The clinical relevance of timed motor performance in children with Duchenne muscular dystrophy

Physiother Theory Pract. 2015 Mar;31(3):173-81. doi: 10.3109/09593985.2014.989294. Epub 2014 Dec 24.

Abstract

Background: The measurement of time and compensatory movements for functional tasks is not frequently used to evaluate children with Duchenne muscular dystrophy (DMD). As muscle weakness progresses, new synergies (compensatory movements) are selected to perform the tasks, demanding higher times.

Objectives: The present study aimed to describe the timed motor performance of rising from the floor to standing, sitting down on the floor from standing, climbing up four steps and climbing down four steps 18 and 6 months prior to gait loss and to investigate possible relationships between these timed performances, the compensatory movements and the Vignos Scale (VS) scores.

Method: Fourteen children with DMD (mean age: 9.6) were videotaped performing the tasks. Spearman correlation tests investigated the relationships between the times, compensatory movements (scored by FES-DMD) and VS.

Results: The timed performance and the compensatory movements for rising from the floor, climbing up and climbing down steps varied broadly and were correlated to each other among patients with DMD at 18 and 6 months prior to gait loss. The relationship was not found for sitting on the floor. The timed performance and compensatory movements for climbing up and down steps also correlated to the VS.

Conclusion: Rising from the floor, climbing up, and climbing down steps have some components in common, such as the demand for muscle strength and the recruitment of compensatory muscle synergies, as DMD progresses. To sit down on the floor, some children let themselves fall, resulting in a faster performance, but more compensatory movements.

Keywords: Duchenne muscular dystrophy; function; measures.

MeSH terms

  • Adolescent
  • Child
  • Humans
  • Motor Skills*
  • Muscular Dystrophy, Duchenne / physiopathology*
  • Muscular Dystrophy, Duchenne / psychology
  • Severity of Illness Index
  • Time Factors