The type and number of compensatory strategies may correlate with the stage, progression, and functionality of patients with Duchenne muscular dystrophy (DMD), according to a study recently published in Perceptual and Motor Skills.

“We observed that trunk control is very similar among ambulatory patients and does not present significant differences in the execution times of tasks and in the number of compensatory strategies,” the authors wrote.

This cross-sectional study included 31 children and adolescents aged 5 to 18 years who were previously diagnosed with DMD. Researchers analyzed the results of the Mental Mini-Examination, Vignos scale, Segmental Assessment of Trunk Control, Timed Up and Go test, and 10-meter walk test to determine cognitive abilities, disease staging, and motor status.


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Patients with advanced stages of DMD performed a greater amount of compensation strategies when getting up from a chair and walking. For example, patients with a Vignos score of 5 required arm support to complete activities. On the contrary, individuals who scored lower on the Vignos scale needed only leg support compensation.

“The assessment of compensations during gait activity, compared with the Vignos scale, demonstrated the beginning of compensations with medium foot support, pelvic tilt and increased lateral displacement when considering Vignos 1,” the authors noted.

Participants in earlier stages elevated their shoulders and anterior head to balance abdominal weakness and remain upright. As the disease progressed, patients elevated their head and further compensated with movements of the head, cervical region, and shoulder girdle.

Patients in the following stages exhibited compensations for hyperkyphosis in the thoracic region and pelvic retroversion. Finally, individuals with a Vignos score of 5 presented with attempts to compensate for lumbar hyperlordosis and thoracic rectification.

Interestingly, the degree of trunk control did not seem to decrease with disease progression, as patients who exhibited total control had varying scores on the Vignos scale from 1 to 5 points. These results highlight the ample functionality variations that patients with DMD may have, further suggesting the need for individualized approaches.

Reference

Dazzi MDAR, De Sá CDSC. Gait and sit-to-stand motor compensation strategies in children and adolescents with Duchenne muscular dystrophy. Percept Mot Skills. Published online September 19, 2022. doi:10.1177/00315125221128129