The dynamic interplay between loneliness and health behaviors from adolescence to midlife: A Norwegian population-based cohort study.

On behalf of all authors, the corresponding author states that there is no conflict of interest. Elsass Foundation and Grossere LF Foghts Foundation supported the study economically. Muscular dystrophy (MD) comprises genetic disorders marked by muscle degeneration and replacement with fat and fibrous tissue. Phenotypes vary from mild to severe with some patients requiring wheelchairs from early childhood. At Copenhagen Neuromuscular Center, approximately 10% of patients with MD are wheelchair users. This group commonly experience both disease- and immobility-related symptoms, including muscle pain (especially in the lower back and legs), fatigue, constipation, and an increased risk of lifestyle disorders, often affecting the quality of life (QoL). There is no cure for most patients with MD. Emerging therapies like gene therapy are unlikely to benefit those in advanced stages, who must rely on supportive interventions to manage symptoms and maintain health. Exercise could be one such option. In healthy individuals, exercise improves fatigue, constipation, pain, cardiometabolic health, muscle function, and QoL. While exercise is well-studied in ambulatory patients with MD, it remains underexplored in wheelchair users, where prior research has mainly focused on masticatory and respiratory muscles. No studies have evaluated systemic exercise effects in this population. Barriers may include assumptions that interventions are too late or technical exercise challenges (e.g., inability to operate equipment independently). This highlights the need to explore feasible, home-based exercise options.