# Exercise as it relates to Disease/Exercise and Duchenne muscular dystrophy
#### Description

    Duchenne muscular dystrophy is a genetic mutation disease on the x chromosone. It is the complete lack of the protein dystrophin. This causes necrosis and severe atrophy of the muscle cells. 1 in 3500 boys are affected by this disease, which only has a life expectancy of 30. Very similar and related to Duchenne muscular dystrophy is Becker muscular dystrophy; which is not a complete lack of dystrophin, but very low levels.

#### Diagnosis

    Duchenne muscular dystrophy is a hereditary disease. Symptoms become obvious in young children as sufferers' are much slower at learning to walk and often appear clumsy. Enlarged calf muscles are also noticeable at an early age. Muscle wastage begins around the hips and Legs, before spreading to other areas of the body. Becker muscular Dystrophy sufferers' have similar symptoms, however the onset isn't until adolescence. It becomes apparent when physical activity becomes increasingly difficult. DNA testing, muscle biopsies, electromyography(EMG) and Creatine Kinase tests are used to diagnose the disorder.

#### Complications

    The lack of mobility is the main complication involved with the disease. Boys often lost their ability to walk at around the age of 10. Heart complications such as arrhythmia's and heart failure can be a problem with the myocardial losing the ability to work. Heart transplants are common for sufferers' after the age of 20. Other complications include Mental impairment, pneumonia and respiratory failure. Becker muscular dystrophy sufferers' begin to experience these problems around the age of 30.

## Treatments

    There is no cure for this disease, although there are a few treatments which prolong its severity. These treatments include:
   * Exercise
   * Massage
   * Nutrition
   * Temperature
   * Pharmaceuticals
   * Whole Body Vibration

## Exercise
#### Recommendations

   * Low to moderate intensity aerobic exercise
   * yoga
   * Stretching
   * Swimming
    These exercises prove to be beneficial as they can increase muscular strength, stride length, muscle contraction and gait stability. Vo2 max is also improved via the aerobic exercise. The main benefit from these exercises is that the decay of muscle size and strength is prevented. Sub maximal effort (under 60% vo2 max) changes muscle fibres to type 1, which are better at preventing degradation. Swimming is the best exercise for sufferers' as damage and strain of the muscles is minimized due to the buoyancy of the water. Therefore diagnosis of the disease early as possible would be helpful for the independence of sufferers'. The introduction of these exercises into their lifestyles as early as possible will increase the longevity of their mobility and independence via the decrease of fibrosis in the muscle cell.

#### Problems

    Muscular dystrophy sufferers' should not take part in resistance exercise, especially ones involving eccentric contractions. These exercises damage muscles in order for improvement, therefore with already weakened muscles the damage could prove catastrophic. High intensity exercises are also exercises that should not be taken part in for the same reasons.

## Further reading

    National Institute of Health; Duchenne muscular dystrophy
    http://www.nlm.nih.gov/medlineplus/ency/article/000705.htm
    Muscular Dystrophy Foundation Australia
    http://web.archive.org/web/20130410193212/http://mdaustralia.org.au/files/2012/07/002_ducene_becker-july-2012.pdf

## References

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Australia, M. D. F., 2012. Facts about Duchenne and Becker Muscular Dystrophies. [Online] Available at: http://web.archive.org/web/20130410193212/http://mdaustralia.org.au/files/2012/07/002_ducene_becker-july-2012.pdf
National Human Genome Research Institute, n.d. Learning About Duchenne Muscular Dystrophy. [Online] Available at: http://www.genome.gov/19518854 [Accessed 21 10 2012].
Health, N. I. o., 2012. Duchenne muscular dystrophy. [Online] Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000705.htm [Accessed 21 10 2013].
Roque, J. M. et al., 2011. Physical Training in Becker Muscular Dystrophy Associated with Heart Failure. Arquivos Brasileiros de Cardiologia, 97(6), pp. e128 - e131.
Jansen, M., Groot, I. J. d., Alfen, N. v. & Geurts, A. C., 2010. Physical training in boys with Duchenne Muscular Dystrophy: the protocol of the No Use is Disuse study. Biomed Central, 10(55).
Zeviani, M., 2008. Train, train, train! No pain, just gain. Oxford Journals, 131(11), pp. 2809–2811.
Sveen, M. L., 2008. Endurance training improves fitness and strength in patients with Becker muscular dystrophy. Oxford Journals, 131(11), pp. 2824–2831.
Klinger, W., 2012. The role of fibrosis in Duchenne muscular dystrophy. Acta Myol., 31(3), pp. 184–195.
* ↑ Australia, M. D. F., 2012. Facts about Duchenne and Becker Muscular Dystrophies. [Online] Available at: http://web.archive.org/web/20130410193212/http://mdaustralia.org.au/files/2012/07/002_ducene_becker-july-2012.pdf
* ↑ National Human Genome Research Institute, n.d. Learning About Duchenne Muscular Dystrophy. [Online] Available at: http://www.genome.gov/19518854 [Accessed 21 10 2012].
* ↑ Health, N. I. o., 2012. Duchenne muscular dystrophy. [Online] Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000705.htm [Accessed 21 10 2013].
* ↑ Roque, J. M. et al., 2011. Physical Training in Becker Muscular Dystrophy Associated with Heart Failure. Arquivos Brasileiros de Cardiologia, 97(6), pp. e128 - e131.
* ↑ Jansen, M., Groot, I. J. d., Alfen, N. v. & Geurts, A. C., 2010. Physical training in boys with Duchenne Muscular Dystrophy: the protocol of the No Use is Disuse study. Biomed Central, 10(55).
* ↑ Zeviani, M., 2008. Train, train, train! No pain, just gain. Oxford Journals, 131(11), pp. 2809-2811.
* ↑ Sveen, M. L., 2008. Endurance training improves fitness and strength in patients with Becker muscular dystrophy. Oxford Journals, 131(11), pp. 2824-2831.
* ↑ Klinger, W., 2012. The role of fibrosis in Duchenne muscular dystrophy. Acta Myol., 31(3), pp. 184-195.