Are high-load resistance training and eccentric exercises recommended for children with Duchenne muscular dystrophy?

• A. Only with supervision
• B. For older children
• C. Yes
• D. No

Answer: (D)

In Duchenne muscular dystrophy, muscles are particularly fragile because the absence of dystrophin makes the muscle cell membranes more susceptible to damage from contraction. High-load resistance training and eccentric (lengthening) exercises impose greater mechanical stress on muscle fibers, which can lead to more membrane disruption, inflammation, and accelerated muscle degeneration. Because the goal in DMD is to preserve function and avoid triggering further damage, these high-stress loading strategies are not recommended for children with the condition. Instead, activity programs focus on low-intensity, submaximal, functional movements with careful monitoring, aiming to maintain range of motion and overall function without provoking muscle injury.

Other options imply that some form of loading or eccentric work could be appropriate or beneficial, but the inherent vulnerability of dystrophic muscle makes high-load and eccentric approaches unsafe regardless of supervision or age.