Introduction
Atrophy and dystrophy are both terms related to muscular functioning. Though they appear similar, they are not exactly the same. Muscular atrophy is wasting of muscles due to loss of tissue while muscular dystrophy is a group of muscle diseases that have weakness in the muscles and leads to reduced mobility.
Muscular dystrophy causes debility and the person becomes progressively disabled as they lose the power of movement. It is a group of diseases that cause progressive weakness and loss of muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle.
Signs & symptoms
- Balance problems, difficulty walking, and falls.
- Difficulty rising from a lying or sitting position.
- Trouble running and jumping.
- Waddling gait.
- Walking on the toes.
- Large calf muscles.
- Muscle pain and stiffness.
- Learning disabilities.
- Difficulty with swallowing.
- Facial weakness.
- Gradual difficulty walking and speaking,
- Memory loss,
- Tingling or weakness of extremities.
- Impaired balance and coordination.
Causes
Genetic mutations or abnormal genes
Pathophysiology
Multiple proteins are involved in the complex interactions of the muscle membrane and extracellular environment. For sarcolemmal stability, dystrophin and the dystrophin-associated glycoproteins (DAGs) are important elements.
The dystrophin gene is located on the short arm of chromosome X near the p21 locus and codes for the large protein Dp427, which contains 3685 amino acids. Dystrophin accounts for only approximately 0.002% of the proteins in striated muscle, but it has obvious importance in the maintenance of the muscle’s membrane integrity.
Dystrophin aggregates as a homotetramer at the costomeres in skeletal muscles, as well as associates with actin at its N-terminus and the DAG complex at the C-terminus, forming a stable complex that interacts with laminin in the extracellular matrix. Lack of dystrophin leads to cellular instability at these links, with progressive leakage of intracellular components; this results in the high levels of creatine phosphokinase (CPK) noted on routine blood workup of patients with Duchenne MD.
Less-active forms of dystrophin may still function as a sarcolemmal anchor, but they may not be as effective a gateway regulator because they allow some leakage of intracellular substance. This is the classic Becker dystrophy. In both Duchenne and Becker MD, the muscle-cell unit gradually dies, and macrophages invade. Although the damage in MD is not reported to be immunologically mediated, class I human leukocyte antigens (HLAs) are found on the membrane of dystrophic muscles; this feature makes these muscles more susceptible to T-cell mediated attacks.
Physical examination including muscle bulk, tone and strength.
Medical history
MRI
Blood tests to identify mutations in some of the genes that cause types of muscular dystrophy.
Muscle biopsy.
Treatments
Currently, there is no cure for muscular dystrophy. Medications and various therapies help slow the progression of the disease and keep the patient mobile for the longest possible time.
Medications like corticosteroids and cardiac medications like beta blockers and angiotensin converting enzyme inhibitors are used. Other treatment measures are the following:
Physical therapy
General exercises:
Breathing assistance:
Mobility aids like Canes, wheelchairs, and walkers
Braces
ultrasound therapy
Treatments for muscle atrophy vary depending on the degree of muscle loss and the presence of any underlying medical conditions.
Treating the underlying condition causing the muscle atrophy may help slow down the progression of the muscle loss.
Treatments for muscle atrophy include:
Physical therapy
Physical therapy may help improve mobility in people with muscle atrophy.
Functional electrical stimulation (FES)
Focused ultrasound therapy
Surgery
Prognosis
Patients with progressive muscular atrophy have a relentlessly progressive disease course and poor prognosis. But prognosis for muscular atrophy is good as person is otherwise normal and except one group of muscles can use the rest of the muscles well, whereas in dystrophy the prognosis is bad as the patient keeps deteriorating and eventually becomes immobile. In some cases, the prognosis for people with Muscular dystrophy varies according to the type and progression of the disorder. Some cases may be mild and progress very slowly over a normal lifespan, while others produce severe muscle weakness, functional disability, and loss of the ability to walk.
Complications
Trouble walking, confined to a wheelchair.
Trouble using arms and fingers for activities.
Shortening of muscles or tendons around joints (contractures)
Breathing problems
Curved spine (scoliosis)
Heart problems
Swallowing problems
Disease & Ayurveda
Peseedourballyam/Peseekshayam
Nidana
Causative factors for the vitiation of Vaata and Kapha
Kshata-injury
Purvaaroopa
Not mentioned
Samprapti
Due to various reasons, the vitiated Kaphadosha gets lodged inn raktadhatu, mamsaddhatu and medodhatu which are very closely related and the circulation of Vaatadosha and bodyfluids are affected. Due to defective circulation and nervous supply, vitiated Kapha and Vaata doshas when get lodged in muscles, develop weakness, heaviness & pain of the muscles and restricts the body movements and locomotor functions.
Lakshana
Weakness of muscles
Heaviness of muscles
Pain & tenderness in the affected area
Inability to move and limited locomotor functions
Divisions
Not mentioned
Prognosis
Yaapyam/asaadhyam
Chikithsa
Samana
Lepanam with Rookshana dravyas
Swedanam
Mardanam (in completely vaatika)
Udwartanam
After the blockage of channels are removed by Rookshana&langhana, application of oils and nourishing therapies should be done.
Sodhana
Abhyangam
Swedanam
Virechanam
Asthapanavasti
Anuvasanavasti
Commonly used medicines
Dhanadanayanadi Kashayam
Drakshadi Kashayam
Vidaryadi Kashayam
Maharasnadi kashayam
Rasnasunthyadi kashayam
Amruthotharam kashayam
Yogarajaguggulu
Shaddharanam choornam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Measures that may provide relief from muscle problems include:
- Regular stretching exercises
- Traction and pulling
- Sona bath, steam bath etc.
- avoiding weight lifting sessions until the problem is resolved
- Stress-relief activities and exercises such as yoga and meditation to relieve tension
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil, Ragi, Flax seeds
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme climate changes.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle.
Yoga
Regular stretching and mild cardio exercises are advised according to the strength of the patient. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
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