The Association between the Respiratory System and Upper Limb Strength in Males with Duchenne Muscular Dystrophy: A New Field for Intervention?

Agnieszka Sobierajska-Rek, Eliza Wasilewska (), Karolina Śledzińska, Joanna Jabłońska-Brudło, Sylwia Małgorzewicz, Andrzej Wasilewski and Dominika Szalewska
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Agnieszka Sobierajska-Rek: Department of Rehabilitation Medicine, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-219 Gdańsk, Poland
Eliza Wasilewska: Department of Pulmonology and Allergology, Faculty of Medicine, Medical University of Gdansk, 80-211 Gdańsk, Poland
Karolina Śledzińska: Department of Internal and Pediatric Nursing, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdańsk, Poland
Joanna Jabłońska-Brudło: Department of Rehabilitation Medicine, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-219 Gdańsk, Poland
Sylwia Małgorzewicz: Department of Clinical Nutrition, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-416 Gdańsk, Poland
Andrzej Wasilewski: Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
Dominika Szalewska: Department of Rehabilitation Medicine, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-219 Gdańsk, Poland

IJERPH, 2022, vol. 19, issue 23, 1-12

Abstract: Progressive, irreversible muscle weakness is the leading symptom of Duchenne muscular dystrophy (DMD), often resulting in death from respiratory muscle failure. Little is known about the relationship between the functioning of the respiratory system and the hand grip—a function which remains long preserved. This study aimed to investigate the interdependence between muscle strength and the function of both hand grip and the respiratory system in patients with DMD. Materials and Method: The study included cohort patients, aged 6–17, with DMD, recruited from the Rare Disease Centre, Gdansk, Poland. Clinical status (Vignos scale, Brook scale), pulmonary function (respiratory muscle strength—MIP, MEP); spirometry (FEV1; FVC), as well as upper limb function (performance of the upper limb—PUL 2.0) and hand grip strength (HGS) (hand-held dynamometer) were evaluated in all participants. Results: Finally, 53 boys (mean age 11.41 ± 3.70 years, 25 non-ambulant) were included. Each of the participants presented a lower %pv of MIP (48.11 ± 27), MEP (38.11 ± 22), PUL (75.64 ± 27), and HGS (33.28 ± 18). There were differences between the ambulatory and non-ambulatory groups in values of MIP, MEP, FVC, PUL, HGS ( p < 0.001 for all), and FEV1 ( p < 0.013). There were correlations between PUL, HGS, and MIP (R = 0.56; R = 0.61, p < 0.001 both), MEP (R = 0.59; R = 0.62, p < 0.001), FVC (R = 0.77; R = 0.77, p < 0.001), and FEV1 (R = 0.77; R = 0.79; p < 0.001). These correlations were found for all participants, but non-ambulatory patients presented stronger relationships. Conclusions: 1. The pulmonary and upper limb functions were within the normal range in ambulatory and low in non-ambulatory patients with DMD, but the muscle strength of both systems was low, regardless of the stage of the disease. 2. There seems to be an interdependence between the respiratory system and upper limb strength in terms of muscle strength and function in DMD patients, which is stronger in non-ambulatory patients. This may be the basis for the creation of a new personalized plan in rehabilitation—the simultaneous rehabilitation of the respiratory and upper limb muscles. Further studies on this theory should be conducted.

Keywords: Duchenne muscular dystrophy; pulmonary function; pulmonary function test; MIP; MEP; upper limbs; respiratory muscles; hand grip; hand grip strength; PUL (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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