Page 16 - A Guide to Physical and Occupational Therapy for CMT

Foot and Ankle Weakness
Exercise has undisputed health
benefits and is potentially therapeutic
for neuromuscular disorders such as
CMT. But there is a risk of harm from
overexertion and weakness. Progressive
foot dorsiflexion weakness, also called
foot drop, due to axon degeneration, is a
debilitating problem in patients with CMT
that can cause difficulty walking, painful
deformities and reduced quality of life. To
date, exercise trials for CMT have been
limited to adults, proximal muscles and
short-term outcomes
(www.cmtausa.org/exercise-abstract).

In Australia, a team of rehabilitation professionals led by professor Joshua
Burns, PhD, recently conducted a randomized controlled trial demonstrating
that six months of progressive resistance exercise of ankle dorsiflexors was
safe and effective in delaying strength loss in children and adolescents with
CMT. This was the first randomized controlled trial to assess exercise therapy
for pediatric CMT. It was found that six months of targeted moderate-intensity
progressive resistance exercise of the foot dorsiflexors preserved long-term
dorsiflexion strength without detrimental effect on the muscle size or shape and
without producing other signs of overwork weakness. This trial provides
evidence that the concept of progressive resistance exercise is safe and
effective, and based on other studies in adults of similar muscle groups,
suggests that progressive resistance exercise will also be safe and effective for
other muscle groups under appropriate guidance and supervision.