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Muscular Dystrophy

To meet the unique needs of an individual with muscular dystrophy in an aquatic environment, a very small teacher-student ratio is required; typically, a one-on-one ratio is necessary.

 

Most individuals with muscular dystrophy have the Duchene or Pseudohypertrophic type of dystrophy. Typically, weakness and atrophy of the muscles begins in the pelvic and hip girdle and then affects the shoulder girdle. A warm water learning environment provides a wonderful opportunity for an individual with significant muscle weakness and little muscular endurance to move independently or with little support.

 

Water activity for the individual with muscular dystrophy who is still ambulatory on land should focus on the opportunity for the individual to practice walking and upright equilibrium development in the water. Walking in water between waist and chest deep will afford the individual with muscular dystrophy the chance to maintain strength and range of motion required for walking without the deleterious effect of gravity. In-the-water exercises for the legs and the arms will help maintain function. The instructor should avoid exercises which force the individual to take his limbs out of the water. Exercises can be done in chest deep water or in deeper water with floatation support.

 

  • As the individual’s functional movement capacity declines, as muscle tissue is replaced by fat tissue, the individual’s relative density will change and adjustments must be made in patterns for movement through water. Most individuals with muscular dystrophy will find it easier to move through the water in a supine position, using an elementary backstroke with a homologous arm pattern and a flutter kick. Weakness in shoulder girdle muscles, and eventually weakness in neck muscles, make it difficult to keep the head in alignment.

  • Caution should be taken not to allow the individual to become over fatigued. Most individuals with muscular dystrophy self-monitor quite well and will tell the teacher when they are become too tired. Other noticeable signs include rapid breathing, rapid pulse, and increasingly uncoordinated arm movements.

  • Special care must be taken when transferring a individual with muscular dystrophy from a wheelchair to a transferring chair or to a matted pool deck. Under no circumstances should one individual attempt a transfer, even with a small child. One person should support the body weight under the thighs and control the individual’s descent to the deck or into the chair. The other must take care to grasp the individual around the chest, but never under the arms, as it is too easy to dislocate the arm at the shoulder.

  • In order to prepare the individual with muscular dystrophy for eventual decline, the physical education program should include activities the individual can use through his lifespan. Fishing is a particularly good lifetime aquatic activity.

  • The warm water environment is also an excellent environment in which to teach conscious relaxation skills that will be very useful as the individual with muscular dystrophy deals with his disability.

 

 

Carol Huettig, Ph.D.

Texas Woman's University

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