The effects of hydrotherapy on muscle strength, body composition, and quality of life in boys with Duchenne dystrophy

Duchenne muscular dystrophy (DMD) is one of the most rampant x-linked recessive lethal genetic disease with prevalence of approximately 1 out of 3500-5000 newborn boys worldwide. DMD is mutations-induced in gene encoding dystrophin that prevent the production of the muscle isoform of dystrophin (Dp427m). This study aims to evaluate the impact of hydrotherapy on health-related quality of life and body composition changes, as well as how it affects on skeletal muscle strength in boys with DMD.  Eight boys, ranging from 6 to 12 years old with DMD were enrolled in this study. The patients were randomly assigned to either a hydrotherapy group as the intervention group (Group 1; n=4) or a non-exercise group as the control group (Group 2; n=4), to receive 12 sessions of a hydrotherapy program. The patients were assessed for changes in muscle strength in the lower limbs and back, left and right quadriceps, left and right-hand grip, LBM, SMM, and general mobility and balance, before and after hydrotherapy. Significant improvements in general mobility and balance were observed, along with a significant increase in muscle strength and lean body mass (P<0.05). This study suggests that hydrotherapy with a precise protocol of low to moderate intensity can improve general mobility and balance, increase muscle strength in the lower limbs and back, left and right quadriceps, left and right-hand grip, and LBM in patients with DMD. The increase in strength is accompanied by increase in LBM, which not only has implications for function but also has much broader impacts on the health-related quality of life in patients.