PTCase ReportJournal of physical therapy science2016

Usefulness of continuous actigraph monitoring in the assessment of the effect of corticosteroid treatment for Duchenne muscular dystrophy: a case report.

Hitomi Nishizawa, Naoko Shiba, Akinori Nakamura

PMID 27942159

WHAT IT FOUND

In a child with Duchenne muscular dystrophy, home actigraph data rose after corticosteroids began, matching his clinic walk tests.

This case report shows a possible monitoring pattern, not proof the drug or device works.

Key findings

01Actigraph mean energy expenditure rose from 1,108.7 kcal/day to 1,246.0 kcal/day (p=0.024), and mean steps rose from 10,081.8 steps/day to 12,205.0 steps/day (p=0.033) after corticosteroid administration.

02Conventional tests also changed: the 10-meter run went from 4.4 to 3.7 seconds, the conventional 6-minute walk went from 366 to 372 meters, the metronome-paced 6-minute walk went from 375 to 393 meters, and the North Star Ambulatory Assessment went from 22/34 to 29/34.

03The actigraph recorded data for 14 days before and 14 days after corticosteroid administration, while conventional tests were done at hospital visits once a month.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

This is a case report, so the findings cannot show that corticosteroids caused the changes or that actigraphy works for other patients. The actigraph data cover only short periods before and after administration, so they do not show what happens over months. The conventional tests were done at hospital visits and were infrequent and discontinuous. The authors say future studies need many subjects and longer evaluation before the actigraph can be used as a primary outcome tool.

Declared interests

The supplied text does not report funding sources or conflict of interest declarations.

The easy way to misread this

Do not read the rise in steps, energy expenditure, walk distance, or NSAA score as proof that corticosteroids caused improvement. This is a case report, and the authors say larger studies over a longer period are needed.

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