Ankle bracing practices in ambulatory, corticosteroid-naive boys with Duchenne muscular dystrophy

Muscle Nerve. 2020 Jan;61(1):52-57. doi: 10.1002/mus.26727. Epub 2019 Oct 16.

Abstract

Introduction: Loss of ambulation in Duchenne muscular dystrophy presages scoliosis, respiratory failure, and death. Strategies to maintain ankle range of motion are employed, but little evidence exists to support these approaches and limited information is available concerning current practice.

Methods: In this study we assessed baseline bracing data from 187 boys participating in a multicenter, international clinical trial.

Results: Ankle-foot orthoses (AFOs) were recommended for 54% of the boys, with nighttime static AFOs and nighttime dynamic AFOs utilized in 94% and 6% of these boys, respectively. Daytime static AFOs were recommended for 3 boys. Compliance with bracing recommendations was 54% for nighttime static braces and 67% for nighttime dynamic braces.

Discussion: The basis for the variation in recommended AFO use is unknown and requires further study. Long-term follow-up of boys may permit assessment of the effects of AFO use.

Keywords: Duchenne muscular dystrophy; bracing; corticosteroids; dynamic ankle-foot orthoses; pediatrics; static ankle-foot orthoses.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ankle Joint
  • Ankle*
  • Braces*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Foot
  • Humans
  • Male
  • Muscular Dystrophy, Duchenne / rehabilitation*
  • Muscular Dystrophy, Duchenne / therapy*
  • Orthotic Devices
  • Patient Compliance
  • Physical Therapy Modalities
  • Range of Motion, Articular
  • Treatment Outcome
  • Walking