There are a lot of evidences that support the interventions for improved NMD an ROM is still lacking but with some generally accepted processes and principles the impact and disability from such contractures in NMD can be minimized. There are few concepts of such management of contractures which when known will help you to get the best and most desired results. All that is required is an early diagnosis of such contractures and to initiate physical medicinal approaches. When the level of contractures is low splinting before contracture and passive ROM method can be followed for effective results.
Contractures Are Inevitable
There are some NMD conditions where contractures are inevitable and when these are in the advanced stage then it becomes a permanent problem causing acute and excruciating Lower Back Pain. Such advanced conditions have very little effect to the conservative interventions like splinting or stretching and this is when surgical interventions are required. The most significant and rational way to control such lower limb contractures is by minimizing the adverse effects it has on independent ambulation. It is not necessary always to become wheelchair reliant which is primarily an effect of mental weakness and certainly not due to the formation of contractures.
Avoid Static Positioning
It is essential to avoid static positioning for both upper as well as the lower limbs which is the primary cause of formation of contractures resulting in upper as well as lower back pain, though mild contractures may not impact your functionality n an adverse manner. There are several ways for rehabilitation management for lower limb contracture for which you will have to carry out four principal modalities of physical therapy. This will immensely help those who suffer from musculoskeletal deformity to delay or even prevent the formation of lower limb contractures.
The Principal Therapy Modalities
The physical therapy modalities include regular and prescribed periods of standing and walking on a daily basis, passive stretching of joints and muscles, right positioning of limbs to oppose flexion and promote extensionand lastly splinting which is considered as the most significant measure for delay or formation of contractures. Diligent and regular following of such methods for about 2 to 3 hours can control contracture formation in case of myopathies and may reduce the need for Contracture Equipment often.
Improving Rage of Motion
It is important to improve and maintain the range of motion so that you do not have to use the contracture equipment often which you can keep it as your last resort as these are most effectivein delaying the development of contractures in DMD. Make sure you start such programs at the earliest for better results and make it your morning and evening routine on a regular basis.