Becker muscular dystrophy (BMD) is an inherited muscle-wasting condition predominantly affecting boys. Although there is currently no cure for the disease there are several ways to help patients manage their symptoms.
As symptoms may vary from individual to individual, different healthcare professionals may need to be involved to address each patient’s individual needs.
Muscle loss caused by BMD can lead to difficulty walking, loss of balance and coordination, frequent falls and fatigue. Physical therapy, improves symptoms by stretching tight muscles, thus helping to maintain their function longer.
Moderate exercise can also benefit BMD patients by building skeletal muscle, keeping the cardiovascular system functioning better, and improving mental health. However, excessive exercise should be avoided as it could lead to further muscle damage. Doctors usually recommend swimming and aquatic therapy, as the buoyancy of the water can help prevent muscle strain and injury.
Dealing with contractures
Muscle deterioration may cause painful contractures (fixations of the joints) that restrict mobility and flexibility over time. Regular range-of-motion exercises can help keep tendons from shortening prematurely, and delay the onset of contractures.
Ankle-foot braces may be prescribed for night wear to keep feet pointing upward and keep the Achilles tendon stretched, delaying the onset of contractures. Surgery to release tendons may be performed to relieve advanced contractures.
As BMD also affects the heart muscle, patients should have cardiac evaluations at least every other year starting at age 10. Doctors may also prescribe medication such as angiotensin-converting enzyme (ACE) inhibitors and beta blockers to lessen the workload of the heart and slow the deterioration of heart muscle. These medications can be more effective if started as soon as abnormalities on echocardiogram appear and before symptoms occur.
In advanced stages of the disease, heart transplants may be needed and have proved successful in treating BMD patients with cardiomyopathy (disease of the heart muscle).
As BMD patients grow older and breathing muscles weaken, breathing difficulties may appear, especially during sleep. A breathing machine may help, though difficulties may eventually occur during the day also, necessitating the use of such a machine day and night.
As the condition progresses, the lungs get weaker and preventing lung infections becomes essential. Patients may need pneumonia vaccinations as well as and manual or mechanical-assisted support to prevent mucus accumulation in the respiratory tract.
Doctors may prescribe vitamins and other medication to BMD patients to help prevent bone problems resulting from muscle weakness and lack of movement. These problems include scoliosis or curvature of the spine, which may cause breathing difficulties. Bones may also grow weaker and thinner, increasing the risk of fractures.
A well-balanced diet may help BMD patients manage issues like weight problems, heartburn, constipation and difficulty swallowing. In advanced stages of the disease, a feeding tube may be needed to ensure adequate nutrition.
BMD sometimes causes cognitive disabilities. In such cases, patients should receive educational and psychological support.
Although some studies have shown that steroid medication can help maintain muscle strength in patients with other types of muscular dystrophy, information on their use on BMD patients is still limited.
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