The progressive muscle weakness that occurs in Duchenne muscular dystrophy (DMD) is known to be associated with secondary muscle tightness and contracture. The Achilles tendon (TA) and calf muscle complex (gastrocnemius and soleus) is typically one of the earliest and most severely affected muscle groups. It has been noticed clinically that there is a subset of boys who develop surprisingly early shortening in the presence of well-preserved lower limb muscle strength. A small prospective study has commenced to assess the effects of short term below knee serial casting on muscle length as well as strength, physical function and endurance. Tight inclusion criteria ensure that only boys with good anti-gravity muscle strength and range of motion at hip and knee are included. Outcome measures include goniometry, myometry, timed function tests, the North Star Ambulatory Assessment, Six Minute Walk Test, falls frequency and measurement of gait parameters using the GAITRite system. Early data will be presented.
