Effects of a hand training programme in five patients with myotonic dystrophy type 1.

The aim of this study was to evaluate hand function and self-rated occupational performance before and after specific hand training in five participants with myotonic dystrophy (MD) type 1. MD is the commonest of the muscular dystrophies with adult onset and is associated with muscle weakness, wasting and myotonia. Compensatory techniques and strategies are mostly offered as the only intervention therapy. In the present study, the participants were their own controls using pre- and post-test measures. Each participant was tested at intervals a total of nine times before and nine times after hand training. A hand-held myometer (Microfet2), Grippit, Purdue Pegboard and self-rated myotonia were used as outcome measures. Occupational performance was assessed pre- and post-test using the Canadian Occupational Performance Measurement (COPM) in which the participants rated their own performance and satisfaction in five self-chosen occupational performance areas. The participants performed hand training for a total of three months, three times per week using a specific resistance training programme including Theraputty, a silicone-based putty. Hand function was significantly increased and a positive change in self-rated occupational performance was noted after the training period. This study indicates that hand training has a positive effect on hand function, i.e. motor function and occupational performance. The present results need to be replicated in a controlled study including a larger number of patients and over a longer period of time.