Effects of a balance exercise programme in myotonic dystrophy type 1: A pilot study

Abstract

This pilot study aimed to evaluate the effects of balance exercises in adults with classical myotonic dystrophy type 1 (DM1) directly after intervention and at follow-up after 12 weeks. Eleven outpatients (median age 49 years, range 36–60 years) with balance difficulties participating in a 10 week intervention were assessed before, after and at follow-up. The primary outcome measure was balance confidence, measured with the Activities-specific Balance Confidence (ABC) scale. Secondary outcome measures were the Step Test, Timed Up and Go test, Timed 10 m Walk at maximum pace, isometric muscle force in legs and number of falls. The most important findings directly after the intervention were that nine of the 11 patients scored higher on the ABC scale (p = 0.02), and that the number of steps in the Step Test increased in nine of 10 participants. The increased number of steps remained increased at follow-up, but the increased confidence was not maintained for all patients. Timed Up and Go was unchanged but the time to walk 10 m increased. The knee extensor force and number of falls did not show any statistically significant changes. Unexpectedly, all patients deteriorated in the ankle dorsiflexor force (mean –17%) after intervention. The study showed that self-assessed balance confidence is likely to increase following an individualized balance exercise programme in outpatients with DM1.

Key words::

• Accidental falls
• gait
• muscle force
• physical therapy modalities
• postural balance

Acknowledgements

We thank all the balance exercise programme participants who willingly came to the assessments and exercise sessions during the study. We also want to express our gratitude to the exercise leader, RPT Jennie Ann Ohlsson, who carefully led and inspired the participants through the exercises.

Declaration of interest: The authors report no conflicts of interest. This work was supported by grants from the Trust fund of Norrbacka-Eugenia, the Council of Research and Development in Göteborg and southern Bohusl n, and Muskelfonden, Sweden. The funding sources have had no influence over the design, conduction or the report of the study.

Supplementary material available online

Supplementary Appendix available online at http://informahealthcare.com/doi/abs/10.3109/21679169.2015.1049204.