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Meeting report: Translating exercise research in dystrophinopathy to the clinic
Donovan J Lott1, Tina Duong2, Rachel Schrader3
1Department of Physical Therapy, University of Florida, Gainesville, FL, USA.
Objective:
To integrate current evidence and expert consensus on safe, effective exercise prescription in Duchenne and Becker muscular dystrophy (DMD/BMD), translating key pathophysiological principles into practical clinical guidance.
Methods:
Proceedings from the June 2025 Parent Project Muscular Dystrophy meeting, Translating Exercise Research in Dystrophinopathy to the Clinic, were synthesized. Faculty reviewed dystrophinopathy pathology and exercise physiology, analyzed data from clinical trials and pilot studies, summarized outcome-measure selection, and discussed pragmatic solutions to overcome barriers. Through interactive discussion, expert opinion on clinical management was aligned with exercise prescription frameworks (FITT) and clinic resources.
Results:
Exercise modality and dosing are understudied in dystrophinopathies yet represent critical factors for safe and effective interventions. In DMD, assisted low-intensity cycling can stabilize function and moderate isometric protocols can increase strength without evidence of injury. In BMD, aerobic training and supervised low-intensity resistance generally improve fitness/strength, whereas high-intensity loads may pose risks. Pragmatic assessments support monitoring and anticipatory care. Individualized prescriptions, supervised onboarding, and social engagement may mitigate dosing uncertainty, equipment access, and adherence barriers. The clinical framework should emphasize movement observation, postural strategies, oculomotor and cognitive-motor screening, and documentation for insurance coverage. Safety guidance emphasizes physician clearance, submaximal dosing, fatigue management, and clear "red flag" escalation pathways.
Conclusion:
Contemporary data and expert consensus support integrating conservative, systematically monitored exercise as an essential adjunct to DMD/BMD care. Available evidence indicates low-to-moderate aerobic activity and moderate-intensity isometric exercise appear feasible and safe when individualized and supervised. Further controlled studies should refine dosing and strengthen disease-stage-specific guidance.
