Patients with Duchenne and Becker muscular dystrophies are not more asymmetrical than healthy controls on timed performance of upper limb tasks

Abstract

This study aimed to investigate possible asymmetries and relationships between performance of dominant and non-dominant upper limbs (UL) in patients with Duchenne and Becker muscular dystrophies (DMD/BMD), to compare UL performance of patients and healthy subjects and to investigate the relationship between timed performance of UL and age, motor function and muscle strength in DMD/BMD patients. Sixteen patients with DMD and 3 with BMD were evaluated with Jebsen-Taylor Test (timed performance), Vignos scale and Dimension 3 of Motor Function Measure (motor function), and Medical Research Council scale (muscle strength) on a single session. ANOVA showed no asymmetry between dominant and non-dominant UL, except in the writing subtest, in patients and in healthy controls. There were relationships between dominant and non-dominant UL performances. Correlations between timed performance, motor function and muscle strength were found, but age was not correlated with these variables. These findings may reduce the assessment time, prevent fatigue and provide more accurate clinical reasoning involving UL in DMD/BMD treatment.

Reliability, validity and description of timed performance of the Jebsen–Taylor Test in patients with muscular dystrophies

“…13,14 The Jebsen---Taylor Test was applied to people with MD in a previous pilot study. 26 Based on those results, we improved the application protocol of the Test and set the inclusion/exclusion criteria of the present study.…”

Motor Compensation Strategies for Reduced Upper Limb Function Among Individuals With Duchenne Muscular Dystrophy

“…Finally, we excluded those with a Mini Mental State Examination Score (MMSE; Folstein et al, 1975) of less than 10 points as individuals with difficulty understanding a simple command. Past authors (Artilheiro et al, 2017b;Voos et al, 2015) observed that a cut-off of 10 or higher (versus 18) points would assure that all of these patients would be able to perform all JTT tasks.…”

“…The Jebsen-Taylor Test (JTT) was developed to assess manual function in performing ADLs by objectively measuring the child’s ability to perform functional tasks requiring distal and proximal UL domains (Jebsen et al, 1969). Designed to quantitatively assess execution times of these skills across various forms of muscular dystrophy and to discriminate categories of disease progression during treatment, the JTT is unable to assess movement quality (Artilheiro et al., 2017b; Mazzone et al., 2012). A Brazilian version of the Functional Skill Scale (EHF, in Portuguese; FSS in English) specifically details proximal movements, changes in movement control and the presence of compensatory UL movements (Sarfaraz et al., 2008).…”

Timed immersion expiration measures in patients with muscular dystrophies

“…Decreased joint mobility and range of motion occur due to muscle weakness, which also impacts on static and dynamic postural balance control [4]. The maintenance of trunk symmetry is important to preserve functional movements and positioning and to prevent deformities [5], because trunk muscles have crucial role in respiratory functions. The respiratory muscles weakness leads to secondary changes such as atelectasis, decreased lung compliance, ineffective cough and repeated infections [6][7][8].…”