Adapted Exercise Training: A Therapeutic Component for Managing Duchenne and Becker Muscular Dystrophy
I. Goldfarb
Duchenne muscular dystrophy and Becker muscular dystrophy are progressive neuromuscular disorders characterized by muscle degeneration, chronic inflammation, and the replacement of muscle tissue with fat and fibrosis. These changes impair skeletal-muscle, cardiac, and pulmonary function, leading to a progressive functional decline, loss of independence, and premature mortality. Historically, concerns about exercise-induced muscle damage have contributed to physical inactivity and sedentary behavior among individuals with these disorders, further reducing muscle strength, physical function, metabolic health, and quality of life. Recent evidence supports appropriately prescribed exercise as an important component of multidisciplinary disease management. Supervised light-to-moderate aerobic exercise, submaximal resistance training, and regular stretching can help preserve ambulatory function, improve muscle strength, modulate inflammatory and muscle regenerative processes, and slow functional decline. Exercise may also reduce secondary complications, including sarcopenic obesity, low bone density, and cardiopulmonary impairment, while enhancing self-efficacy, social participation, and overall well-being. Physical-education teachers, physiotherapists, sport-medicine physicians, and exercise professionals are central to translating scientific evidence into individualized clinical, educational, and community-based practice. Exercise prescription should be guided by frequency, intensity, time, and type, while accounting for disease severity, ambulatory status, functional capacity, and load management. Collaboration among healthcare professionals, families, and peers is essential for adherence and sustained participation. This review paper integrates current genetic, clinical, and functional evidence with practical recommendations for individualized exercise training in children, adolescents, and young adults with muscular dystrophy. It highlights adapted exercise as a safe and valuable component of multidisciplinary care aimed at preserving function, improving health outcomes, and enhancing quality of life.