Chiropractic Care in Muscular Dystrophy: Safety Considerations

Introduction to Muscular Dystrophy

Muscular dystrophy is characterized by progressive muscle weakness and loss of function requiring specialized multidisciplinary care 1
Respiratory complications worsen over time, requiring specialized respiratory support 2, 3

Muscle weakness can lead to joint instability, increasing the risk of injury during manipulation 1
Progressive scoliosis affects nearly all DMD patients after losing independent ambulation, which could be worsened by spinal manipulation 4
Respiratory compromise may be exacerbated by certain positioning required during chiropractic procedures 2, 3

The American Academy of Neurology recommends regular assessment by specialized healthcare providers including neurologists, orthopedic surgeons, and rehabilitation specialists 1
Preventive measures to maintain muscle extensibility and minimize contractures through appropriate physical therapy are recommended by the American Academy of Physical Medicine and Rehabilitation 1
Careful monitoring of respiratory function with specialized interventions as needed is advised by the American Thoracic Society 3, 5

Patients require regular monitoring of respiratory parameters, such as forced vital capacity (FVC) and peak cough flow (PCF) 3, 5
Positioning during procedures can compromise respiratory function in patients with weakened respiratory muscles, according to the American Journal of Respiratory and Critical Care Medicine 2
Sleep-disordered breathing is common and requires specialized management, as recommended by the American Academy of Sleep Medicine 6

Nearly all DMD patients develop scoliosis after losing ambulation, which is a concern for orthopedic management 4
Joint contractures develop progressively and require careful management, as advised by the American Academy of Orthopaedic Surgeons 1

Careful respiratory assessment beforehand is necessary, along with monitoring of oxygen saturation and carbon dioxide levels, as recommended by the American College of Chest Physicians 7
Availability of appropriate respiratory support and avoidance of certain anesthetic agents that may trigger complications are crucial during procedures 7