UNIVERSIDADE FEDERAL DE SÃO PAULO ESCOLA PAULISTA DE MEDICINA DEPARTAMENTO DE NEUROLOGIA E NEUROCIRURGIA Setor de Investigação de Doenças Neuromusculares Aquatic Activities for Children and Youth with Muscular Dystrophy: Aspects to be Considered Caetano RB, Fontes SV, Oliveira ASB Background: Aquatic activities are often muscular weakness. requested by parents or indicated by doctors at According to additional research, practical experience Neuromuscular a and knowledge of professionals at Neuromuscular supportive treatment to improve quality of life in Disease Unit, there are some relevant aspects to children with Muscular Dystrophy (MD). discuss related to water immersion and exercises with Disease Purpose: Unit at Unifesp as MD as: Cardiovascular System; Exercise Training; Review available evidence regarding aquatic activities for children with MD and present Movement Compensation; Body Density and Compensatory Strategies. aspects to consider. Method: Electronic database search using MEDLINE, PubMed, PEDro and Cochrane established since 2000 until 2012. MD connected with keywords: water activities, aquatic therapy, hydrotherapy, water exercise and swimming. Inclusion criteria were language, intervention (aquatic activity), population (children with MD) and any study design. Additional search includes related topics to MD, water activities and immersion effects on human body. Results: Initial search identified 19 articles that Conclusion/Considerations: matched searching criteria, 18 were excluded, 2 There is insufficient high-level evidence to evaluate because of language, 5 intervention were about the effectiveness of aquatic interventions in children medication, genetic therapy or nutrition, 6 population with MD because of limitations in design and the use were adults or other neuro muscular diseases and 5 of different measurement instruments. However, the presented animal models. The included article was a available literature supports important factors to systematic review (Getz 2006), including one article consider: muscular fatigue, type of exercise training, with sample of 3 individuals with progressive severe and decompensate heart failure and respiratory distress in aquatic environment. References: Eagle M. Report on the muscular dystrophy campaign workshop: exercise in neuromuscular diseases Newcastle, January 2002. Neuromuscular disorders: NMD: NMD [Internet]. 2002 Dec;12(10):975–83. Getz M, Hutzler Y, Vermeer A. Effects of aquatic interventions in children with neuromotor impairments: a systematic review of the literature. Clin Rehabil. 2006 Nov;20(11):927–36. Caetano RB, Sá CSC de, Fávero FM, Oliveira ASB, Fontes SV. Tradução e Adaptação Cultural para o Brasil Das Escalas De Habilidades Aquáticas , Aquatic Independence Measure ( AIM ) e Water Orientation Test Alyn ( Wota 1 e 2 ): Versão Preliminar. Universidade Federal de São Paulo; 2011. p. 200. Cardiac Involvement Determines the Prognosis of Duchenne Muscular Dystrophy. Pediatric Cardiology. 2007;74:2007–2007. Bockel EAPV, Lind JS, Zijlstra JG, Wijkstra PJ, Meijer PM, Berg MPVD, et al. Cardiac assessment of patients with late stage Duchenne muscular dystrophy. Heart. 2009;17(6):232–7. Chaves ACX. Doenças Neuromusculares - Atuação da Fisioterapia - Guia Teórico e Prático Coordenadoras ... [et al.]. - São Paulo: Roca, 2012. 1st ed. Roca; 2012. Bleijenberg G, Zwarts MJ, Padberg GW. Muscle Fatigue In Muscular Dystrophies. In: Williams CA, Ratel S, editors. Human Muscle Fatigue. 1st ed. Routledge; 2009. p. 285–312. Blaauw B, Agatea L, Toniolo L, Canato M, Quarta M, Dyar K a, et al. Eccentric contractions lead to myofibrillar dysfunction in muscular dystrophy. Journal of applied physiology (Bethesda, Md. : 1985) [Internet]. 2010 Jan [cited 2011 Jul 22];108(1):105–11 Gaudreault N, Gravel D, Nadeau S, Houde S, Gagnon D. Gait patterns comparison of children with Duchenne muscular dystrophy to those of control subjects considering the effect of gait velocity. Gait & posture [Internet]. Elsevier B.V.; 2010 Jul [cited 2011 Sep 15]; 32(3):342–7.