A randomized comparative study of two methods for controlling Tendo Achilles contracture in Duchenne muscular dystrophy.
A 30-month prospective randomized study of 27 Scandinavian boys with confirmed diagnosis of Duchenne muscular dystrophy was done to compare the effect of passive stretching combined with the use of night splints (group A) or passive stretching (group B) on the evolution of Tendo Achilles contractures. Assessments were based on the methodology of Scott et al. (Muscle Nerve 1982;5:291-301)Analysis of the pattern and mechanism of dropout was done to eliminate bias between the two groups. Logistic regression showed that Tendo Achilles contracture was the most important variable (P=0.0020) for dropout. Methods of statistical analysis for longitudinal data avoiding induced serial correlations were used in the analysis. The expected annual change in Tendo Achilles contracture was found to be 23% less in group A than in group B after equalization for total muscle strength (%MRC).
Hyde
S A
SA
Institute for Neuromuscular Diseases, Muskelsvindfonden, Kongsvang Allé 23, DK-8000, C, Aarhus, Denmark.
FlŁytrup
I
I
Glent
S
S
Kroksmark
A K
AK
Salling
B
B
Steffensen
B F
BF
Werlauff
U
U
Erlandsen
M
M
D000125:Achilles Tendon / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D013165:Splints; D016896:Treatment Outcome