Importance of hamstring flexibility for ambulation in Duchenne Muscular Dystrophy?

Öz

Purpose: The aim of this study was to investigate the relationship between hamstring flexibility and ambulation in children with Duchenne Muscular Dystrophy (DMD).
Materials and methods: Sixty children with a diagnosis of DMD between the ages of 5 and 13,5 and whose functional levels were Level 1 and 2 according to the Brooke Lower Extremity Functional Classification (BLEFC) were included in the study. The hamstring flexibility of the children was evaluated with the popliteal angle test and their ambulation with the North Star Ambulation Assessment (NSAA) scale. The relationship between hamstring flexibility and parameters of NSAA was evaluated with Spearman correlation analysis.
Results: The mean hamstring flexibility of the children included in the study was 53.78°±30.32° and the mean of the NSAA scale was 24.93±6.44 points. A negative, moderate correlation was found between the hamstring flexibility and NSAA (r=-0.544, p<0.001). When the relationships between NSAA sub-parameters and hamstring flexibility were examined a significant, negative, weak-medium strength, the relationship was found between flexibility and many sub-parameters (p<0.05). In addition, it was found that hamstring flexibility and NSAA score differ between Levels 1 and 2 according to BLEFC (p<0.001).
Conclusion: Hamstring flexibility was determined to be an important factor for ambulation of children with DMD. Inclusion of hamstring flexibility increasing/protective approaches in physiotherapy and rehabilitation programs from the early period was thought to be important in terms of preserving/developing ambulation in this patient group.

Anahtar Kelimeler

• Duchenne Muscular Dystrophy
• Hamstring Flexibility
• Ambulation

Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?

Öz

Amaç: Bu çalışmanın amacı Duchenne Musküler Distrofi (DMD)’li çocuklarda hamstring esnekliği ile ambulasyon arasındaki ilişkiyi araştırmaktır.
Gereç ve yöntem: Çalışmaya yaşları 5 ile 13,5 arasında değişen fonksiyonel seviyeleri Brooke Alt Ekstremite Fonksiyonel Sınıflandırması (BAEFS)’na göre Seviye 1 ve 2 olan 60 DMD tanısı alan çocuk dahil edildi. Çocukların hamstring esnekliği popliteal açı testi, ambulasyonları ise North Star Ambulasyon Değerlendirme (NSAD) skalası ile değerlendirildi. Hamstring esnekliği ve NSAD’nin parametreleri arasındaki ilişki Spearmen korelasyon analizi ile değerlendirildi.
Bulgular: Çalışmaya dahil edilen çocukların hamstring esnekliği ortalamaları 53,78°±30,32° ve NSAD skalası ortalaması ise 24,93±6,44 puandı. Hamstring esnekliği ile NSAD skalası arasında negatif yönde, orta kuvvette ilişki bulundu (r=-0,544, p<0,001). NSAD alt parametreleri ile hamstring esnekliği arasındaki ilişkiler incelendiğinde ise esneklik ile birçok alt parametre arasında negatif yönde, zayıf-orta kuvvette anlamlı ilişki bulundu (p<0,05). Ayrıca, BAEFS’na göre Devre 1 ve 2’nin hamstring esnekliği ve NSAD skorunun farklı olduğu bulundu (p<0,001).
Sonuç: Hamstring esnekliğinin DMD’li çocukların ambulasyonu için önemli bir faktör olduğu belirlendi. Hamstring esnekliğini artırıcı/koruyucu yaklaşımların erken dönemden itibaren fizyoterapi ve rehabilitasyon programlarında yer almasının bu hasta grubunda ambulasyonun korunması/geliştirilmesi açısından önemli olduğu düşünüldü.

Anahtar Kelimeler

• Duchenne Musküler Distrofi
• Hamstring Esnekliği
• Ambulasyon

Kaynakça

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