Aerobic Exercise A study done by Sherief et al. (2021), shows that interventions that include aerobic exercises on the treadmill show better improvements for balance and walking abilities in school-aged boys diagnosed with DMD. ⁴⁰

Stretching The study conducted by Morris et al., (2020) explains that individuals with MD, specifically spinal muscular atrophy (SMA) and DMD typically develop limited Temporomandibular active range of motion due to progressive muscle weakness.⁴¹ The loss of range of motion significantly impacts feeding and oral hygiene which are key components of ADLs Morris et al., (2020).⁴¹ The Therabite® is another adaptive device that can be used for individuals with MD. The purpose of a study by Morris et al., (2020), was to assess whether the TheraBite® , an intraoral stretching device, improves Temporomandibular range of motion (ROM).⁴¹ This study found that improving temporomandibular PROM increases feeding efficiency and safety for people with DMD and SMA. Improvement of temporomandibular ROM will improve QOL of people with muscular dystrophy and atrophy and will potentially reduce premature morbidity Morris et al., (2020).⁴¹

Splinting In a study done by Nishizawa et al., (2018), research indicates that the consistent use of night splints on the lower extremities in boys diagnosed with DMD can improve the standing motor function.³⁷ As DMD is known to decrease the ability to ambulate independently in those diagnosed with the condition, splinting techniques to preserve / restore ankle integrity and strength can be beneficial to clients with DMD.

Assistive Devices In the study conducted by Longatelli et al., (2021) two UE adaptive devices including the Wrex arm support, as a passive body-powered antigravity exoskeleton, and the Ayura semi-active solution, for gravity compensation, were assessed and compared to observe whether or not clients with MD could improve UE function by using an adaptive device.⁴² It was reported that the Ayura semi-active device produces greater independence in ADLs with faster movements and fewer compensatory movements. Interestingly, those with severe muscle weakness found that ADs inhibit movement and participants preferred their caregiver’s assistance instead. Overall, results demonstrated that ADs help to improve UE function in those with MD (Longatelli et al., 2021).⁴²

Currently, there is very little research done to address pain experienced by those diagnosed with Duchenne Muscular Dystrophy. While it is known that individuals diagnosed with DMD do experience varying levels of pain, it is not a widely assessed area (Kim et al., 2022).³⁸ Therefore, limited evidence is available supporting pain management interventions pertaining specifically to those suffering from DMD symptoms.

Common pain interventions that are commonly used by occupational therapists include:

• Ultrasound

• Heat therapy

• Cryotherapy

• Manual massage

• Passive muscle stretching

• Aerobic exercising