Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2016, 5, 10:182-186 182 Early Therapeutic intervention for Limb Girdle Muscular Dystrophy in Late Adolescence – A Case Report Shefali Gambhir 1 , Narkeesh Arumugam 2 and Kanimozhi D. 3 1,2,3 Department of Physiotherapy, Punjabi University, Patiala, 3 MMIPR, Mullana _____________________________________________________________________________________________ ABSTRACT This paper reports the benefits of strength & endurance training based programme in the early rehabilitation of Limb girdle muscular dystrophy (LGMD) patient. LGMD is an autosomal X-linked disorder, mainly involve shoulder & pelvic muscles with variable rate of progression occur in first & second decade of life. An intervention of 30 days ( 5 days per week for 6 weeks) was given to the patient & prognosis was observed on various outcome variables like Muscular dystrophy Functional Rating Scale (MDFRS), Berg Balance Sclae (BBS) & Brroke & Vignos Scale before & after the intervention. Considerable improvement was seen by applying both theory of strength & endurance training in patient with LGMD. Keywords- LGMD, Muscular Dystrophy, Endurance training, Physiotherapy, Strength _____________________________________________________________________________________________ INTRODUCTION Limb-girdle muscular dystrophy (LGMD) is a purely descriptive term, generally reserved for childhood- or adult- onset muscular dystrophies that are distinct from the much more common X- linked dystrophinopathies, which include Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) (Pegoraro, 2007). Walton and Nattrass first proposed limb-girdle muscular dystrophy (LGMD) as a nosological entity in 1954. Their definition included the following characteristics: • Expression in either male or female sex • Onset usually in the late first or second decade of life (but also middle age) • Usually autosomal recessive and less frequently autosomal dominant • Involvement of shoulder or pelvic-girdle muscles with variable rates of progression • Severe disability within 20-30 years • Muscular pseudohypertrophy and/or contractures uncommon LGMDs are typically nonsyndromic & like other muscular dystrophies, is primarily a disorder of voluntary/ skeletal muscles. These are the muscles you use to move the limbs, neck, trunk and other parts of the body that are under voluntary control. Individuals with LGMD generally show weakness and wasting restricted to the limb musculature, proximal greater than distal. Proximal weakness refers to weakness of the muscles closer to the centre of the body (including the shoulder, pelvic girdle, upper thighs, and upper arms). Distal weakness refers to weakness in muscles farther from the centre of the body (including lower legs and feet, lower arms and hands) (Pegoraro, 2007). Often, people with LGMD first notice a problem when they begin to walk with a “waddling” gait because of weakness of the hip and leg muscles. They may have trouble getting out of chairs, rising from a toilet seat or climbing stairs. Onset, progression, and distribution of the weakness and wasting may vary considerably among individuals and genetic subtypes the involuntary muscles, except for the heart (which is a special type of involuntary muscle), aren’t affected in LGMD. Digestion, bowel, bladder and sexual function remain normal. The brain, intellect and senses also are unaffected in LGMD. Cardiopulmonary complications sometimes occur in later stages of the disease (MDA). Over time, muscle weakness and atrophy can lead to limited mobility and disability Establishing the Diagnosis (Pegoraro, 2007)