Combination of steroids and ischial weight-bearing knee ankle foot orthoses in Duchenne’s muscular dystrophy prolongs ambulation past 20 years of age – A case report

• Published in: Neuromuscular disorders : NMD Vol. 21; no. 11; pp. 800 - 802
• Main Authors: Pardo, Andrea C, Do, Twee, Ryder, Ted, Meyer, Amy, Miles, Lili, Wong, Brenda L
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.11.2011
• Subjects: Ambulation; Duchenne’s muscular dystrophy (DMD); Foot - innervation; Humans; Ischial weight-bearing knee ankle foot orthoses; Ischium - physiology; Long-term steroid treatment; Male; Muscular Dystrophy, Duchenne - physiopathology; Muscular Dystrophy, Duchenne - therapy; Neurology; Orthotic Devices; Steroids - therapeutic use; Walking; Weight-Bearing - physiology; Young Adult; Duchenne’s muscular dystrophy (DMD); Ischial weight-bearing knee ankle foot orthoses; Ambulation; Long-term steroid treatment
• ISSN: 0960-8966; 1873-2364
• DOI: 10.1016/j.nmd.2011.06.006

Abstract Patients with Duchenne muscular dystrophy (DMD) lose ambulation by age 12. Long-term steroids have lengthened ambulation by 2–5 years. Ischial weight-bearing knee ankle foot orthoses prolong ambulation for 2–3 years. We report the outcome of the ambulatory status of a patient with DMD treated with daily steroid therapy and orthoses. This male patient was diagnosed with DMD at age of 2. He has been treated with daily steroids since age 7 years. He lost the ability to arise from the floor and walk up steps at age 14 and lost ambulation by age 16. He was fitted with orthoses at age 16 following surgical correction of his lower extremity contractures and regained independent ambulation. At age 20, he was able to stand independently in his orthoses and take steps with moderate support. We conclude that a combination of daily steroids and orthoses prolongs ambulation beyond that of the natural history DMD.