the results. Standing time was self-reported, which may be inaccurate. Adherence was low, so the study did not test the effect of the full prescribed dose of standing. The design did not include a control group, so natural disease progression cannot be separated from the intervention's effect.

Declared interests

The authors declared no conflicts of interest. The study was supported by the NIH and non-U.S. government sources.

The easy way to misread this

Do not assume that supported standing prevents bone loss in Duchenne muscular dystrophy. In this small pilot, no participant showed increased bone density, and three showed significant decreases. The intervention's primary benefit observed here was safety and potential flexibility gains, not skeletal protection.

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