Rehabilitation approach to spinal muscular atrophy

Abstract

Spinal muscular atrophy is a genetically inherited severe neuromuscular disease due to degeneration of alpha motor neurons in spinal cord and brainstem. SMA is divided into clinical subtypes using the age of onset and achieved development milestones. It is characterized by tetraparesis with a proximal pattern, affecting predominately the lower limbs and hypotonia. Recently, the paradigm of SMA has changed after approval of the first disease-modifying therapy. The pharmacological treatment will have a better outcome if accompanied by a structured rehabilitation care program. In this review, we discuss the management of feeding and swallowing disorders, musculoskeletal deformities, sleep disorders and pulmonary impairment. We will review the therapeutic approaches, including positioning, stretching and exercise, as well as assistive devices prescription.