Practical problems and management of seating through the clinical stages of Duchenne's muscular dystrophy

Meigen Liu, Kiyoshi Mineo, Kozo Hanayama, Toshiyuki Fujiwara, Naoichi Chino

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To describe seating problems in patients with Duchenne's muscular dystrophy (DMD), for the purpose of identifying management solutions that are practicable for both patient and caregiver. Design: Case series. Setting: A Japanese long-term care facility. Participants: Ninety-five patients with DMD (mean age, 15.9±4.4y; Swinyard stages: stage 5, n=17; stage 6, n=24; stage 7, n=33; stage 8, n=21). Interventions: Not applicable. Main Outcome Measures: Spinal deformity types, frequency and sites of pain, wheelchair propulsive ability, activities of daily living, and caregiving-related problems. Results: Thirty-three percent of the patients belonged to the early straight group, 21% to the scoliotic group, 20% to the kyphoscoliotic group, 2% to the kyphotic group, and 24% to the extended spine group. The percentage needing support for sitting was higher in patients with spinal deformities (76% vs 0%, P<.05). Forty-one percent had pressure problems, and the percentage increased with advancing stages, with pain sites related to spinal deformity types. Self-feeding was difficult in 10 patients having spinal deformities. Four patterns of manual wheelchair propulsion were observed: upper extremity, anteroposterior trunk flexion, lateral trunk flexion, and wrist-hand patterns; and propulsion became increasingly less practical in this order. For toileting, more patients were cared for on wheelchairs with backrests reclined with stage progression. Of 60 caregivers, 58% experienced trauma related to seating systems. Conclusion: The seating problems that were identified enabled specific, practical suggestions to be made for better management.

Original languageEnglish
Pages (from-to)818-824
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume84
Issue number6
DOIs
Publication statusPublished - 2003 Jun 1
Externally publishedYes

Fingerprint

Duchenne Muscular Dystrophy
Wheelchairs
Caregivers
Pain
Aptitude
Long-Term Care
Activities of Daily Living
Wrist
Upper Extremity
Spine
Hand
Outcome Assessment (Health Care)
Pressure
Wounds and Injuries

Keywords

  • Activities of daily living
  • Muscular dystrophy, Duchenne
  • Quality of life
  • Rehabilitation
  • Spinal curvatures
  • Wheelchairs

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Practical problems and management of seating through the clinical stages of Duchenne's muscular dystrophy. / Liu, Meigen; Mineo, Kiyoshi; Hanayama, Kozo; Fujiwara, Toshiyuki; Chino, Naoichi.

In: Archives of Physical Medicine and Rehabilitation, Vol. 84, No. 6, 01.06.2003, p. 818-824.

Research output: Contribution to journalArticle

Liu, Meigen ; Mineo, Kiyoshi ; Hanayama, Kozo ; Fujiwara, Toshiyuki ; Chino, Naoichi. / Practical problems and management of seating through the clinical stages of Duchenne's muscular dystrophy. In: Archives of Physical Medicine and Rehabilitation. 2003 ; Vol. 84, No. 6. pp. 818-824.
@article{844820489f90423bb8dd4b870126cd09,
title = "Practical problems and management of seating through the clinical stages of Duchenne's muscular dystrophy",
abstract = "Objective: To describe seating problems in patients with Duchenne's muscular dystrophy (DMD), for the purpose of identifying management solutions that are practicable for both patient and caregiver. Design: Case series. Setting: A Japanese long-term care facility. Participants: Ninety-five patients with DMD (mean age, 15.9±4.4y; Swinyard stages: stage 5, n=17; stage 6, n=24; stage 7, n=33; stage 8, n=21). Interventions: Not applicable. Main Outcome Measures: Spinal deformity types, frequency and sites of pain, wheelchair propulsive ability, activities of daily living, and caregiving-related problems. Results: Thirty-three percent of the patients belonged to the early straight group, 21{\%} to the scoliotic group, 20{\%} to the kyphoscoliotic group, 2{\%} to the kyphotic group, and 24{\%} to the extended spine group. The percentage needing support for sitting was higher in patients with spinal deformities (76{\%} vs 0{\%}, P<.05). Forty-one percent had pressure problems, and the percentage increased with advancing stages, with pain sites related to spinal deformity types. Self-feeding was difficult in 10 patients having spinal deformities. Four patterns of manual wheelchair propulsion were observed: upper extremity, anteroposterior trunk flexion, lateral trunk flexion, and wrist-hand patterns; and propulsion became increasingly less practical in this order. For toileting, more patients were cared for on wheelchairs with backrests reclined with stage progression. Of 60 caregivers, 58{\%} experienced trauma related to seating systems. Conclusion: The seating problems that were identified enabled specific, practical suggestions to be made for better management.",
keywords = "Activities of daily living, Muscular dystrophy, Duchenne, Quality of life, Rehabilitation, Spinal curvatures, Wheelchairs",
author = "Meigen Liu and Kiyoshi Mineo and Kozo Hanayama and Toshiyuki Fujiwara and Naoichi Chino",
year = "2003",
month = "6",
day = "1",
doi = "10.1016/S0003-9993(02)04953-5",
language = "English",
volume = "84",
pages = "818--824",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Practical problems and management of seating through the clinical stages of Duchenne's muscular dystrophy

AU - Liu, Meigen

AU - Mineo, Kiyoshi

AU - Hanayama, Kozo

AU - Fujiwara, Toshiyuki

AU - Chino, Naoichi

PY - 2003/6/1

Y1 - 2003/6/1

N2 - Objective: To describe seating problems in patients with Duchenne's muscular dystrophy (DMD), for the purpose of identifying management solutions that are practicable for both patient and caregiver. Design: Case series. Setting: A Japanese long-term care facility. Participants: Ninety-five patients with DMD (mean age, 15.9±4.4y; Swinyard stages: stage 5, n=17; stage 6, n=24; stage 7, n=33; stage 8, n=21). Interventions: Not applicable. Main Outcome Measures: Spinal deformity types, frequency and sites of pain, wheelchair propulsive ability, activities of daily living, and caregiving-related problems. Results: Thirty-three percent of the patients belonged to the early straight group, 21% to the scoliotic group, 20% to the kyphoscoliotic group, 2% to the kyphotic group, and 24% to the extended spine group. The percentage needing support for sitting was higher in patients with spinal deformities (76% vs 0%, P<.05). Forty-one percent had pressure problems, and the percentage increased with advancing stages, with pain sites related to spinal deformity types. Self-feeding was difficult in 10 patients having spinal deformities. Four patterns of manual wheelchair propulsion were observed: upper extremity, anteroposterior trunk flexion, lateral trunk flexion, and wrist-hand patterns; and propulsion became increasingly less practical in this order. For toileting, more patients were cared for on wheelchairs with backrests reclined with stage progression. Of 60 caregivers, 58% experienced trauma related to seating systems. Conclusion: The seating problems that were identified enabled specific, practical suggestions to be made for better management.

AB - Objective: To describe seating problems in patients with Duchenne's muscular dystrophy (DMD), for the purpose of identifying management solutions that are practicable for both patient and caregiver. Design: Case series. Setting: A Japanese long-term care facility. Participants: Ninety-five patients with DMD (mean age, 15.9±4.4y; Swinyard stages: stage 5, n=17; stage 6, n=24; stage 7, n=33; stage 8, n=21). Interventions: Not applicable. Main Outcome Measures: Spinal deformity types, frequency and sites of pain, wheelchair propulsive ability, activities of daily living, and caregiving-related problems. Results: Thirty-three percent of the patients belonged to the early straight group, 21% to the scoliotic group, 20% to the kyphoscoliotic group, 2% to the kyphotic group, and 24% to the extended spine group. The percentage needing support for sitting was higher in patients with spinal deformities (76% vs 0%, P<.05). Forty-one percent had pressure problems, and the percentage increased with advancing stages, with pain sites related to spinal deformity types. Self-feeding was difficult in 10 patients having spinal deformities. Four patterns of manual wheelchair propulsion were observed: upper extremity, anteroposterior trunk flexion, lateral trunk flexion, and wrist-hand patterns; and propulsion became increasingly less practical in this order. For toileting, more patients were cared for on wheelchairs with backrests reclined with stage progression. Of 60 caregivers, 58% experienced trauma related to seating systems. Conclusion: The seating problems that were identified enabled specific, practical suggestions to be made for better management.

KW - Activities of daily living

KW - Muscular dystrophy, Duchenne

KW - Quality of life

KW - Rehabilitation

KW - Spinal curvatures

KW - Wheelchairs

UR - http://www.scopus.com/inward/record.url?scp=0038653388&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038653388&partnerID=8YFLogxK

U2 - 10.1016/S0003-9993(02)04953-5

DO - 10.1016/S0003-9993(02)04953-5

M3 - Article

VL - 84

SP - 818

EP - 824

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 6

ER -