Presenter: HPM
Dabare
Affiliations: General Sir
Joghn Kotelawala Defence University, Sri Lanka
Presentation Type: Oral Presentation (In-Person)
🧬 Exercise Adherence in Children with Duchenne
Muscular Dystrophy (DMD): Facilitators and Barriers in a Sri Lankan Pediatric
Setting
📌 Introduction
Duchenne Muscular Dystrophy (DMD)
is a progressive genetic disorder characterized by muscle degeneration and
weakness, typically diagnosed in early childhood. Although relatively uncommon,
DMD significantly affects mobility, independence, and overall quality of life.
While there is currently no
definitive cure, structured exercise programs play an essential role in
maintaining functional ability, delaying complications, and improving daily
living outcomes. However, maintaining consistent adherence to prescribed
exercise programs remains a challenge. Understanding both the facilitating
factors and barriers is crucial for improving long-term rehabilitation outcomes.
🎯 Study Objective
This study aimed to explore the
factors influencing exercise adherence among children diagnosed with DMD
attending Lady Ridgeway Hospital (LRH), Sri Lanka.
🧪
Methodology
A qualitative cross-sectional
study was conducted among 30 children diagnosed with DMD at LRH, Borella.
🔹 Sampling and Ethical Considerations
·
Convenience
sampling was used.
·
Ethical
approval was obtained from the Faculty of Medicine, General Sir John Kotelawala
Defence University and Lady Ridgeway Hospital.
·
Written
informed consent was obtained from parents/guardians.
🔹 Data Collection Methods
Data were gathered using multiple
approaches to ensure comprehensive insights:
·
Pre-tested
interviewer-administered questionnaires for parents/guardians
·
Anthropometric
measurements (height, weight, BMI calculation)
·
Focus
group discussions (FGDs) with parents and children
·
In-depth
interviews with pediatric physiotherapists
Data from qualitative components
were analyzed using an inductive thematic approach, while quantitative data
were processed using SPSS version 25.
📊 Participant Characteristics
·
Mean
age of children: 9.9
± 3.0 years
·
Mean
age of mothers: 38.9
± 5.9 years
·
Mean
age of fathers: 43.7
± 7.6 years
·
Mean
BMI of children: 17.6
± 5.3 kg/m²
·
Clinic
visit completion rate: 89.2
± 13.4%
These findings indicate relatively
good clinic attendance but varying physical and socioeconomic contexts.
🗣 Insights from Parents and Guardians
Multiple focus group discussions
revealed key themes related to exercise adherence.
🔹 Perceived Benefits and Challenges
Parents recognized the importance
of exercise in maintaining mobility and slowing disease progression. However,
they also reported fatigue, discomfort, and emotional distress as challenges.
🔹 Child Motivation and Behavioral Responses
Parents described varying levels
of child cooperation, influenced by mood, disease progression, and peer
comparison.
🔹 Parental Support Strategies
Caregivers used encouragement,
structured routines, and supervision to improve adherence. Education level and
awareness influenced consistency.
🔹 Positive Influences
·
Strong
family support
·
Clear
physiotherapy guidance
·
Parental
belief in benefits
·
Regular
clinic follow-up
🔹 Negative Influences
·
Transportation
difficulties
·
Financial
constraints
·
Limited
access to facilities
·
Physical
fatigue and disease severity
👩⚕️ Perspectives from
Physiotherapists
In-depth interviews with ten
pediatric physiotherapists highlighted additional challenges.
🔹 Treatment-Related Difficulties
·
Limited
resources
·
Time
constraints
·
Progressive
nature of DMD affecting compliance
🔹 Parent and Patient Attitudes
Physiotherapists noted that
positive parental involvement strongly influenced adherence. Conversely, fear,
misconceptions, or frustration reduced consistency.
🔹 Professional Observations
Clinicians emphasized the
importance of early intervention, continuous counseling, and individualized
exercise planning to optimize outcomes.
🌍 Socioeconomic and Environmental Factors
The study identified several
broader determinants affecting exercise adherence:
·
Household
income
·
Parental
education level
·
Transportation
access
·
Home
environment suitability
·
Social
and emotional support systems
These contextual factors play a
significant role in shaping rehabilitation behaviors.
🧠
Conclusion
This study provides valuable
insights into the complex interplay of social, economic, environmental, and
personal factors influencing exercise adherence among children with DMD in Sri
Lanka.
While family support and positive
healthcare guidance act as strong facilitators, barriers such as transportation
difficulties, financial limitations, and physical fatigue hinder consistent
participation.
Addressing these challenges
through multidisciplinary support, caregiver education, and improved accessibility
may significantly enhance rehabilitation adherence and long-term quality of
life for children living with DMD.
👩⚕️ About the Speaker
Dr. Prasangi Dabare is an academic and senior lecturer in
physiotherapy, currently serving as the Head of the Department of Physiotherapy
at the Faculty of Allied Health Sciences, General Sir John Kotelawala Defence
University, Sri Lanka. With a profound background in both clinical practice and
academic research, Dr. Dabare has made significant contributions to the field
of physiotherapy, particularly in pediatric and geriatric care, physical
activity among children and adolescents, and body composition analysis methods.
🌍 Join the Global Conversation
Event:
International Conference on Pediatrics, Neonatology & Child Health
📅 March
26–28, 2026
📍 Singapore
& Online
🔗 Website: https://pediatrics.miconferences.com/
🔗 Register: https://pediatrics.miconferences.com/register
🔗 Abstract
Submission: https://pediatrics.miconferences.com/abstract-submission
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