The overall functional level of patients with Duchenne muscular dystrophy (DMD) may directly correlate with the severity of objectively measured upper limb function, according to an article published in the Irish Journal of Medical Science.

“For these reasons, we think that facilitating the clinical evaluation of pain, muscle stiffness, and dysfunction, which are common symptoms of DMD, is important because it is a progressive disease,” the authors wrote.

This observational study included 38 pediatric patients with a mean age of 10.58 years who had previously been diagnosed with DMD. The investigators assessed the functional level of all children using the Brooke and Vignos scales, while the Upper Limb Short Questionnaire (ULSQ) determined the pain, stiffness, and function of the upper limbs.

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Greater physical impairment of the upper extremities, demonstrated by a higher ULSQ score, correlated with higher scores on both the Brooke and Vignos scales, suggesting associations between the overall functional level of patients with DMD and upper limb pain, stiffness, and function.

Moreover, increased scores on the Vignos scale were specifically correlated with alterations in the function and stiffness assessments of the ULSQ, while no association occurred in regard to pain. Conversely, all 3 subcategories of the ULSQ correlated with increased Brooke scale scores. 

These findings highlight the key role of upper limb muscles on patients’ overall ability to perform daily functions, possibly even including activities related to the lower limbs such as ambulation. This impairment likely translates into a decreased quality of life for patients and a greater need for assistance in performing their daily routine. 

“The findings of our study showed the importance of physiotherapy and rehabilitation practices aimed at protecting and increasing upper extremity skills in patients with DMD as a result of the decrease in their upper extremity skills in the later stages of the disease,” Savaş and Şimşek concluded.


Savaş D, Şimşek TT. Functional level and its relationship to upper extremity function, pain, and muscle stiffness in children with Duchenne muscular dystrophy. Ir J Med Sci. Published online September 16, 2022. doi:10.1007/s11845-022-03162-z