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Effects of Osteopathic Manipulative Treatment (OMT) on Functional Impairment in Limb Girdle Muscular Dystrophy Patient: A Case Report (271)

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 29. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

case report [514]
children [228]
limb girdle muscular dystrophy [1]
OMT [2951]
osteopathic manipulative treatment [2973]
pediatrics [375]

Abstract:

Introduction/Background: Limb Girdle Muscular Dystrophy (LGMD) is a group of disorders characterized by progressive weakness of the proximal limb girdle muscles (1). Clinical features of disease include tiptoe walking, difficulty running and climbing stairs, and joint contractures (1). Treatment of LGMD remains supportive (2). Physiotherapy has been recommended to delay joint deformities and promote walking (2). OMT can be effective in addressing structural and musculoskeletal dysfunctions of Duchenne Muscular Dystrophy (3); this case demonstrates the positive effects of OMT in a case of LGMD. Case: An 8-year-old female with LGMD presents with tiptoe walking, bilateral lower extremity (LE) hypertonicity, and bilateral LE pain. Patient has attempted passive stretching and antiinflammatory diet with minimal relief. On physical examination, 4/5 strength is present bilaterally in hip flexion/extension, knee flexion/extension, ankle plantarflexion and dorsiflexion. Decreased range of motion (ROM) in dorsiflexion and hip flexion bilaterally was noted. Myofascial release (MFR), muscle energy technique (MET), and facilitated positional release (FPR) was utilized to treat somatic dysfunctions (SD) of the lumbar spine, pelvis, sacrum, and lower extremities. Results: Immediately post-treatment, pain levels decreased from a 7/10 pre-treatment to a 3/10 post-treatment when walking. MET significantly improved dorsiflexion and hip flexion ROM. Over a one-month course of receiving OMT weekly, patient reported the ability to climb 1 additional flight of stairs and walk 2-3 additional blocks without fatigue. Patient also reported decreased reliance on crawl method to climb stairs. Discussion: This case demonstrated improvement in functional impairment in a LGMD patient after OMT. Limitations of this study include subjective measurements of improvement in pain and daily function. In all, further research is required to understand the effect of OMT on LGMD.


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