CHAPTER 16 MUSCULAR DYSTROPHY AND JUVENILE RHEUMATOID ARTHRITIS (JRA). MUSCULAR DYSTROPHY ( ADD THE CASE STUDY FROM PAGE 237 HERE.).
CHAPTER 16MUSCULAR DYSTROPHYANDJUVENILE RHEUMATOID ARTHRITIS (JRA)
I.Definition – Skeletal neuromuscular disease is characterized by persistent deterioration of striated muscle tissue. Muscular Dystrophy is distinguished from other Neuromuscular diseases by four criteria:
(Insert Figures 16.1 and 16.2 on page 239 here.)
(Insert Table 16.1 on page 238 here.)
Progression through stages of functional ability include:
1. Low strength/endurance; normal ambulation with possible overwork weakness; slight deficiency in function.
2. Reduction in activity; tendency to fatigue easily; reduced strength/endurance; habitual activity, mild contractures and possible overwork weakness; ambulation with assistance.
3. Poor strength/endurance; overwork weakness; contractures; limited ambulation and decrease in physical activity and standing.
4. Ambulation significantly decreased; functional use of wheelchair; severe contractures and muscular weakness; pulmonary difficulties and cardiomyopathy.
Individuals with muscular dystrophy commonly demonstrate low muscle endurance and fatigue quickly while walking and climbing stairs.
Guidelines for Intervention:
A. Concerns:Early recognition is essential for early intervention physical activity will help maintain muscular strength and functional ability. Recommendation for intervention should promote range of motion, maintain positive and alleviate contractures. Several concerns are evident in developing an excise program. They include:
B. Individualized Program Approach:
The components of an exercise program should include strength, endurance and aerobic power that is essential for standing, walking and functional daily tasks. Goals of the program should include:
C. Community Home Based Interventions
(Insert Table 16.2 on page 244 here.)
Input is needed from the collaborative team and alleviating stress on their joints on joint protection. The Arthritis Foundation recommends 3 types of exercises:
Add Table 16.3 from page 249 here.