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Updated: Apr 30, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Investigation of the relationship between upper extremity proprioception and upper extremity functions in children
Kardelen Koç1, Numan Bulut2, Öznur Tunca2
1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Erzurum Technical University, Erzurum, Turkey.
Insights
Children with Duchenne muscular dystrophy (DMD) have impaired wrist proprioception, affecting upper-limb function and participation. These deficits highlight the need for proprioceptive assessments in rehabilitation planning for DMD patients.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Upper-extremity proprioception is vital for functional independence, enabling coordinated reaching and grasping.
- Limited research exists on upper-limb proprioception in pediatric Duchenne muscular dystrophy (DMD).
Purpose of the Study:
- To compare wrist proprioception between children with DMD and healthy peers.
- To investigate the relationship between wrist proprioception and upper-limb function in children with DMD.
Main Methods:
- A cross-sectional observational study involving 62 children (42 with DMD, 20 controls) aged 6-15 years.
- Wrist proprioception assessed via verbal description, position verification, and matching tasks (eyes open/closed) at 45° flexion.
- Secondary outcomes included range of motion, grip strength, and functional assessments (PUL 2.0, ABILHAND-Kids, ACTIVLIM).
Main Results:
- Children with DMD demonstrated significantly poorer wrist proprioception compared to controls, with larger errors in both eyes open and eyes closed conditions.
- Proprioceptive deficits in DMD correlated with limitations in elbow and wrist range of motion.
- Impaired proprioception was also associated with reduced hand dexterity, participation, and overall upper-limb performance in children with DMD.
Conclusions:
- Children with Duchenne muscular dystrophy exhibit significant wrist proprioceptive deficits.
- These deficits are linked to impaired upper-limb function, including range of motion limitations and reduced dexterity.
- Proprioceptive assessment should be integrated into rehabilitation strategies for DMD to enhance functional outcomes and participation.
Background And Objective:
Upper-extremity proprioception contributes to coordinated reaching and grasping, which are critical for functional independence; however, evidence on upper-limb proprioception in children with Duchenne muscular dystrophy (DMD) remains limited. Therefore, we aimed to compare wrist proprioception in children with DMD versus healthy peers and to examine its relationship with upper-limb function.
Methods:
Cross-sectional observational study conducted at a pediatric neuromuscular clinic, enrolling children aged 6-15 years who were able to sit independently. Wrist proprioception at 45° flexion was assessed using verbal description, position verification, and ipsilateral/contralateral matching under two conditions (eyes open and eyes closed). Absolute angular error was calculated for each condition, and the open - closed difference was derived as the within-subject change between conditions; angles were measured using a goniometer. Secondary outcomes included elbow/wrist ROM limitation, grip strength, PUL 2.0, ABILHAND-Kids, and ACTIVLIM.
Results:
Sixty-two children participated (42 DMD, 20 controls); 80.9% of the DMD group were ambulatory. Compared with controls, the DMD group had poorer wrist proprioception, showing larger EO - EC differences and higher EC errors (all p < .001), except for contralateral matching where the within-group EO - EC change was not significant (p = .156). Only location verification and ipsilateral matching correlated with elbow ROM limitation (p = .007-0.002), wrist ROM limitation (both p < .001), hand dexterity (ABILHAND-Kids p = .005-0.006), participation (ACTIVLIM p = .012-0.006), and upper-limb performance (PUL total p = .002-0.004).
Discussion:
Children with DMD exhibit wrist proprioceptive deficits that are associated with joint ROM limitations and with measures of upper-limb performance and participation, supporting the inclusion of proprioceptive assessment in rehabilitation planning to help maintain distal function.
