Do you have any articles on muscular dystrophy and exercise prescription?
There are at least 10 different forms of Muscular Dystrophy(MD), and several theories as to their cause. Each of the different variations of MD require special evaluations from the Health Care Professional(HCP) handling the care. You have not stated which MD your client is afflicted with. This may make a huge difference in their physical training. You will have to find out what specific myopathic process he or she has from their health care person and work in conjunction with them. There does not seem to be to much information regarding exercise prescription. However, there may be a few things to consider, with the HCP, before training.
- The first thing to consider is how many organ systems are involved. This will help you and the HCP define the training parameters that can or should be worked on.
- Will the client benefit from using creatine? Creatine seems to be an effective way to help people with myopathic diseases. During these type of diseases the mitochondria seem to have a difficult time synthesizing ATP and resynthesizing PC to form more ATP,(1). It has also been determined that the intracellular levels of creatine are below normal and may aggravate muscle weakness and deterioration,(2). Creatine supplementation may assist in regaining energy homeostasis, muscle energy production and have a nitrogen sparing effect,(3).
- The physical training profile for someone with a myopathic disorder may be highly individual, depending upon that person's state of health. Some research has indicated that resistance training is helpful, but it is unknown what the long term effects may be, if any. The biochemical responses of people with MD are a little slower than the controls,(4,5). This may indicate a longer recovery cycle between lifts and training days. One well defined study did use a 3s X 10r @80% of 1 RM protocol/ 3 X week for 12 weeks and observed no negative side effects from the workouts,(6).
In my estimation, the items listed above would be a good starting point to discuss and formulate a training plan, with the HCP, and the client. You know how important the client's feedback is, especially with a special population like MD.
- Vorgerd,M. et al.(2000) Mitochondrial impairment of human muscle in Freidreich's ataxia in vivo. Neuromuscular Disorders ol.1,no.6,pp430-435
- Felber,S. et al.(2000) Oral creatine supplementation in Duchene's Muscular Dystrophy: a clinical and 31P magnetic resonance spectroscopy study. Scand.Journal of Rehab.Medicine vol.22,no.2, pp145-150
- Persky,A. and G.Brazaue (2001) Clinical Pharmacology of dietary creatine monohydrate. Journal of Clinical Pharmacology vol.53,no.2, pp161-176
- Ansred, T.(2001)Muscle training in Muscular Dystrophies. Acta Physiolo.Scandinavia vol.171,no.3, pp359-366
- Kilmer,D et al(2001) Response to high intensity eccentric muscle contractions in persons with myopathic diseases. Journal of Muscle and Nerve vol.24,no.9,pp1181-1187
- Toolback,A. et al (1999) Effects of high resistance training in patients with myotonic dystrophy. Scand.Journal of Rehabil.Medicine vol.31,no.1,pp9-16