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Rehabilitation Practice and Science

Abstract

Dysphagia is a recognized complication in patients with muscular dystrophies, but its characteristics in Becker muscular dystrophy (BMD) remain underexplored. This case report describes a man with BMD who developed dysphagia, initially presenting with mild symptoms but later experiencing aspiration pneumonia with respiratory failure. He regained safe oral intake after swallowing training. Three years later, he suffered worsening dysphagia following a severe coronavirus disease-2019 (COVID-19) infection, ultimately losing the ability to resume oral feeding despite months of rehabilitation. Literature on swallowing disorder in BMD reported poor mastication, reduced laryngeal elevation, and increased pharyngeal residue; however, silent aspiration, as observed in this patient, is not commonly seen. Multiple factors—including post-COVID syndrome, impaired lower airway sensation from prolonged intubation and tracheostomy, and declining pulmonary function—likely contributed to dysphagia in the patient. This case highlights the complexity of dysphagia management in BMD, especially when exacerbated by respiratory infections. It underscores the importance of early dysphagia intervention, multidisciplinary management, and the potential impact of COVID-19 on swallowing dysfunction. This provides a better understanding of the pathophysiology of dysphagia in Becker muscular dystrophy and the efficacy of therapeutic interventions.

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