The influence of resistance training on muscular, gait and psychological impairments in adults with facioscapulohumeral, limb-girdle and Becker muscular dystrophy

O'Dowd, Dawn Nicola (2019) The influence of resistance training on muscular, gait and psychological impairments in adults with facioscapulohumeral, limb-girdle and Becker muscular dystrophy. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Muscular dystrophies are inherited disorders that cause progressive muscle deterioration and weakness. Impaired walking and mental challenges are also recognised clinically, but there is little quantification of these in the literature. Resistance training was historically believed to be detrimental in this population, but the evidence for this is limited to anecdote and murine investigation. Potentially, as in healthy adults, resistance training could improve muscle strength in this population, together with physical function, gait and mental health. Part A of this thesis aimed to describe lower-limb muscle strength, physical function, gait patterns and mental health profiles of adults with Facioscapulohumeral (9), Limb-girdle (6) and Becker (7) Muscular Dystrophy, compared to an age-matched control group (10). Part B of this thesis aimed to examine the effect of 12-weeks’ resistance training on lower-limb muscle strength, kinematics and kinetics of gait and mental health in 17 ambulatory adults with muscular dystrophy. Muscle strength, physical function, gait and mental health were impaired in the muscular dystrophy groups compared to controls. Mean adherence to the training programme was 96%. Isometric maximum voluntary contraction torque increased in 6 muscle groups by between 13% and 65%, along with improvements in functional movements such as a 23% decrease in stair descent time. Gait speed increased by 8% with additional improvements in gait abnormalities, such as a 4° reduction in the severity of knee hyperextension, a 2° increase in mean dorsi-flexion in the swing phase and a 9% increase in peak plantarflexion generation power in late stance. Perceived quality of life improved, with a 19% and 11% reduction in the severity of depression and trait anxiety and a 10% and 15% increase in self-esteem and physical self-worth. This thesis described areas of predominant muscle weakness, gait abnormalities and poor mental health, previously un-reported in these muscular dystrophies. Resistance training was feasible and highly beneficial to muscle strength, gait and mental health. Thus, resistance training is an innovative approach to improving muscle strength and managing the physical and mental challenges of muscular dystrophy and in doing so, helping to maintain independence in this population.