Occupational Therapeutic Intervention in children with Duchenne Muscular Dystrophy (DMD): a case study

Duchenne muscular dystrophy is a progressive disorder that affects the musculature leading to debility and excessive weakness. This study describes an occupational therapy intervention in a child suffering of Duchenne muscular dystrophy. The intervention sought to prevent the functional inactivity caused by the progressive aggravation process, mainly of the motor coordination, which sometimes causes emotional damage, social isolation, cognitive deficit and family dysfunction, thus aiming to reach a healthy occupational performance. In the initial assessment, the child presented compensatory movements and posture-including roam, difficulty to perform postural changes and poor global motor coordination, but no difficulty in fine-motor coordination as well as in uni/bimanual and prehension functions. Regarding the cognitive aspects, the child showed learning difficulties and was interested only in toys that were inadequate for the age. The main therapeutic goals focused on the performance of occupations related to the activities of daily living (ADLs), playing, education and participation. The treatment occurred from August to November 2007 and from May to July 2009, once a week, 45 minutes in average. AsDuchenne muscular dystrophyis a progressive disorder, some difficulties in walking, standing and keeping the adequate feet positioning intensified, leading to the necessity of using a wheelchair. However, along the treatment, it was possible to notice some adjustment in the playing, motivation in social participation, adequacy to the school environment that enabled progress in this area, as well as more independence in the ADLs, improving the quality of life of the child and the child's family.