The Effect of Dual-tasking Program on Cognitive and Physical Functions and Independence in Activities of Daily Living in Children With Duchenne Muscular Dystrophy: A Single-blind Randomized Controlled Trial

Summary

Duchenne Muscular Dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle degeneration and frequent developmental, cognitive and behavioral impairments, occurring in one in 5000 live births of boys. DMD is caused by a deficiency of the protein dystrophin, which maintains the structure and functionality of muscle cells. The absence of dystrophin leads to the weakening and eventual death of muscle cells, resulting in reduced muscle strength and impaired motor function. In early childhood, children with DMD may experience delays in basic motor skills such as walking and standing. Later in life, the disease leads to more severe motor dysfunctions, including loss of muscle strength, problems with balance and coordination, and an increased risk of falls.

DMD can also negatively affect cognitive function. Dystrophin is found not only in muscles but also in the brain, and its deficiency in the brain can lead to cognitive problems such as learning disabilities, attention deficits and impaired executive function. These cognitive impairments can affect the academic performance of children with DMD and their functional abilities in everyday life.

In this project, the potential effects of a dual task program designed for children with DMD on physical and cognitive functioning will be examined. Dual task training aims to increase children's capacity to perform two different tasks simultaneously, which may improve the integration of cognitive and motor functions. For example, activities such as counting while walking or answering a question while carrying an object in the hand require children to use both motor and cognitive skills simultaneously. Such exercises can increase coordination between cognitive and motor functions and improve the independence of children with DMD in activities of daily living and their overall quality of life.

The main goals of the program are to produce positive effects on motor skills and cognitive functions, improve balance and coordination, and enable children to move more independently in activities of daily living. Furthermore, this study highlights the value of a multidisciplinary approach, providing important insights into how rehabilitation approaches can be developed for individuals with a special condition such as DMD. Collaboration between physiotherapists and occupational therapists plays a critical role in providing comprehensive care for these children.

The methodology of this study included boys with DMD who were admitted to Lokman Hekim University Muscular and Nerve Diseases Application Center. The children will be randomly assigned to the intervention and control groups, and the children in the intervention group will be enrolled in a dual task performance program for two days a week, one session a day, 45 minutes each session, for eight weeks, with at least two days in between. The effectiveness of the program will be measured using various motor and cognitive assessment tools.

The hypotheses of this study are that dual task training will positively affect motor and cognitive and physical functions in children with DMD, improve balance and coordination, and increase the level of independence of these children in activities of daily living. In conclusion, this project aims to contribute to the development of innovative approaches in the treatment of children with DMD. This approach can improve the overall quality of life of children, as well as support their social participation and educational achievement.

Conditions

• Duchenne Muscular Dystrophy (DMD)

Interventions

OTHER

Conventional physiotherapy program

Breathing exercises such as thoracic extension Stretching exercises for upper and lower extremity muscles Active-assisted, active and low resistance exercises for lower and upper extremity muscles according to muscle strength They will be asked to perform a home program including functional exercises (going up and down stairs, taking steps, etc.) at least 5 days a week, 2 times a day. The exercises will be checked by phone once a week and regular participation in the program will be ensured.

OTHER

Conventional physiotherapy program + Dual task program

Breathing exercises such as thoracic extension Stretching exercises for upper and lower extremity muscles Active-assisted, active and low resistance exercises for lower and upper extremity muscles according to muscle strength They will be asked to perform a home program including functional exercises (going up and down stairs, taking steps, etc.) at least 5 days a week, 2 times a day. The exercises will be checked by phone once a week and regular participation in the program will be ensured. Dual task program: Walking 10 meters (Single task) and basic dual task introduction. Simple motor-motor tasks (e.g., holding a ball while walking). Carrying a half-full water bottle in each hand while walking. Placing or carrying objects accompanied by exercises requiring balance. Counting Counting backwards while walking. Solving simple math problems while walking Complexification of motor-motor and cognitive-motor tasks. Dual tasks similar to activities of daily living

Sponsors & Collaborators

• Lokman Hekim University

  lead OTHER_GOV

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

6 Years

Max Age

12 Years

Sex

MALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-14

Primary Completion

2027-01-15

Completion

2027-01-16

Countries

• Turkey (Türkiye)

Study Locations