Impact of physical and clinical complications on the time required to perform lower limb functional activities in a boy with Duchenne muscular dystrophy: case study

Abstract

Introduction: The set of activities of getting up and sitting on the floor and on a chair, going up and down stairs and walking are essential for the patient's independence and mobility, and their assessment is of great clinical relevance for the functional monitoring of children diagnosed with Duchenne muscular dystrophy. Objective: To describe the relationship between the time taken to perform lower limb motor activities and physical and clinical complications in a boy with Duchenne muscular dystrophy, monitored fortnightly for a period of one year. Methods: The participant was chosen from a set of 182 medical records. The inclusion criteria were having completed the one-year period performing the functional activities to be analyzed, having attended all biweekly physical therapy sessions in the one-year period and having a history of physical and clinical complications in the anamnesis. The times taken to perform the functional activities were systematically timed and complications such as falls and flu were investigated. The activities of getting up from the floor and from a chair, going up and down stairs and walking were evaluated. Results: Minor physical and clinical complications increased the time spent performing activities with a temporary worsening of motor functions, but did not alter the observed progressive course of the disease. After the events, the data returned to the expected evolution line, characteristic of Duchenne muscular dystrophy. The collection and contextualized interpretation of the times to perform motor activities was essential for immediate clinical decision-making, assisting in the choice of appropriate physical therapy intervention for the patient. Conclusion: Measuring the time to perform lower limb motor activities was relevant in understanding the current clinical-functional state of the patient at the time of the physical therapy intervention, especially when contextualized with situations of physical and clinical complications. We suggest these assessment measures in clinical physiotherapy routines, focusing on at least one of the functional activities, since collecting multiple measures compromises the time of care in the session.