MUSCULAR DYSTROPHY
Helping the child to keep walking for as long as possible
Exercise. To keep as strong as possible and prevent
contractures, probably the best therapy, at least at
first, is to stay active, to walk, run, and play. While
range-of-motion and stretching exercises may
help (see Chapter 42), it is even better to involve
the child in games, work, and other activities that
keep his joints flexible. Even though he is slow and
awkward, encourage him to take part. Feeling sorry
for him and just letting him sit is the worst thing
you can do.
Walking uphill
and hillside
farm work help
prevent tiptoe
contractures of
the ankles.
Braces. Long-leg braces should not be used until absolutely necessary, as they
will let the child’s legs grow weaker faster. Sometimes lightweight plastic ankle
splints, worn day and night, will help delay ankle contractures and keep him
walking better. (See Chapter 58.)
If contractures of the knees and hips begin to develop, try resting or sleeping with
‘sand bags’ to press down the legs and help straighten them.
bags made of soft cloth
filled with clean sand
plastic
ankle
splints
sand bag
cushion
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CAUTION: Balance your efforts to provide therapy or surgery against the need
of the child (and his family) to lead as full, happy, and normal a life as possible. His
weakness will increase and his life will be short regardless of all efforts. The goal
of all care for the child with muscular dystrophy should be to help him get the most
out of living NOW. The temporary benefits of surgery should be weighed against
the pain and hardships it would involve.
Other aids. The child will reach a point
where he needs to use crutches. Later,
(often by age 10) he will not be able to
walk. Do not force him when it becomes
too hard. Instead, try to obtain or make
a wheelchair. (See Chapters 64 to 66.)
At first, the child may be able to roll it
himself. But as his weakness progresses,
he may need to be pushed.
A wide cloth
or canvas
strap across
his belly
and chest
may allow
the child to
play, to lean
forward, and
to use his
arms more
freely.
Breathing deeply is
important, especially when
the muscles that move the
lungs begin to weaken.
Encourage the child to
sing loudly, to shout, to
blow whistles, and to
blow up balloons.
Shouting and climbing are both good exercises for the lungs.
disabled village children