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Bracing for Ambulation in Childhood Progressive Muscular Dystrophy
George E. SpencerJR.; Paul J. VignosJR.
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Department of Orthopaedic Surgery and the Department of Medicine, Western Reserve University School of Medicine, Cleveland
1962 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1962; 44:234-242 
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Abstract

1. Fifteen of seventeen patients with childhood muscular dystrophy who had ceased walking because of muscle weakness were able to walk independently again after correction of contractures and fitting of long lower-extremity braces.

2. The criterion for bracing is recent loss of the ability to walk independently or the ability to walk only with assistance in a patient who stands less than half an hour a day.

3. Contrary to previous opinion, there is enough residual muscle power for walking in braces when muscle weakness prevents independent walking.

4. When braces are needed to continue walking, the patient with muscular dystrophy has lost 60 per cent of his muscle mass.

5. It is usually necessary to correct heel-cord and iliotibial-band contractures surgically before application of braces.

6. The additional energy requirements for walking with braces have not caused any significant cardiovascular complications as far as can be determined through clinical observation aided by serial electrocardiograms and cardiac roentgenograms.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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