Muscular dystrophy

Muscular dystrophy is a disease of the muscular sys­tem characterized by weakness and atrophy of the muscles of the body. Weakness often afflicts the mus­cles that enable breathing and results in major com­plications including congestive heart failure and pneumonia.

The etiology of muscular dystrophy is not known. Speculation regarding the exact cause includes faulty metabolism (related to inability to utilize vitamin E), endocrine disorders, and deficiencies in the periph­eral nerves. There is some indication that an inher­ited abnormality causes the body's chemistry to be unable to carry on proper muscle metabolism.

The physical characteristics of persons with muscular dystrophy are relevant to the degenerative stage as well as type of muscular dystrophy. In the late stages of' the disease connective tissue replaces most of the muscle tissue. In some cases deposits of fat give the appearance of well-developed muscles. Despite the muscle atrophy, there is no apparent central nervous system impairment.

The age of onset of muscular dystrophy is of im­portance to the total development of the children. Persons who contract the disease after having had an opportunity to secure an education, or part of an ed­ucation, and develop social and psychological strengths are better able to cope with their environ­ments than are those who are afflicted with the dis­ease prior to the acquisition of basic skills.

Although the characteristics of patients with mus­cular dystrophy vary according to the stage that the disease has reached, some general characteristics are as follows:

1. There is a tendency to tire quickly.

2. There may be a tendency to lose fine manual dexterity.

3. Intelligence is normal, but there is a lack of motivation to learn because of isolation from social contacts and limited educational oppor­tunities.

4. Progressive weakness tends to produce adverse postural changes.

5. Emotional disturbance may be prevalent be­cause of the progressive nature of the illness and the resulting restrictions placed on oppor­tunities for socialization.

Muscular dystrophy is probably the most serious dis­abling condition that can occur in childhood. Al­though not fatal in itself, the disease contributes to premature death in most known cases because of its progressive nature.

Medical Treatment. Nothing currently known will arrest muscular dystro­phy once it begins. The negativism prevalent in some cases as a result of the inability of children with mus­cular dystrophy to serve a social purpose has been a serious deterrent to expansion of educational plans for these patients. However, it is worth noting that scientific research may be close to solving unan­swered questions regarding the disease, and eventu­ally the progressive deterioration of muscles may be halted.

Progressive weakness and muscle deterioration make the child with muscular dystrophy particularly sus­ceptible to respiratory infections. Therefore, the physical educator and therapist should be particularly alert not to expose these children to damp environ­ments or to situations mat are conducive to respiratory infections

Therapeutic Treatment. Inactivity seems to contribute to the progressive weakening of the muscles of persons with muscular dystrophy. Exercise of muscles involved in the activi­ties of daily living to increase strength may permit greater functional use of the body. Furthermore, ex­ercise may assist in reducing excessive weight, which is a burden to those who have muscular dystrophy. The diet should be closely monitored. Control of ex­cess weight is essential to the success of the rehabilitation program of persons with progressive muscu­lar dystrophy. For individuals whose strength is marginal, any extra weight throws an added burden on ambulation and on activities for daily living.

A great deal can be done to prevent deformities and loss of muscle strength from inactivity. If a spe­cific program is outlined during each stage of the dis­ease, it is possible that the child may extend the abil­ity to care for most daily needs for many additional years. In addition to the administration of specific de­velopmental exercises for the involved muscles exercises should include development of walking pat­terns posture control, muscle coordination and stretching of contractures involved in disuse atrophy.

One must recognize that all the types of muscular dystrophy cannot be considered the same; therefore, the physical and social benefits that children can de­rive from physical education and recreation pro­grams are different. Children who have milder forms of muscular dystrophy, which progress slowly, can derive many benefits from well-constructed adapted physical education and therapeutic programs and should be allowed to play as long as they can

Дата добавления: 2015-11-16