Physical Therapy, Optimizing Function in Neuromuscular Diseases: Megan Iammarino, PT, DPT

WATCH TIME: 5 minutes

“With the addition of all these new treatments that are available, it changes how our supportive therapies—such as physical therapy and occupational therapy—are structured and how we're going to intervene. Previously, it was all supportive therapies or comfort care as we wanted to make the patient as comfortable as possible and limit secondary impairments. Now that there are treatments available, we have the opportunity to optimize function in these younger patients. It's changing the whole landscape of the way that we look, treat, and evaluate pediatric patients with [spinal muscular atrophy].”

Conversations in the neuromuscular field have shifted in recent years thanks to advances in spinal muscular atrophy (SMA), and specifically, the introduction of 3 FDA-approved therapies. It began in 2016, when nusinersen (Spinraza; Biogen) became the first approved therapy to treat SMA.¹ Following that approval, in May 2019, onasemnogene abeparvovec-xioi (Zolgensma; AveXis), a gene therapy, was approved for the treatment of SMA in pediatric patients less than 2 years of age with mutations in the SMN1 gene.² And finally, in May 2022, risdiplam (Evrysdi; Genentech) gained approval as a treatment for presymptomatic babies under 2 months old with SMA.³ These treatments changed the landscape of care for SMA, especially with regard to physical therapy; however, access to them remains a challenge for many patients.

Recently, at the 2023 Muscular Dystrophy Association (MDA) Clinical & Scientific Conference, March 19-22, in Dallas, Texas, Megan Iammarino, PT, DPT, presented a talk on a novel approach for optimizing the function of movement in treated pediatric patients with SMA. The rest of the talks given during the session focused on topics centered around different physical therapy interventions for patients with neuromuscular diseases.⁴

Iammarino, a research physical therapist at Nationwide Children’s Hospital, sat down with NeurologyLive® in an interview to share her thoughts on the events and sessions that happened at this year’s conference. In addition, she spoke about the current therapies that are available for SMA, as well as the important aspects of care for this patient population. She also talked about her day-to-day practice, and the challenges that still come up in the field of physical therapy for patients with neuromuscular diseases.

Click here for more coverage of MDA 2023.

REFERENCES
1. Youn B, Proud CM, Wang N, et al. Examining real-world adherence to nusinersen for the treatment of spinal muscular atrophy using two large US data sources. Advances in Therapy. Published online January 16, 2023. doi:10.1007/s12325-022-02414-9
2. AveXis receives FDA approval for Zolgensma®, the first and only gene therapy for pediatric patients with spinal muscular atrophy (SMA). News Release. Novartis. Published May 24, 2019. Accessed April 6, 2023. https://www.novartis.com/news/media-releases/avexis-receives-fda-approval-zolgensma-first-and-only-gene-therapy-pediatric-patients-spinal-muscular-atrophy-sma
3. FDA approves Genentech’s Evrysdi (risdiplam) for use in babies under two months with spinal muscular atrophy (SMA). News release. Genentech. April 6, 2023. Accessed May 31, 2022. https://www.biospace.com/article/releases/fda-approves-genentech-s-evrysdi-risdiplam-for-use-in-babies-under-two-months-with-spinal-muscular-atrophy-sma-/?s=85
4. Iammarino M. A Novel Approach to Optimizing Movement in Treated Children with Spinal Muscular Atrophy. Presented at: MDA Clinical & Scientific Conference; March 19-22, 2023; Dallas, TX. Therapy Interventions – Modify Therapy Approaches with Evolving Market Landscape session.