Neurological Sciences and Neurophysiology

: 2020  |  Volume : 37  |  Issue : 1  |  Page : 38--39

Long-term intense exercise training in becker muscular dystrophy: 3-year follow-up

Gokce Yagmur Gunes Gencer, Naciye Fusun Toraman 
 Faculty of Health Sciences, Akdeniz University, Antalya, Turkey

Correspondence Address:
Gokce Yagmur Gunes Gencer
Faculty of Health Sciences, Akdeniz University, Antalya

How to cite this article:
Gunes Gencer GY, Toraman NF. Long-term intense exercise training in becker muscular dystrophy: 3-year follow-up.Neurol Sci Neurophysiol 2020;37:38-39

How to cite this URL:
Gunes Gencer GY, Toraman NF. Long-term intense exercise training in becker muscular dystrophy: 3-year follow-up. Neurol Sci Neurophysiol [serial online] 2020 [cited 2022 Jun 30 ];37:38-39
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Full Text

Dear Editor,

A 17-year-old patient, who provided written informed consent and admitted to the University of Health Sciences Antalya Training and Research Hospital, Neuromuscular Diseases Center due to genetic diagnosis of Becker muscular dystrophy (BMD), requested the exercise training program by stating that he swam for 5 years under the supervision of a trainer for 1–2 h, 6 days/per week, he came in third in the swimming championship held in Antalya, and he wanted to become a swimming coach.

At first examination, he did not have any complaint and his musculoskeletal, cardiac, pulmonary, and neurologic examinations were normal, but needle electromyography (EMG) examination of the quadriceps, iliopsoas, deltoideus, and tibialis anterior muscles of the left side showed low-amplitude, short-duration MUPs. In addition, there was giant amplitude of MUPs for left quadriceps muscle. Motor and sensory neural conductions were normal. Repeated EMG studies showed similar findings, and we did not observed progression of EMG findings after exercise.

The variables of advised training in the aerobic training were as follows: intensity, 50% of maximal heart rate; duration, 20 min per se ssion; and frequency, 3 days a week. After 2 weeks, first the duration and then the intensity were increased every 2 weeks. Dynamic resistance exercises were organized as a row of ten resistance exercise stations for back, arm, chest, leg, and shoulder muscles. Initially, the patient performed unloaded exercises as a single set of eight repetitions; the repetitions were increased to 12 in the 4th week, and the number of sets was increased to three in the 6th week. Resistance training began at 50% of the 1-repetition maximum (RM), and the load was gradually increased to 80% of the 1-RM. The frequency was 2 days a week. The flexibility program included static stretching of the major muscle tendon groups. The training program lasted for 3 years.

[Table 1] shows the assessment results of the patient at a 3-year follow-up.{Table 1}

The effect of exercise on the muscle in dystrophinopathy is not yet known. Low-intensity exercises are preferred instead of high-intensity, eccentric exercises[1] because it is thought that high-intensity exercise training increases mechanical stress and therefore causes muscle damage while low-intensity exercise can contribute to the muscle contraction mechanism.[2] In the literature, it has been shown that muscle strength and functional capacity increase in BMD patients applying low-medium intensity aerobic and strength exercises together.[3] In this case, high-intensity strength and aerobic exercise have been revealed to increase muscle strength and functional capacity despite the presence of increased plasma creatine kinase levels.

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1Tramonti C, Rossi B, Chisari C. extensive functional evaluations to monitor aerobic training in Becker muscular dystrophy: A case report. Eur J Transl Myol 2016;26:5873.
2Petrof BJ. The molecular basis of activity-induced muscle injury in Duchenne muscular dystrophy. Mol Cell Biochem 1998;179:111-23.
3Jensen BR, Berthelsen MP, Husu E, Christensen SB, Prahm KP, Vissing J. Body weight-supported training in Becker and limb girdle 2I muscular dystrophy. Muscle Nerve. 2016;54:239-43.