Is Exercise the Right Medicine for Dystrophic Muscle?

Introduction Duchenne muscular dystrophy (DMD) is a neuromuscular disease caused by a dystrophin protein deficiency. Dystrophin functions to stabilize and protect the muscle fiber during muscle contraction, thus the absence of functional dystrophin protein leads to muscle injury. DMD patients experience progressive muscle necrosis, loss of function, and ultimately succumb to respiratory failure or cardiomyopathy. Exercise is known to improve muscle health and strength in healthy individuals as well as positively impact other systems. Because of this, exercise has been investigated as a potential therapeutic approach for DMD. Methods This review aims to provide a concise presentation of the exercise literature with a focus on dystrophin deficient muscle. Our intent was to identify trends and gaps in knowledge with an appreciation of exercise modality. Results After compiling data from mouse and human studies it became apparent that endurance exercises such as a swimming and voluntary wheel running have therapeutic potential in limb muscles of mice and respiratory training was beneficial in humans. However, in the comparatively few long-term investigations the effect of low intensity training on cardiac and respiratory muscles was contradictory. In addition, the effect of exercise on other systems is largely unknown. Conclusion In order to safely prescribe exercise as a therapy to DMD patients, multi-systemic investigations are needed including the evaluation of respiratory and cardiac muscle. Address for Correspondence: Joshua Selsby, Ph.D., 2356 Kildee Hall, Ames, IA 50011. Office: 515.294.7227. Fax: 515.294.4471. email: jselsby@iastate.edu The authors have no conflicts of interest. Partial support for HRS provided by Project Parent Muscular Dystrophy (PPMD), Ryan's Quest and Michael's Cause. The results of the study do not constitute and endorsement by the American College of Sports Medicine. © 2018 American College of Sports Medicine

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