Table 4.

Treatment of Manifestations in Individuals with Spinal and Bulbar Muscular Atrophy

Manifestation/ConcernTreatmentConsiderations/Other
UMN & LMN
involvement / ADL 		Physical medicine & rehab / PT & OTAnkle-foot braces, walkers, wheelchairs, hospital beds, toileting equipment, lifts to improve functionality
Dysarthria Speech/language therapyUse of augmentative communication devices
Dysphagia Feeding eval & therapy
  • Safe swallowing techniques, diet modifications, education re cutting food into small pieces for eating & avoiding items that may be difficult to chew & swallow
  • Gastrostomy tube as needed
Gynecomastia Breast reduction surgery as needed
Cardiac & other
manifestations 		Standard treatment per cardiologist &/or endocrinologistMonitor blood sugar, lipids, & cholesterol for insulin resistance & nonalcoholic fatty liver disease.
Family/caregiver
support & resources 		Psychosocial support & education via caregiver & patient support groupsTo ↓ stress & burden on caregivers

ADL = activities of daily living; LMN = lower motor neuron; OT = occupational therapy; PT = physical therapy; UMN = upper motor neuron

From: Spinal and Bulbar Muscular Atrophy

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