Physiotherapy
Regular physiotherapy is important to keep your child mobile, healthy and well. Physical activity without over-exertion, and normal social play, are recommended for children with DMD.
Frequently Asked Questions
A physio is an allied health professional who can assess how a young person’s body is growing, moving, and functioning. They:
Measure muscles in the arms and legs to check for tightness and may assess muscle strength, walking, function, and posture.
May provide a home exercise program for individuals to do themselves or a plan to manage tiredness throughout the day.
May provide guidance for managing respiratory (breathing and coughing) problems at home.
May work in the specialist hospital clinic or be a community physio close to your home. Most young people have check-ups with the hospital physio and do regular exercise sessions with their community physio.
At each stage of DMD, you and your child will work closely with a physio to help support, protect and get the most out of their body and its abilities.
A regular physiotherapy assessment helps to monitor what physical things are happening with your child, to allow your physio to manage any challenges you are noticing, such as getting tired or falling.
The physio can work closely with the rest of your health team to achieve the best possible health-outcomes for a young person with DMD.
Your physio can update your home exercise program and work with your community therapy team to ensure that all available supports are in place to enable your child’s confident participation in all aspects of life, such as school, family, community and social experiences.
Usually, they would see a physio soon after they are first diagnosed.
The nature of the advice, assessment and management you and your child receive, will target the concerns you bring to the session and your child’s individual assessment on the day.
A physiotherapy appointment for DMD usually involves:
A conversation to catch up on how things are going. The physio will want to get an idea of how your child is coping with day to day life, the supports they currently have, how they are going with their home program, whether they are falling etc...
Measurement of your child’s arm and leg movements on the therapy bed, using a goniometer.
Observation of your child completing different physical activities. The activities are done in the same way each clinic visit, so that the physio can understand any changes or challenges your child is having with their movement.
A plan and home exercise program will be provided based on the assessment. If you are comfortable, the physio will communicate this to your community physio so they can support you in any plan provided.
For resources to help your child prepare for their physiotherapy appointment see the extra resources for parents and children tab below.
- Comfortable, stretchy clothing such as a tracksuit/shorts, t-shirt and runners
- Splints if you have them, including resting-night splints/AFOs
- Contact details for your community therapists
- Questions or concerns you may have about your child with DMD’s physical function
- Support for your child to feel comfortable during the hospital visit : such as entertainment (eg: toys, books or IPAD) or sensory tools for calming
The physio is measuring to check for joint or muscle tightness that may affect your child’s movement.
DMD can cause muscles to become tight. When this happens, your child’s body cannot move as easily. Walking and other activities are more tiring and your child may fall more frequently. It’s important that we check for muscle tightness so we can add stretching exercises to your child’s home exercise program.
Your child will lie on the clinic bed. When he is relaxed the physio moves the body part (such as an ankle joint) and measures how far as it can comfortably go. The physio will use a goniometer to measure the joint angle – it looks like a ruler.
Physios target tight muscles with home exercise programs of stretching, positioning and in some cases, night splints/AFOs or serial casting. These are aimed at slowing the tightening process for as long as possible.
If it is needed, your physio will refer to an Orthotist or Orthopaedic Specialist for advice on managing the joint and muscle tightness.
These activities are called functional outcome measures and have been designed for children with DMD.
Outcome measures allow the physio to see what physical things your child can do and where they may be finding movement more difficult. This helps the physio to understand how their body and daily life is being affected by the DMD.
This information can be used to:
Monitor for change since the last physiotherapy appointment
Provide you with accurate advice
Build a plan with you and your child to manage the effect of DMD on their physical function.
It can be useful to talk with and prepare your child before attending their appointment, so they know what to expect.
We have a range of resources available depending on the level your child is at with their communication. If you are concerned or need more information before your appointment, contact your local physio.
For resources to help your child prepare for their clinic visit to the physio see the extra resources for parents and children tab below.
Yes, you can.
If you are on the National Disability Insurance Scheme (NDIS) you can apply for funding support to access regular Physiotherapy visits in the community. Seek guidance from your NDIS Local Area Coordinator (LAC) or support coordinator to find an appropriate therapist in your area.
If you are not interested in joining NDIS or not eligible, please talk to your healthcare team about other funding possibilities.
Ideally, you and your child should find a physio who either has experience working with kids (a paediatric physiotherapist) or treats people with neurological conditions or disabilities. Not all physios in the community will have an understanding of DMD due to it being a relative rare condition.
However, as long as the physio you find is happy to work with your local neuromuscular team at the hospital and learn about DMD, they can help you. Most importantly, you and your child must feel comfortable with whoever you are seeing.
For introductory information about DMD to give to your physio see extra resources for parents and children.
It is useful for your hospital (neuromuscular clinic) and the community physio to stay in contact and share their assessment findings. This helps to ensure you and your child receive consistent information about your child’s function and physiotherapy plan.
It also means, that if you or the community physio have any concerns about how your child is going, they can help you alert your hospital neuromuscular team as soon as possible for review.
Please note that you need to be comfortable with, and provide consent for your community and hospital physios talking to each other about your child.
It is important that your child with DMD is able to take care of their body between clinic visits. This may be by targeting tight muscles with a stretching program and participating in safe activity to maintaining general fitness.
Your clinic physio will suggest an exercise program specifically for your child based on their assessment. If you have a community therapist, they will be able to support and enhance this program.
Make sure you let someone know - either your community or hospital physio. Work closely with your community physio to trouble shoot the problems. Seek support from your hospital neuromuscular team if further help is needed.
Further Learning
Safe Activity
For all children, exercise and physical activity are important parts of remaining fit and healthy. For children with DMD, exercising can be difficult due to muscle weakness and certain precautions should be taken to ensure that exercise is safe and effective. Click on the button for more information about safe exercise and activity.
Advice for PE teachers and coaches
Each child with DMD is different and factors like age and their disease stage have a big effect on their function. Engagement in physical activity and exercise needs to be encouraged and supported even when your student’s strength and abilities begin to deteriorate. Click on the button below for more information.
Footwear
There are different kinds of shoes for different activities. Shoes can be functional everyday shoes like runners and school shoes, or occasional shoes like party shoes and thongs/flip-flops. For children with foot and ankle weakness and walking or balance problems, footwear choice is important. It is recommended that everyday, supportive shoes are worn as much as possible. Click on the button for more information about footwear.
Extra resources for parents and children
These are easy-to-read summaries for parents to read with their children. Click the links below to access them.
These are short picture books for parents to read with their children to prepare them for some physio assessments. You can download and print these picture books by clicking on the links below.
These are diary templates that parents can print out for their children to help them keep track of their daily stretches and night splints. You can download and print these templates by clicking the links below.
