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FSH Muscular Dystrophy

Discussion in 'General Issues and Discussion Forum' started by nicola selhuber, Nov 21, 2007.

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    Does anyone have any experience in treating a patient with muscular dystrophy? My patient is a middle-aged man with progressive muscle weakness primarily affecting his left side, including the pelvis and lower limb. I'd be grateful for management suggestions.
     
  2. DaVinci

    DaVinci Well-Known Member

    You are going to have to be more specific if you want any advice. Management of what? The muscular dystrophy? The foot problem? What is the presenting complaint?
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. sorry, podiatric management, ie trying to facilitate mobility in the light of a progressive muscular wasting disease via whatever means are at the disposal of podiatrists. This patient has left sided foot drop and is hip hiking to achieve ground clearance, and expending valuable energy unnecessarily, so other than the obvious AFO I am keen to know whether anyone has any experience in helping these patients from the podiatric perspective.
     
  5. Boots n all

    Boots n all Well-Known Member

    l only have two clients that l see with MD, but we can treat/help your client the same way we could a stoke victim in many ways.

    Once they have the AFO, in this case the left foot, l would place a heel wedge in the right shoe, this will help with the swing through phase and reduce the "Hip Hike" of the left side as the amount of lift required is not as much now due to the heel lift in the right shoe and we are only talking 4mm maybe less, you will have to fiddle with that one yourself.

    We would also modify the sole to have a lateral flare plus rocker sole.
    If you are unable to do a rocker sole at least grind down and smooth the toe of the left shoe, there is no need for grip at that end of the shoe and the smooth surface will help it slide rather than catch.
    Good luck hope this helps !

    PS Dont forget the AFO will also add to the overall leg length of the left side wich can be 3mm or more and this needs to be "counterbalanced" before the extra possible 4mm is added
     
    Last edited: Nov 21, 2007
  6. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Here are my lecture notes on muscular dystrophy:
     
  7. Dear Boots n all

    thank you for your advice, these are just the kind of practical suggestions I was hoping for. According to the classification in Craig's lecture notes (thank you Craig) it is the fascioscapulohumeral type which is affecting this patient.
     
  8. j1nxst3r

    j1nxst3r Member

    Hi All,

    This is a very interesting thread.. I have 2 sons who have Duchenne, and they are the main reason I have started Podiatric training (just finished my 1st year). I am obviously thinking ahead and can certainly see the equinus foot in my oldest little boy - he also falls down more frequently than i'd like too!

    Could I ask what is AFO? Also, i'm thinking of my thesis for 3rd year and would like to do something that is DMD related. Does anyone have any good ideas for a research project?

    Kind Regards,

    Mike Taylor
     
  9. Tuckersm

    Tuckersm Well-Known Member

    Mike
    An AFO is an Ankle-Foot Orthosis, there are a variety of them available, and their primary aim is to manage a foot drop, but can also be used for other deformities.

    For your 3rd yr project, you could look at surveying the DMD community on their foot issues.

    good luck

    Stephen
     
  10. j1nxst3r

    j1nxst3r Member

    Hi Stephen, many thanks on the clarification

    Mike
     
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