Hesperian Health Guides

Helping the Child to Keep Walking for As Long As Possible

Walking uphill and hillside farm work help prevent tiptoe contractures of the ankles.
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Exercise. To keep as strong as possible and prevent contractures, probably the best therapy, at least at first, is to stay active, to walk, run, and play. While range-of-motion and stretching exercises may help (see Chapter 42), it is even better to involve the child in games, work, and other activities that keep his joints flexible. Even though he is slow and awkward, encourage him to take part. Feeling sorry for him and just letting him sit is the worst thing you can do.

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Braces. Long-leg braces should not be used until absolutely necessary, as they will let the child’s legs grow weaker faster. Sometimes lightweight plastic ankle splints, worn day and night, will help delay ankle contractures and keep him walking better. (See Chapter 58.)

If contractures of the knees and hips begin to develop, try resting or sleeping with ‘sand bags’ to press down the legs and help straighten them.

child lies down with sand bags and splints
bags made of soft cloth filled with clean sand
plastic ankle splints
child lies down with sand bags and cushions
sand bag
CAUTION! Balance your efforts to provide therapy or surgery against the need of the child (and his family) to lead as full, happy, and normal a life as possible. His weakness will increase and his life will be short regardless of all efforts. The goal of all care for the child with muscular dystrophy should be to help him get the most out of living NOW. The temporary benefits of surgery should be weighed against the pain and hardships it would involve.
Other aids. The child will reach a point where he needs to use crutches. Later, (often by age 10) he will not be able to walk. Do not force him when it becomes too hard. Instead, try to obtain or make a wheelchair. (See Chapters 64 to 66.) At first, the child may be able to roll it himself. But as his weakness progresses, he may need to be pushed. DVC Ch10 Page 111-5.png A wide cloth or canvas strap across his belly and chest may allow the child to play, to lean forward, and to use his arms more freely.
Breathing deeply is important, especially when the muscles that move the lungs begin to weaken. Encourage the child to sing loudly, to shout, to blow whistles, and to blow up balloons.
child shouts across a field
Shouting and climbing are both good exercises for the lungs.

This page was updated:21 Nov 2019