Terapias Dmd

Exercise boards

1/28/05

3:11 PM

Page 1

STRETCHES AND EXERCISES
The enclosed sheets contain stretches and exercises which can be used to
delay and minimise the development of contractures and deformities
occurring in children with Duchenne muscular dystrophy.
These sheets accompany the booklet Physiotherapy Management for Duchenne
Muscular Dystrophy, A Home Exercise Book.
Eachstretch and exercise is on a separate sheet and can be combined, on the
advice of your physiotherapist, into an individual programme to suit your
child’s needs. This programme can be carried out at home but should be
reviewed regularly as the needs of your child change.
All the enclosed stretches and exercises are general. Some may not be
appropriate for your child and additional ones may berecommended.
Contents
1.
2.
3a.
3b.
3c.
4a.
4b.
5a.
5b.
6a.
6b.
7.
8a.
8b.
9.
10a.
10b.
11.

Stretch for the ankles
Stretch for the knees
Stretch for the hips
Stretch for the hips
Stretch for the hips
Iliotibial stretch
Iliotibial stretch
Stretch for the elbows
Stretch for the elbow and wrist
Stretch for the wrist, elbow and fingers
Stretch for the wrist, elbow andfingers
Self-stretch for the calf
Self-stretch for the knees
Self-stretch for the knees
Deep breathing
Postural drainage
Postural drainage for older children
Assisted coughing

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Page 2

EXERCISE CHART
(for recording the exercises you do and the order in which you do them)
Date plan devised:
Exercise numbers:

Date plan reviewed:
Exercisenumbers:

Date plan reviewed:
Exercise numbers:

Date plan reviewed:
Exercise numbers:

Date plan reviewed:
Exercise numbers:

Date plan reviewed:
Exercise numbers:

Date plan reviewed:
Exercise numbers:

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3:11 PM

Page 3

1 STRETCH FOR THE ANKLES

Position
The child lies on his or her back and is encouraged to go floppy and relax.
The helperstands on one side.
Place one hand on the sole of the foot with the fingers pointing towards
the heel.
Grasp the heel, firmly but gently, between the fingers and thumb.
Hold the knee straight with the other hand but do not push down on it.
Stretch
Look at your child so that you can see the face.
Gently, but firmly, pull down on the heel, as if trying to make the leg longer,
and push the frontof the foot up to a right angle (dorsiflexion) or as far as
possible.
Do not let the knee bend.
You will find it easier and less tiring if, rather than just using the strength of
your arms, you lean towards the child’s head transferring your weight from
one foot to the other as you push the foot up with your forearm.
If you encounter some tightness or resistance to the movement, maintain
thepressure for a little and then gradually increase it again to move the
foot a few more degrees.
It may be helpful to ask the child to try to pull up his or her foot as you
stretch.
Hold ____________________ seconds

Repeat _________________ times

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3:11 PM

Page 4

2 STRETCH FOR THE KNEES

Position
To stretch the knee flexor muscles at the back of thethigh the child must
lie on his or her back.
Bend one leg so the hip and knee are at right angles (90 degrees).

Stretch
Gradually straighten the knee keeping the thigh still.
The other leg should be kept down flat.

Hold ______________________________ seconds ( There is evidence to
advocate holding stretches for 15-20 seconds to allow the muscle to
accommodate it.)
Repeat____________________________ times

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3a

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Page 5

STRETCH FOR THE HIPS

Position
The child lies on one side with the underneath leg bent and the top leg
straight.
Stand behind and place one hand on the child’s pelvis to steady it and slide
your other hand under the lower thigh of the top leg.
Stretch
Draw the leg back towards you, so stretching the hip...