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Duchenne Muscular Dystrophy - Essay Example

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An essay "Duchenne Muscular Dystrophy" reports that his legs weakened and had to push his knees in order to stand. His calves began to swell later with fibrous tissue, which felt firm and rubbery, rather than muscle. He then began walking with adding gait due to the weakened legs…
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Duchenne Muscular Dystrophy
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Download file to see previous pages At the age of six, he had already developed contractures with the calf muscles being the most severely affected (Larsen & Lubkin, 2013). By the age of nine climbing stairs and rising unaided was impossible, and at ten years, he was confined to a wheelchair. He has weakening trunk muscles which can easily cause scoliosis. His diaphragm muscles are also weakened which makes breathing and coughing difficult, and increases chances of lung infection. Complications such as sleep-disordered breathing; ineffective cough and nocturnal hypoventilation are being experienced. The patient also has difficulties learning through listening and attention span is low (American Thoracic Society, 2010). DMD symptom management The focus of this study is the symptom management of neuromuscular and skeletal muscles. In a review article by a team of 84 practitioners representing the specialists who provide care to DMD patients selected by Centre for Disease Control (CDC), they independently rated the interventions and assessments that are used in DMD management (DMD Care Considerations Working Group, 2009). From this assessment, CDC expert panelists came up with management interventions for the neuro and skeletal muscles for a DMD patient at the stage in which this patient is. The first intervention for muscle strength and function is pharmacological intervention to address the progression of muscle degeneration in a DMD patient. The treatment that the review focuses on is the use of the glucocorticoids to optimize strength and function of these muscles. Glucocorticoids slow the collapsing of muscle strength, as well as its function, thereby reducing the risk of scoliosis and stabilize pulmonary function. The initial RCTs of patients on 0.75 mg/kg daily dose of prednisone for six months showed improvement in muscle strength. Prednisolone and deflazacort are other glucocorticoids that were shown to be effective on a daily dose instead of alternate days. These medications were shown also to prolong ambulation and in patients that have become non- ambulatory showed reduced risks of progressive scoliosis and stabilization of pulmonary function. There is no agreed time to start the glucocorticoids therapy since this is based on serial assessments, as well as parental report in the disease’s three phases. However, for a patient who has lost ambulation such as this one, the CDC experts review points the therapy can be introduced or continued in order to preserve upper limb strength, reduce progression of scoliosis and slow down a loss of respiratory and cardiac function. The review concludes that other supplements could be used to manage the neuro and skeletal muscles weaknesses such as coenzyme Q10, carnitine, and antioxidants such as fish oils, vitamin E, green tea extracts and amino acids. In another review article by the CDC expert panel on the implementation of multidisciplinary care in the management of DMD, the expert panel of the CDC project addresses skeletal and respiratory management (DMD Care Considerations Working Group, 2009). In spinal management, the earlier management with the use of glucocorticoid treatment is retaliated to curb progression of scoliosis and a small chance of developing vertebral compression fractures caused by osteoporosis. ...Download file to see next pagesRead More
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