Effectiveness of Telerehabilitation on Pulmonary Function in Children with Duchenne Muscular Dystrophy: A Pre-Post Intervention Study

Priyanka  Gupta; Seveka  Bali; Amrit Pal Singh  Sood; Amit Kumar  Mital; Priyanka  Choudhary; Sudhansu Sekhar  Baral; Somya  Saxena; Rita  Upadhyay; Renu  Suthar

doi:10.18502/jmr.v20i2.21711

Priyanka Gupta Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Seveka Bali Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Amrit Pal Singh Sood Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Amit Kumar Mital Department of Pediatrics, Shri Atal Bihari Vajpayee Government Medical College, Faridabad, India.
Priyanka Choudhary Department of Community Medicine, Shri Atal Bihari Vajpayee Government Medical College, Faridabad, India.
Sudhansu Sekhar Baral Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Somya Saxena Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Rita Upadhyay Department of Physical Medicine and Rehabilitation, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Renu Suthar Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

DOI: https://doi.org/10.18502/jmr.v20i2.21711

Keywords: Telerehabilitation; Duchenne muscular dystrophy; Spirometry; Breathing exercises; Pulmonary function tests

Abstract

Introduction: Duchenne muscular dystrophy (DMD) is an inherited neuromuscular disorder caused by mutations in the dystrophin gene, leading to progressive muscle weakness. This study aimed to evaluate the efficacy of telerehabilitation in improving pulmonary function in patients with DMD.

Materials and Methods: An interventional study was conducted among boys aged 5-12 years with DMD enrolled in the Pediatric Neurology Clinic from September 2023 to February 2024. Telemedicine-based respiratory exercises were explained to patients and their parents every 15 days for a 3-month period, and the patients were encouraged to exercise for at least 5 days a week. Pulmonary function tests (PFTs), including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁), were recorded before and after the intervention.

Results: A total of 67 children participated in the study. There was significant improvement in FVC (P<0.001, Cohen’s d=1.93) and FEV₁ (P<0.001, Cohen’s d=1.06). The FEV₁/FVC ratio, a parameter that can be elevated in restrictive diseases, was also significantly decreased (P<0.001, Cohen’s d=-0.63). For a one-unit increase in age, the FVC change after intervention was predicted to decrease significantly by 0.24 units, holding other variables constant.

Conclusion: Telemedicine-based pulmonary rehabilitation for 3 months markedly improved pulmonary function, indicating that this intervention is effective in improving pulmonary function in patients with DMD, with greater effectiveness when initiated at an early age.