Aquatic training improves muscle strength and functional mobility in adults with myotonic dystrophy type 1: a pilot randomized trial.

Myotonic dystrophy type 1 (DM1) is the most common adult muscular dystrophy and is characterized by progressive muscle weakness and reduced functional mobility. Management mainly relies on non-pharmacological interventions such as strength and aerobic training. Aquatic training is frequently used in neuromuscular disorders because of water's supportive properties, but its effects in DM1 remain undocumented. This pilot study aimed to assess the effects of aquatic training on muscle strength, functional mobility, and quality of life in adults with DM1. Twenty-two adults with DM1 were randomly assigned to either an aquatic or land-based training group. Both groups completed two 1-h sessions per week for 12 weeks. Sessions included a warm-up, 30 min of resistance exercises, 15 min of ball-passing games, and a cooldown period. Exercise intensity was based on perceived exertion ("somewhat hard" to "hard" on the Borg scale). Outcomes assessed before and after training included the 6-Minute Walk Test (6MWT), Manual Muscle Testing, Timed Up and Go (TUG), SF-36, and MHAVIE. The 6MWT distance did not improve significantly. However, several upper- and lower-limb strength measures improved in the aquatic group (p < 0.05), whereas only shoulder abduction, elbow supination, and hip extension improved in the land group. SF-36 scores improved in both groups, while TUG performance improved only in the aquatic group (p < 0.05). Both interventions improved quality of life, but aquatic training was more effective than land-based training in improving shoulder and ankle strength as well as functional mobility.