Date of Award

2019

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Renee Mabey

Keywords

Disease Management; Myotonic Dystrophy -- therapy; Case Reports

Abstract

Background and Purpose. This article describes the 3-week outpatient Physical Therapy management of a 63-year-old female with a diagnosis of Myotonic Muscular Dystrophy (MMD) Type 2. MMD is an inherited disorder, which progressively impacts muscular, respiratory, cardiac, nervous, and endocrine systems. MMD Type 2 is characterized by muscle weakness, muscle pain, and myotonia. The patient in this case study presented to physical therapy with upper and lower extremity weakness and balance impairment. The purpose of this article is to describe the initial physical therapy evaluation process for a patient with MMD, as well as the interventions used for this patient and the patient's response to treatment. Research involving the physical therapy management of a patient with MMD Type 2 is scarce, and this article intends to add to the limited available information.

Description. The treatment of this patient involved a generalized strengthening program for the upper and lower extremities, aerobic conditioning, balance training, and soft tissue massage for tissue restrictions.

Outcomes. Following physical therapy intervention, the patient improved in functional outcome scores and balance assessment scores. The patient also demonstrated increased tolerance to aerobic exercise. Grip and pinch strength dynamometry were recorded revealing increased strength. Variable results were compiled from the manual muscle testing strength assessment, with a general trend of increased strength following the 3-week period of therapy.

Discussion. The rationale for treatment was based on addressing the patient's presenting symptoms and goals. Information gathered from a thorough literature review was used to guide treatment. Treatment was altered or progressed based on the patient's response.

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