Is Exercise the Right Medicine for Dystrophic Muscle?

Spaulding HR, Selsby JT. Is Exercise the Right Medicine for Dystrophic Muscle? Medicine and science in sports and exercise 2018;50:1723-1732

Spaulding_2018_Med Sci Sports Exerc. Sep;50(9);1723-1732

In this review is summarised what is currently know about the effects of exercise in DMD. Since in DMD multiple muscles and body functions are affected, caution should be taken since it can both have beneficial as detrimental effects. Available data from mouse studies suggest that exercise like swimming and running is beneficial for the limb muscles, but aggravates cardiac and respiratory problems. Therefore more research in patients is needed.



INTRODUCTION: Duchenne muscular dystrophy (DMD) is a neuromuscular disease caused by a dystrophin protein deficiency. Dystrophin functions to stabilize and protect the muscle fiber during muscle contraction; thus, the absence of functional dystrophin protein leads to muscle injury. DMD patients experience progressive muscle necrosis, loss of function, and ultimately succumb to respiratory failure or cardiomyopathy. Exercise is known to improve muscle health and strength in healthy individuals as well as positively affect other systems. Because of this, exercise has been investigated as a potential therapeutic approach for DMD.

METHODS: This review aims to provide a concise presentation of the exercise literature with a focus on dystrophin-deficient muscle. Our intent was to identify trends and gaps in knowledge with an appreciation of exercise modality.

RESULTS: After compiling data from mouse and human studies, it became apparent that endurance exercises such as a swimming and voluntary wheel running have therapeutic potential in limb muscles of mice and respiratory training was beneficial in humans. However, in the comparatively few long-term investigations, the effect of low-intensity training on cardiac and respiratory muscles was contradictory. In addition, the effect of exercise on other systems is largely unknown.

CONCLUSIONS: To safely prescribe exercise as a therapy to DMD patients, multisystemic investigations are needed including the evaluation of respiratory and cardiac muscle.

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