Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis

Objective: To evaluate the effects and safety of exercise training, and to determine the most effective exercise intervention for people with Duchenne muscular dystrophy. Exercise training was compared with no training, placebo or alternative exercise training. Primary outcomes were functioning and...

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Main Authors: Stian Hammer, Michel Toussaint, Maria Vollsæter, Marianne Nesbjørg Tvedt, Ola Drange Røksund, Gregory Reychler, Hans Lund, Tiina Andersen
Format: Article
Language:English
Published: Medical Journals Sweden 2022-01-01
Series:Journal of Rehabilitation Medicine
Subjects:
Online Access:https://medicaljournalssweden.se/jrm/article/view/985
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author Stian Hammer
Michel Toussaint
Maria Vollsæter
Marianne Nesbjørg Tvedt
Ola Drange Røksund
Gregory Reychler
Hans Lund
Tiina Andersen
author_facet Stian Hammer
Michel Toussaint
Maria Vollsæter
Marianne Nesbjørg Tvedt
Ola Drange Røksund
Gregory Reychler
Hans Lund
Tiina Andersen
author_sort Stian Hammer
collection DOAJ
description Objective: To evaluate the effects and safety of exercise training, and to determine the most effective exercise intervention for people with Duchenne muscular dystrophy. Exercise training was compared with no training, placebo or alternative exercise training. Primary outcomes were functioning and health-related quality of life. Secondary outcomes were muscular strength, endurance and lung function.  Data sources: A systematic literature search was conducted in Medline, EMBASE, CINAHL, Cochrane Central, PEDro and Scopus.  Study selection and data extraction: Screening, data extraction, risk of bias and quality assessment were carried out. Risk of bias was assessed using the Cochrane Collaborations risk of bias tools. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Data synthesis: Twelve studies with 282 participants were included. A narrative synthesis showed limited or no improvements in functioning compared with controls. Health-related quality of life was assessed in only 1 study. A meta-analysis showed a significant difference in muscular strength and endurance in favour of exercise training compared with no training and placebo. However, the certainty of evidence was very low. Conclusion: Exercise training may be beneficial in Duchenne muscular dystrophy, but the evidence remains uncertain. Further research is needed on exercise training to promote functioning and health-related quality of life in Duchenne muscular dystrophy. Lay abstract The aim of this study was to examine the effects of all types of exercise training compared with no training, placebo or alternative exercise training programmes in people with Duchenne muscular dystrophy. The primary outcomes were functioning and health-related quality of life. Secondary outcomes were muscular strength and endurance. A further aim was to evaluate safety and, if possible, to find the most effective exercise training intervention. This review investigates existing research on this topic. The results have been systematically gathered and analysed, to give a broader view of what effect exercise training may have for people with Duchenne muscular dystrophy. The results suggest that exercise training preserves functioning, and benefits muscular strength and endurance. The study was not able to identify the best type of exercise training and prescriptions to use in Duchenne muscular dystrophy. The validity of the results was reduced by the low number of studies included, the low quality of the studies, and diversity in both the interventions and outcome measures used. The results should therefore be interpreted with caution.
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spelling doaj.art-7cb2c2b0c2a64421b1c3eb8d0bd4b1092022-12-21T19:31:49ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812022-01-015410.2340/jrm.v53.985Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-AnalysisStian Hammer0Michel ToussaintMaria VollsæterMarianne Nesbjørg TvedtOla Drange RøksundGregory ReychlerHans LundTiina AndersenDepartment of Physiotherapy, Haukeland University Hospital, Post Box 1400, 5021 Bergen, NorwayObjective: To evaluate the effects and safety of exercise training, and to determine the most effective exercise intervention for people with Duchenne muscular dystrophy. Exercise training was compared with no training, placebo or alternative exercise training. Primary outcomes were functioning and health-related quality of life. Secondary outcomes were muscular strength, endurance and lung function.  Data sources: A systematic literature search was conducted in Medline, EMBASE, CINAHL, Cochrane Central, PEDro and Scopus.  Study selection and data extraction: Screening, data extraction, risk of bias and quality assessment were carried out. Risk of bias was assessed using the Cochrane Collaborations risk of bias tools. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Data synthesis: Twelve studies with 282 participants were included. A narrative synthesis showed limited or no improvements in functioning compared with controls. Health-related quality of life was assessed in only 1 study. A meta-analysis showed a significant difference in muscular strength and endurance in favour of exercise training compared with no training and placebo. However, the certainty of evidence was very low. Conclusion: Exercise training may be beneficial in Duchenne muscular dystrophy, but the evidence remains uncertain. Further research is needed on exercise training to promote functioning and health-related quality of life in Duchenne muscular dystrophy. Lay abstract The aim of this study was to examine the effects of all types of exercise training compared with no training, placebo or alternative exercise training programmes in people with Duchenne muscular dystrophy. The primary outcomes were functioning and health-related quality of life. Secondary outcomes were muscular strength and endurance. A further aim was to evaluate safety and, if possible, to find the most effective exercise training intervention. This review investigates existing research on this topic. The results have been systematically gathered and analysed, to give a broader view of what effect exercise training may have for people with Duchenne muscular dystrophy. The results suggest that exercise training preserves functioning, and benefits muscular strength and endurance. The study was not able to identify the best type of exercise training and prescriptions to use in Duchenne muscular dystrophy. The validity of the results was reduced by the low number of studies included, the low quality of the studies, and diversity in both the interventions and outcome measures used. The results should therefore be interpreted with caution.https://medicaljournalssweden.se/jrm/article/view/985Duchenne muscular dystrophyexercise trainingrespiratory muscle trainingrehabilitationphysiotherapy
spellingShingle Stian Hammer
Michel Toussaint
Maria Vollsæter
Marianne Nesbjørg Tvedt
Ola Drange Røksund
Gregory Reychler
Hans Lund
Tiina Andersen
Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
Journal of Rehabilitation Medicine
Duchenne muscular dystrophy
exercise training
respiratory muscle training
rehabilitation
physiotherapy
title Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
title_full Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
title_fullStr Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
title_full_unstemmed Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
title_short Exercise Training in Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
title_sort exercise training in duchenne muscular dystrophy a systematic review and meta analysis
topic Duchenne muscular dystrophy
exercise training
respiratory muscle training
rehabilitation
physiotherapy
url https://medicaljournalssweden.se/jrm/article/view/985
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