WHEELCHAIRS, SEATING and other EQUIPMENT
• during the earlier ambulatory stage, a scooter, stroller or wheelchair could possibly be utilized for long distances to conserve strength. When your son starts utilizing a wheelchair for lengthier periods, it becomes additional important that posture is carefully looked at, and customization of the chair is usually necessary.
• As difficulty with walking increases, it is recommended that a power wheelchair is supplied sooner as opposed to later. Ideally, the initial power wheelchair should be adapted and customized to optimize comfort, posture and symmetry. Some experts also recommend a power standing feature if available.
• With time, arm strength becomes additional of an issue. physical therapists and occupational therapists will be valuable in recommending assistive devices to help maintain independence. It is best to think proactively about the kind of equipment that will best support independence and participation and plan ahead to supply it in as timely a method as possible.
• additional adaptations in the late ambulatory and non-ambulatory stages could possibly be needed to help with getting upstairs and transferring, eating and drinking, turning in bed and bathing.
Box 6. pain Management
It is important to ask boys/young men with DMD if pain is usually a problem so that it could be addressed and treated properly. Unfortunately, very tiny is at present known about pain in DMD. additional research is needed. If your son is in pain you need to talk for your physician and explain to them that this is usually a problem.
• For efficient pain management, it is important to determine why there is pain so the physicians can supply appropriate interventions.
• as a great deal of pain results from problems with posture and difficulty getting comfortable, interventions include provision of appropriate and individualized orthoses (braces), seating, bedding, and mobility as well as standard drug treatment approaches (e.g. muscle relaxants, anti-inflammatory medications). Interactions with other medications (e.g. steroids and non-steroidal anti-inflammatory drugs [NSAIDs]) and associated side effects, especially those that may affect cardiac or respiratory function, should be considered.
• Rarely, orthopedic intervention may be indicated for pain that cannot be managed in any other way but that may respond to surgery. back pain, especially in people utilizing steroids, means the physicians should check carefully for vertebral fractures, which respond well to bisphosphonate treatment.