**Acknowledgements**

*Muscular Dystrophies*

**Table 1.**

of daily passive stretches, stood and walked for some periods of the day, had a tenotomy of the calcaneus tendon, transferred posterior tibial tendon and applied KAFO-type orthoses. After 2 years of the use of bracing, the calcaneus contractures were identical in those patients who performed and who did not perform surgeries. Near the fourth-year post-bracing, however, patients who did not undergo surgery had more severe contractures. Five to 7 years after the operation and the use of bracing, the management of contractures was still good, especially in those patients

Flexibility Passive/active Daily Low 3x (10–30 seg)

Variable 1–6 per week

1–5 per week

Hydrotherapy

Muscular strength Isokinetic Variable

Knee contractions were controlled 5 to 7 years after the placement of bracing, with or without surgery. Patients who used bracing were able to walk for an average of 13.6 years, and even after they lost the ability to walk with bracing, the use of orthoses allowed these patients to remain in orthostasis for an additional 2 years. Another study [17] also reinforces the prolongation of gait and orthostasis with the aid of KAFO-type orthoses, but there is no clarification as to whether it is possible to prolong gait functionally. These procedures are just suggestions. It is up to the technician to choose the most suitable resources available to his/her patients. It is important to note that fatigue and myalgia on the day after the physical therapy session indicate that there was an excess in the number of exercises and their repetitions and that the intensity should be decreased and have more time to rest. Therefore, the main objective to be achieved is to improve the quality of life and the functionality of these children. The quality of life of an adult can be improved by increasing their independence. For the child, the improvement of their quality of life implies the action of playing,

**Type Frequency Intensity Duration**

Low Variable

Low Variable

1–20 minutes

1–3 series 5–15 repetitions

In the late stages of the life of the DMD patient, the goal is to comfort the patient: treat pain and dyspnoea, provide palliative care, meet the psychosocial and spiritual needs of the patient and family and respect the patient's and family's

A literary survey can be observed that the treatment in pediatrics with the use of hydrotherapy is quite effective in the pathologies that were mentioned for the accomplishment of this work. It can be concluded that the treatment of children in

Neurofunctional intervention has much to do with DMD and DMB, as patients with these conditions cannot be seen only due to their limitations caused by neurological diseases, which need not only motor care. They need to be seen as people who need interdisciplinary action, since complications occur in the orthopedic and cardiorespiratory fields (not counting other needs, such as psychological and

who performed posterior tibial tendon transfer.

Resistance exercises Short walking

*General exercises guidelines for patients with DMD [18].*

choices in what examination and treatment (**Table 1**).

aquatic environment has a great value, due to its positive effects.

however, in a functional way.

**4. Conclusions**

nutritional monitoring).

**84**

This work is supported by national funding through Portuguese Foundation for Science and Technology, IP., DTP/04045/2019 and UID/CED/00194/2019.
