Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care

Lancet Neurol. 2010 Feb;9(2):177-89. doi: 10.1016/S1474-4422(09)70272-8. Epub 2009 Nov 27.


Optimum management of Duchenne muscular dystrophy (DMD) requires a multidisciplinary approach that focuses on anticipatory and preventive measures as well as active interventions to address the primary and secondary aspects of the disorder. Implementing comprehensive management strategies can favourably alter the natural history of the disease and improve function, quality of life, and longevity. Standardised care can also facilitate planning for multicentre trials and help with the identification of areas in which care can be improved. Here, we present a comprehensive set of DMD care recommendations for management of rehabilitation, orthopaedic, respiratory, cardiovascular, gastroenterology/nutrition, and pain issues, as well as general surgical and emergency-room precautions. Together with part 1 of this Review, which focuses on diagnosis, pharmacological treatment, and psychosocial care, these recommendations allow diagnosis and management to occur in a coordinated multidisciplinary fashion.

Publication types

  • Review

MeSH terms

  • Ambulatory Care
  • Bone Diseases / etiology
  • Bone Diseases / therapy
  • Exercise Therapy
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / therapy
  • Heart Diseases / etiology
  • Heart Diseases / therapy
  • Humans
  • Language Disorders / etiology
  • Language Disorders / therapy
  • Muscular Dystrophy, Duchenne / complications
  • Muscular Dystrophy, Duchenne / diagnosis*
  • Muscular Dystrophy, Duchenne / psychology
  • Muscular Dystrophy, Duchenne / therapy*
  • Nutritional Requirements
  • Pain / etiology
  • Pain Management
  • Patient Care Team*
  • Physical Therapy Specialty / methods
  • Quality of Life
  • Respiration Disorders / etiology
  • Respiration Disorders / therapy
  • Treatment Outcome