Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care.
Optimum management of Duchenne muscular dystrophy (DMD) requires a multidisciplinary approach that focuses on anticipatory and preventive measures as well as active interventions to address the primary and secondary aspects of the disorder. Implementing comprehensive management strategies can favourably alter the natural history of the disease and improve function, quality of life, and longevity. Standardised care can also facilitate planning for multicentre trials and help with the identification of areas in which care can be improved. Here, we present a comprehensive set of DMD care recommendations for management of rehabilitation, orthopaedic, respiratory, cardiovascular, gastroenterology/nutrition, and pain issues, as well as general surgical and emergency-room precautions. Together with part 1 of this Review, which focuses on diagnosis, pharmacological treatment, and psychosocial care, these recommendations allow diagnosis and management to occur in a coordinated multidisciplinary fashion.
Bushby
Katharine
K
Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK. kate.bushby@newcastle.ac.uk
Finkel
Richard
R
Birnkrant
David J
DJ
Case
Laura E
LE
Clemens
Paula R
PR
Cripe
Linda
L
Kaul
Ajay
A
Kinnett
Kathi
K
McDonald
Craig
C
Pandya
Shree
S
Poysky
James
J
Shapiro
Frederic
F
Tomezsko
Jean
J
Constantin
Carolyn
C
D000553:Ambulatory Care; D001847:Bone Diseases / Q000209:etiology / Q000628:therapy; D005081:Exercise Therapy; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000628:therapy; D006331:Heart Diseases / Q000209:etiology / Q000628:therapy; D006801:Humans; D007806:Language Disorders / Q000209:etiology / Q000628:therapy; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D009751:Nutritional Requirements; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010348:Patient Care Team; D026761:Physical Therapy Specialty / Q000379:methods; D011788:Quality of Life; D012120:Respiration Disorders / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome