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Updated: Apr 29, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Postural alignment in children with Duchenne muscular dystrophy and its relationship with balance
Cyntia R J A Baptista1, Andreia A Costa2, Tatiana M Pizzato1
1Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Insights
Children with Duchenne muscular dystrophy (DMD) exhibit pelvic anteversion and forward center of mass, which are compensatory strategies for balance deficits. These postural changes help maintain functional performance despite the condition.
Area of Science:
- Biomedical Engineering
- Pediatrics
- Rehabilitation Science
Background:
- Functional deficits in Duchenne muscular dystrophy (DMD) are linked to body misalignment, deconditioning, and obesity.
- The impact of postural deviations on the functional balance of children with DMD requires further investigation.
Purpose of the Study:
- To quantify and compare postural deviations in children with DMD against eutrophic and overweight/obese children.
- To explore the relationship between posture and functional balance in these groups.
Main Methods:
- A case-control study involving 29 children aged 6-11 (10 DMD, 10 eutrophic, 9 overweight/obese).
- Digital photogrammetry and the SAPo program assessed postural alignment; the Pediatric Balance Scale (PBS) measured balance.
- Statistical analyses included Kruskal-Wallis, Dunn post-hoc tests, and Spearman correlation.
Main Results:
- Children with DMD showed pelvic anteversion similar to overweight/obese children and twice that of eutrophic children.
- DMD and overweight/obese groups exhibited an increased forward center of mass compared to eutrophic children.
- Moderate to weak correlations were found between balance scores and pelvic alignment/sagittal plane asymmetries; obesity did not significantly impair balance.
Conclusions:
- Balance deficits in children with DMD are associated with increased forward center of mass and pelvic anteversion.
- These postural changes appear to be compensatory mechanisms enabling DMD children to achieve performance levels similar to unaffected peers.
- Postural alignment is a critical factor in understanding functional balance in pediatric neuromuscular disorders.
Background:
In Duchenne muscular dystrophy, functional deficits seem to arise from body misalignment, deconditioning, and obesity secondary to weakness and immobility. The question remains about the effects of postural deviations on the functional balance of these children.
Objectives:
To identify and quantify postural deviations in children with DMD in comparison to non-affected children (eutrophic and overweight/obese), exploring relationships between posture and function.
Method:
This case-control study evaluated 29 participants aged 6 to 11 years: 10 DMD (DG), 10 eutrophic (EG), and 9 overweight/obese (OG). Digital photogrammetry and SAPo program were used to measure postural alignment and the Pediatric Balance Scale (PBS) was used to measure balance. The Kruskall-Wallis and Dunn post-hoc tests were used for inter-group comparison of posture and balance. Spearman's coefficient tested the correlation between postural and balance variables.
Results:
The horizontal pelvic alignment data indicated that the anteversion of the DG was similar to that of the OG and twice that of the EG (p<0.05). Compared to the EG, the DG and OG showed an increased forward position of the center of mass (p<0.05). There was a moderate and weak correlation between the PBS score and horizontal pelvic alignment (0.58 and 0.47-left/right). The PBS showed a weak correlation with asymmetries in the sagittal plane (-0.39). The PBS scores for the OG and EG suggest that obesity did not have a deleterious effect on balance.
Conclusions:
The balance deficit in children with DMD was accompanied by an increased forward position of the center of mass and significant pelvic anteversion that constitutes a compensatory strategy to guarantee similar performance to the children not affected by the disease.
