Table 2.

Multidisciplinary Domains, Assessments, and Interventions for the NMD Team

Multidisciplinary Domains	Tools / Assessments	Interventions
Diagnostics (Neuromuscular medicine specialist, geneticist, pathologist)	Biomarkers (e.g. Creatine Kinase) Electrodiagnostics Molecular Genetics Muscle Biopsy	Genetic Counseling Family Support
Medication Management (Neuromuscular medicine specialist, neurodevelopmental pediatrician, physiatrist)	Clinical Evaluation Strength Function Range of Motion	Considerations Age of patient Stage of disease Risk factors for side-effects Available medications Choice of regimen Side-effect monitoring and and prophylaxis Dose alteration
Rehabilitation Management	ROM Strength Posture Function Alignment Gait	Stretching Positioning Splinting Orthoses Submaximum exercise / activity Seating Standing devices Adaptive equipment Assistive technology Strollers/scooters Manual / power wheelchairs
Orthopedic Management	Assessment of ROM Spinal assessment Spinal radiograph Bone age (left wrist and hand radiograph) Bone densitometry	Tendon surgery Osteotomies / arthrodesis Posterior spinal fusion
GI, speech/ swallowing, nutrition management	Upper and lower GI investigations Anthropometry	Diet control and supplementation Gastrostomy Pharmacological management of gastric reflux and constipation
Pulmonary Management	Spirometry Static Airway pressures (MIP/MEP) Peak cough Flow Pulse oximetry Capnography / End tidal CO2 ABG Sleep Studies / Polysomnography	Volume recruitment Noninvasive Ventilation (via mask and nasal interfaces) Invasive Ventilation (via tracheostomy) Airway Clearance (Mechanical insufflator/Exsufflator, Theravest) Immunizations
Cardiac management	ECG Echo Holter Cardiac MRI	ACE inhibitors Angiotension Receptor Blockers β blockers Diuretcs Inotropes Other heart failure medication Antiarrhythmics
Psychosocial management	Coping Neurocognitive Speech and language Autism Social work	Psychotherapy Pharmacological interventions Social support Educational support Palliative / Supportive care