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Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study

Year 2024, Volume: 7 Issue: 1, 13 - 20, 25.01.2024
https://doi.org/10.33438/ijdshs.1312910

Abstract

Purpose: Duchenne muscular dystrophy (DMD) is X-linked progressive neuromuscular disorder of childhood onset which leads to loss of ambulation, followed by respiratory and cardiac muscle weakness. Physiotherapy is integral to the multidisciplinary care plan for boys with DMD. During the COVID-19 pandemic, Tele-medicine was increasingly used to provide healthcare to patients. The study aimed to assess the efficacy and feasibility of Tele-rehabilitation among ambulatory boys with DMD. Materials and Methods: Ambulatory boys aged 5 to 12 years with DMD were recruited using purposive sampling. The Tele-rehabilitation program was designed by a neuromuscular team and provided by a physiotherapist through telephonic video calls twice a month for three months. A compliance diary was provided to fill out at home after each session. The outcome was measured with a change in Medical Research Council (MRC) sum score and gower's times at 12 weeks using paired t- test. Results: 92 boys with DMD were enrolled and 66 (71%) boys completed the program and had follow-up at 12 weeks. The baseline MRC sum score was 38.2±3.7, and the gower's time was 9.2±6.7 seconds. At 12 weeks MRC sum score was 38.8±4.2, and gower's time was 8.59±7.7 seconds (p-value- 0.03 and p-value- 0.001), respectively. The Vigno's and Brook's scores didn't show a significant change. Compliance of >50% to the Tele-rehabilitation exercise programs was present in 89% of subjects. Conclusion: A short-term Tele-rehabilitation program was feasible with a high compliance rate and efficacious in motor strengthening among boys with DMD.

References

  • Abramson AS, Rogoff J. (1953). An approach to rehabilitation of children with muscular dystrophy. 1953; New York. p 123-124.
  • Akkurt, L., Gürbüz, İ. A., Karaduman, A., And Yilmaz, Ö. T. (2019). Lower limb flexibility in children with Duchenne muscular dystrophy: effects on functional performance. Pediatric Exercise Science, 31(1), 42-46. [PubMed]
  • Akulwar-Tajane, I., And Bhatt, G.D. (2021). Telerehabilitation: An Alternative Service Delivery Model for Pediatric Neurorehabilitation Services at a Tertiary Care Center in India. Int J Phys Med Rehabil, 9, S4.
  • Alemdaroğlu, I., Karaduman, A., Yilmaz, Ö. T., And Topaloğlu, H. (2015). Different types of upper extremity exercise training in Duchenne muscular dystrophy: effects on functional performance, strength, endurance, and ambulation. Muscle & nerve, 51(5), 697-705. [PubMed]
  • Angelini, C., And Peterle, E. (2012). Old and new therapeutic developments in steroid treatment in Duchenne muscular dystrophy. Acta myologica, 31(1), 9. [PubMed]
  • Appleby, E., Gill, S. T., Hayes, L. K., Walker, T. L., Walsh, M., And Kumar, S. (2019). Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review. PloS one, 14(11), e0225150. [PubMed]
  • Balaban, B., Matthews, D. J., Clayton, G.H., And Carry, T. (2005). Corticosteroid treatment and functional improvement in Duchenne muscular dystrophy: long-term effect. American journal of physical medicine & rehabilitation, 84(11), 843-850. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Alman, B. A., Apkon, S. D., Blackwell, A., And Ward, L. M. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. The Lancet Neurology, 17(4), 347-361. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Brumbaugh, D., And Weber, D. R. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. The Lancet Neurology, 17(3), 251-267. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Colvin, M. K., And Ward, L. M. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan. The Lancet Neurology, 17(5), 445-455. [PubMed] Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Brumbaugh, D., And Weber, D. R. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. The Lancet Neurology, 17(3), 251-267. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Colvin, M. K., And Ward, L. M. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan. The Lancet Neurology, 17(5), 445-455. [PubMed]
  • Brooke, M. H., Griggs, R. C., Mendell, J. R., Fenichel, G. M., Shumate, J. B., And Pellegrino, R. J. (1981). Clinical trial in Duchenne dystrophy. I. The design of the protocol. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 4(3), 186-197. [PubMed]
  • Chen, S. C., Lin, C. H., Su, S. W., Chang, Y. T., And Lai, C. H. (2021). Feasibility and effect of interactive telerehabilitation on balance in individuals with chronic stroke: a pilot study. Journal of neuroengineering and rehabilitation, 18(1), 1-11. [PubMed]
  • Corti, C., Poggi, G., Romaniello, R., Strazzer, S., Urgesi, C., Borgatti, R., And Bardoni, A. (2018). Feasibility of a home-based computerized cognitive training for pediatric patients with congenital or acquired brain damage: An explorative study. PloS one, 13(6), e0199001. [PubMed]
  • Cramer, S. C., Dodakian, L., Le, V., McKenzie, A., See, J., Augsburger, R., And Heckhausen, J. (2021). A feasibility study of expanded home-based telerehabilitation after stroke. Frontiers in Neurology, 11, 611453. [PubMed]
  • Crisafulli, S., Sultana, J., Fontana, A., Salvo, F., Messina, S., And Trifirò, G. (2020). Global epidemiology of Duchenne muscular dystrophy: an updated systematic review and meta-analysis. Orphanet journal of rare diseases, 15, 1-20. [PubMed]
  • Doherty, T. J. (2009). Exercise Therapy in Neuromuscular Disease–Why Bother?. Opening the Black Box: The Mysteries of Therapeutic Exercise Unlocked, 35.
  • D'Souza, A. F., And Rebello, S. R. (2021). Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. International Journal of Telerehabilitation, 13(2). [PubMed]
  • Florence, J. M., Pandya, S., King, W. M., Robison, J. D., Baty, J., Miller, J. P. And Signore, L. C. (1992). Intrarater reliability of manual muscle test (Medical Research Council scale) grades in Duchenne's muscular dystrophy. Physical therapy, 72(2), 115-122. [PubMed]
  • Giliberto, F., Radic, C. P., Luce, L., Ferreiro, V., de Brasi, C., And Szijan, I. (2014). Symptomatic female carriers of Duchenne muscular dystrophy (DMD): genetic and clinical characterization. Journal of the neurological sciences, 336(1-2), 36-41. [PubMed]
  • Hammer, S., Toussaint, M., Vollsæter, M., Nesbjørg, M., Røksund, O. D., Reychler, G., And Andersen, T. (2022). Exercise training in Duchenne muscular dystrophy: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 54. [CrossRef]
  • Huijgen, B. C., Vollenbroek-Hutten, M. M., Zampolini, M., Opisso, E., Bernabeu, M., Van Nieuwenhoven, J., And Hermens, H. J. (2008). Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis. Journal of telemedicine and telecare, 14(5), 249-256. [PubMed]
  • Jansen, M., van Alfen, N., Geurts, A. C., And de Groot, I. J. (2013). Assisted bicycle training delays functional deterioration in boys with Duchenne muscular dystrophy: the randomized controlled trial “no use is disuse”. Neurorehabilitation and neural repair, 27(9), 816-827. [PubMed]
  • Lott, D. J., Taivassalo, T., Cooke, K. D., Park, H., Moslemi, Z., Batra, A., And Vandenborne, K. (2021). Safety, feasibility, and efficacy of strengthening exercise in Duchenne muscular dystrophy. Muscle & nerve, 63(3), 320-326. [PubMed]
  • Lue, Y. J., Jong, Y. J., Lin, Y. T., And Chen, S. S. (1992). The strength and functional performance of patients with Duchenne muscular dystrophy based on natural history. Gaoxiong yi xue ke xue za zhi= The Kaohsiung journal of medical sciences, 8(11), 597-604. [PubMed]
  • Malagoni, A. M., Vagnoni, E., Felisatti, M., Mandini, S., Heidari, M., Mascoli, F., And Manfredini, F. (2011). Evaluation of patient compliance, quality of life impact and cost-effectiveness of a" test in-train out" exercise-based rehabilitation program for patients with intermittent claudication. Circulation Journal, 75(9), 2128-2134. [CrossRef]
  • Moffet, H., Tousignant, M., Nadeau, S., Mérette, C., Boissy, P., Corriveau, H., And Dimentberg, R. (2015). In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. JBJS, 97(14), 1129-1141. [PubMed]
  • Passamano, L., Taglia, A., Palladino, A., Viggiano, E., D'ambrosio, P. A. O. L. A., Scutifero, M. And Politano, L. (2012). Improvement of survival in Duchenne Muscular Dystrophy: retrospective analysis of 835 patients. Acta Myologica, 31(2), 121. [PubMed]
  • Pastora-Bernal, J. M., Hernández- Fernández, J. J., Estebanez-Pérez, M. J., Molina-Torres, G., García-López, F. J., And Martín-Valero, R. (2021). Efficacy, feasibility, adherence, and cost effectiveness of a mhealth telerehabilitation program in low risk cardiac patients: a study protocol. International Journal of Environmental Research and Public Health, 18(8), 4038. [PubMed]
  • Schlichting, T., Martins da Silva, K., Silva Moreira, R., Marques de Moraes, M. V., Cicuto Ferreira Rocha, N. A., Boyd, R. N., And Neves dos Santos, A. (2022). Telehealth program for infants at risk of cerebral palsy during the Covid-19 pandemic: A pre-post feasibility experimental study. Physical & Occupational Therapy In Pediatrics, 42(5), 490-509. [PubMed] Skura, C. L., Padden, T. M., And Fowler, E. G. (2005). The effect of concentric exercise for two children with Duchenne Muscular Dystrophy. Pediatric Physical Therapy, 17(1), 84. [CrossRef]
  • Sobierajska-Rek, A., Mański, Ł., Jabłońska-Brudło, J., Śledzińska, K., Ucińska, A., And Wierzba, J. (2021). Establishing a telerehabilitation program for patients with Duchenne muscular dystrophy in the COVID-19 pandemic. Wiener Klinische Wochenschrift, 133, 344-350. [PubMed]
  • Sobierajska-Rek, A., Mański, Ł., Jabłońska-Brudło, J., Śledzińska, K., Wasilewska, E., And Szalewska, D. (2021). Respiratory telerehabilitation of boys and young men with Duchenne muscular dystrophy in the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18(12), 6179. [CrossRef]
  • Tanner, K., Bican, R., Boster, J., Christensen, C., Coffman, C., Fallieras, K. And Marrie, J. (2020). Feasibility and acceptability of clinical pediatric telerehabilitation services. International Journal of Telerehabilitation, 12(2), 43. [CrossRef]
  • Vignos, P. J., & Watkins, M. P. (1966). The effect of exercise in muscular dystrophy. Jama, 197(11), 843-848. [PubMed]
  • Wasilewska, E., Małgorzewicz, S., Sobierajska-Rek, A., Jabłońska-Brudło, J., Górska, L., Śledzińska, K & Wierzba, J. (2020). Transition from childhood to adulthood in patients with Duchenne muscular dystrophy. Medicina, 56(9), 426. [CrossRef]
Year 2024, Volume: 7 Issue: 1, 13 - 20, 25.01.2024
https://doi.org/10.33438/ijdshs.1312910

Abstract

References

  • Abramson AS, Rogoff J. (1953). An approach to rehabilitation of children with muscular dystrophy. 1953; New York. p 123-124.
  • Akkurt, L., Gürbüz, İ. A., Karaduman, A., And Yilmaz, Ö. T. (2019). Lower limb flexibility in children with Duchenne muscular dystrophy: effects on functional performance. Pediatric Exercise Science, 31(1), 42-46. [PubMed]
  • Akulwar-Tajane, I., And Bhatt, G.D. (2021). Telerehabilitation: An Alternative Service Delivery Model for Pediatric Neurorehabilitation Services at a Tertiary Care Center in India. Int J Phys Med Rehabil, 9, S4.
  • Alemdaroğlu, I., Karaduman, A., Yilmaz, Ö. T., And Topaloğlu, H. (2015). Different types of upper extremity exercise training in Duchenne muscular dystrophy: effects on functional performance, strength, endurance, and ambulation. Muscle & nerve, 51(5), 697-705. [PubMed]
  • Angelini, C., And Peterle, E. (2012). Old and new therapeutic developments in steroid treatment in Duchenne muscular dystrophy. Acta myologica, 31(1), 9. [PubMed]
  • Appleby, E., Gill, S. T., Hayes, L. K., Walker, T. L., Walsh, M., And Kumar, S. (2019). Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review. PloS one, 14(11), e0225150. [PubMed]
  • Balaban, B., Matthews, D. J., Clayton, G.H., And Carry, T. (2005). Corticosteroid treatment and functional improvement in Duchenne muscular dystrophy: long-term effect. American journal of physical medicine & rehabilitation, 84(11), 843-850. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Alman, B. A., Apkon, S. D., Blackwell, A., And Ward, L. M. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. The Lancet Neurology, 17(4), 347-361. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Brumbaugh, D., And Weber, D. R. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. The Lancet Neurology, 17(3), 251-267. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Colvin, M. K., And Ward, L. M. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan. The Lancet Neurology, 17(5), 445-455. [PubMed] Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Brumbaugh, D., And Weber, D. R. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. The Lancet Neurology, 17(3), 251-267. [PubMed]
  • Birnkrant, D. J., Bushby, K., Bann, C. M., Apkon, S. D., Blackwell, A., Colvin, M. K., And Ward, L. M. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan. The Lancet Neurology, 17(5), 445-455. [PubMed]
  • Brooke, M. H., Griggs, R. C., Mendell, J. R., Fenichel, G. M., Shumate, J. B., And Pellegrino, R. J. (1981). Clinical trial in Duchenne dystrophy. I. The design of the protocol. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 4(3), 186-197. [PubMed]
  • Chen, S. C., Lin, C. H., Su, S. W., Chang, Y. T., And Lai, C. H. (2021). Feasibility and effect of interactive telerehabilitation on balance in individuals with chronic stroke: a pilot study. Journal of neuroengineering and rehabilitation, 18(1), 1-11. [PubMed]
  • Corti, C., Poggi, G., Romaniello, R., Strazzer, S., Urgesi, C., Borgatti, R., And Bardoni, A. (2018). Feasibility of a home-based computerized cognitive training for pediatric patients with congenital or acquired brain damage: An explorative study. PloS one, 13(6), e0199001. [PubMed]
  • Cramer, S. C., Dodakian, L., Le, V., McKenzie, A., See, J., Augsburger, R., And Heckhausen, J. (2021). A feasibility study of expanded home-based telerehabilitation after stroke. Frontiers in Neurology, 11, 611453. [PubMed]
  • Crisafulli, S., Sultana, J., Fontana, A., Salvo, F., Messina, S., And Trifirò, G. (2020). Global epidemiology of Duchenne muscular dystrophy: an updated systematic review and meta-analysis. Orphanet journal of rare diseases, 15, 1-20. [PubMed]
  • Doherty, T. J. (2009). Exercise Therapy in Neuromuscular Disease–Why Bother?. Opening the Black Box: The Mysteries of Therapeutic Exercise Unlocked, 35.
  • D'Souza, A. F., And Rebello, S. R. (2021). Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. International Journal of Telerehabilitation, 13(2). [PubMed]
  • Florence, J. M., Pandya, S., King, W. M., Robison, J. D., Baty, J., Miller, J. P. And Signore, L. C. (1992). Intrarater reliability of manual muscle test (Medical Research Council scale) grades in Duchenne's muscular dystrophy. Physical therapy, 72(2), 115-122. [PubMed]
  • Giliberto, F., Radic, C. P., Luce, L., Ferreiro, V., de Brasi, C., And Szijan, I. (2014). Symptomatic female carriers of Duchenne muscular dystrophy (DMD): genetic and clinical characterization. Journal of the neurological sciences, 336(1-2), 36-41. [PubMed]
  • Hammer, S., Toussaint, M., Vollsæter, M., Nesbjørg, M., Røksund, O. D., Reychler, G., And Andersen, T. (2022). Exercise training in Duchenne muscular dystrophy: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 54. [CrossRef]
  • Huijgen, B. C., Vollenbroek-Hutten, M. M., Zampolini, M., Opisso, E., Bernabeu, M., Van Nieuwenhoven, J., And Hermens, H. J. (2008). Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis. Journal of telemedicine and telecare, 14(5), 249-256. [PubMed]
  • Jansen, M., van Alfen, N., Geurts, A. C., And de Groot, I. J. (2013). Assisted bicycle training delays functional deterioration in boys with Duchenne muscular dystrophy: the randomized controlled trial “no use is disuse”. Neurorehabilitation and neural repair, 27(9), 816-827. [PubMed]
  • Lott, D. J., Taivassalo, T., Cooke, K. D., Park, H., Moslemi, Z., Batra, A., And Vandenborne, K. (2021). Safety, feasibility, and efficacy of strengthening exercise in Duchenne muscular dystrophy. Muscle & nerve, 63(3), 320-326. [PubMed]
  • Lue, Y. J., Jong, Y. J., Lin, Y. T., And Chen, S. S. (1992). The strength and functional performance of patients with Duchenne muscular dystrophy based on natural history. Gaoxiong yi xue ke xue za zhi= The Kaohsiung journal of medical sciences, 8(11), 597-604. [PubMed]
  • Malagoni, A. M., Vagnoni, E., Felisatti, M., Mandini, S., Heidari, M., Mascoli, F., And Manfredini, F. (2011). Evaluation of patient compliance, quality of life impact and cost-effectiveness of a" test in-train out" exercise-based rehabilitation program for patients with intermittent claudication. Circulation Journal, 75(9), 2128-2134. [CrossRef]
  • Moffet, H., Tousignant, M., Nadeau, S., Mérette, C., Boissy, P., Corriveau, H., And Dimentberg, R. (2015). In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. JBJS, 97(14), 1129-1141. [PubMed]
  • Passamano, L., Taglia, A., Palladino, A., Viggiano, E., D'ambrosio, P. A. O. L. A., Scutifero, M. And Politano, L. (2012). Improvement of survival in Duchenne Muscular Dystrophy: retrospective analysis of 835 patients. Acta Myologica, 31(2), 121. [PubMed]
  • Pastora-Bernal, J. M., Hernández- Fernández, J. J., Estebanez-Pérez, M. J., Molina-Torres, G., García-López, F. J., And Martín-Valero, R. (2021). Efficacy, feasibility, adherence, and cost effectiveness of a mhealth telerehabilitation program in low risk cardiac patients: a study protocol. International Journal of Environmental Research and Public Health, 18(8), 4038. [PubMed]
  • Schlichting, T., Martins da Silva, K., Silva Moreira, R., Marques de Moraes, M. V., Cicuto Ferreira Rocha, N. A., Boyd, R. N., And Neves dos Santos, A. (2022). Telehealth program for infants at risk of cerebral palsy during the Covid-19 pandemic: A pre-post feasibility experimental study. Physical & Occupational Therapy In Pediatrics, 42(5), 490-509. [PubMed] Skura, C. L., Padden, T. M., And Fowler, E. G. (2005). The effect of concentric exercise for two children with Duchenne Muscular Dystrophy. Pediatric Physical Therapy, 17(1), 84. [CrossRef]
  • Sobierajska-Rek, A., Mański, Ł., Jabłońska-Brudło, J., Śledzińska, K., Ucińska, A., And Wierzba, J. (2021). Establishing a telerehabilitation program for patients with Duchenne muscular dystrophy in the COVID-19 pandemic. Wiener Klinische Wochenschrift, 133, 344-350. [PubMed]
  • Sobierajska-Rek, A., Mański, Ł., Jabłońska-Brudło, J., Śledzińska, K., Wasilewska, E., And Szalewska, D. (2021). Respiratory telerehabilitation of boys and young men with Duchenne muscular dystrophy in the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18(12), 6179. [CrossRef]
  • Tanner, K., Bican, R., Boster, J., Christensen, C., Coffman, C., Fallieras, K. And Marrie, J. (2020). Feasibility and acceptability of clinical pediatric telerehabilitation services. International Journal of Telerehabilitation, 12(2), 43. [CrossRef]
  • Vignos, P. J., & Watkins, M. P. (1966). The effect of exercise in muscular dystrophy. Jama, 197(11), 843-848. [PubMed]
  • Wasilewska, E., Małgorzewicz, S., Sobierajska-Rek, A., Jabłońska-Brudło, J., Górska, L., Śledzińska, K & Wierzba, J. (2020). Transition from childhood to adulthood in patients with Duchenne muscular dystrophy. Medicina, 56(9), 426. [CrossRef]
There are 35 citations in total.

Details

Primary Language English
Subjects Physiotherapy, Rehabilitation
Journal Section Original Article
Authors

Priyanka Gupta 0000-0003-3261-5053

Amrit Pal Singh Sood 0000-0002-5081-522X

Seveka Bali 0000-0002-4447-4844

Somya Saxena 0000-0002-3998-7143

Sudhansu Baral 0000-0002-1328-8723

Ruby Nimesh 0000-0001-5391-2167

Renu Suthar 0000-0003-4701-6168

Early Pub Date December 25, 2023
Publication Date January 25, 2024
Published in Issue Year 2024 Volume: 7 Issue: 1

Cite

APA Gupta, P., Sood, A. P. S., Bali, S., Saxena, S., et al. (2024). Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study. International Journal of Disabilities Sports and Health Sciences, 7(1), 13-20. https://doi.org/10.33438/ijdshs.1312910
AMA Gupta P, Sood APS, Bali S, Saxena S, Baral S, Nimesh R, Suthar R. Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study. International Journal of Disabilities Sports &Health Sciences. January 2024;7(1):13-20. doi:10.33438/ijdshs.1312910
Chicago Gupta, Priyanka, Amrit Pal Singh Sood, Seveka Bali, Somya Saxena, Sudhansu Baral, Ruby Nimesh, and Renu Suthar. “Tele-Rehabilitation for Boys With Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study”. International Journal of Disabilities Sports and Health Sciences 7, no. 1 (January 2024): 13-20. https://doi.org/10.33438/ijdshs.1312910.
EndNote Gupta P, Sood APS, Bali S, Saxena S, Baral S, Nimesh R, Suthar R (January 1, 2024) Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study. International Journal of Disabilities Sports and Health Sciences 7 1 13–20.
IEEE P. Gupta, A. P. S. Sood, S. Bali, S. Saxena, S. Baral, R. Nimesh, and R. Suthar, “Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study”, International Journal of Disabilities Sports &Health Sciences, vol. 7, no. 1, pp. 13–20, 2024, doi: 10.33438/ijdshs.1312910.
ISNAD Gupta, Priyanka et al. “Tele-Rehabilitation for Boys With Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study”. International Journal of Disabilities Sports and Health Sciences 7/1 (January 2024), 13-20. https://doi.org/10.33438/ijdshs.1312910.
JAMA Gupta P, Sood APS, Bali S, Saxena S, Baral S, Nimesh R, Suthar R. Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study. International Journal of Disabilities Sports &Health Sciences. 2024;7:13–20.
MLA Gupta, Priyanka et al. “Tele-Rehabilitation for Boys With Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study”. International Journal of Disabilities Sports and Health Sciences, vol. 7, no. 1, 2024, pp. 13-20, doi:10.33438/ijdshs.1312910.
Vancouver Gupta P, Sood APS, Bali S, Saxena S, Baral S, Nimesh R, Suthar R. Tele-Rehabilitation for Boys with Duchenne Muscular Dystrophy in India Amidst the COVID-19 Pandemic: An Implementation Study. International Journal of Disabilities Sports &Health Sciences. 2024;7(1):13-20.


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