Longitudinal Course of Myotonic Dystrophy Type 1 With Gait Training Using a Hybrid Assistive Limb: A Case Report

Muscle dystrophy type 1 is the most common form of muscular dystrophy and is characterized by progressive distal dominant muscle weakness, muscle atrophy, and myotonic phenomena. Patients with progressive neuromuscular diseases such as myotonic dystrophy type 1 are prone to muscle weakness, movement disorders, and fatigue due to their underlying disease, which may limit their physical activity and ambulation. Six courses of gait training with a hybrid assistive limb (HAL) were performed in an adult male with myotonic dystrophy type 1 over 4.5 years. The two-minute walking distance and knee joint strength tended to increase, and the Timed Up and Go test time tended to decrease with gait training with HAL before and after each intervention. In the long term, the two-minute walking distance decreased slowly, but the Timed Up and Go and knee joint strength tended to be maintained. Functional ambulation category and activities of daily living levels were also maintained. These results suggest that intermittent gait training may be an effective rehabilitation method for maintaining gait independence and activities of daily living in patients with myotonic dystrophy type 1. The frequency and number of interventions should be considered for further effectiveness.