Two-year longitudinal changes in lower limb strength and its relation to loss in function in a large cohort of patients with duchenne muscular dystrophy

Abhinandan Batra, Ann Harrington, Donovan J. Lott, Rebecca Willcocks, Claudia R. Senesac, William McGehee, Dandan Xu, Sunita Mathur, Michael J. Daniels, William D. Rooney, Sean C. Forbes, William Triplett, Jasjit K. Deol, Ishu Arpan, Roxanne Bendixen, Richard Finkel, Erika Finanger, Gihan Tennekoon, Barry Byrne, Barry RussmanH. Lee Sweeney, Glenn Walter, Krista Vandenborne

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective The main objective of this study was to examine the effect of disease on strength in two functionally important lower limb muscles for a period of 2 yrs in children with Duchene muscular dystrophy. Design Seventy-seven Duchene muscular dystrophy children participated in this study. Plantar flexors, knee extensors, strength, and performance on timed tests (6-min walk, 4-stairs, 10-m walk, supine-up) were assessed yearly for 2 yrs. Multivariate normal regression was used to assess changes in strength over time in the Duchene muscular dystrophy group. Spearman correlations were computed to examine relationship between strength and function. Results Normalized plantar flexor and knee extensor strength showed a significant decrease (P < 0.05) over 2 yrs, with larger declines in knee extensor. At baseline, knee extensor strongly correlated with performance on timed tests. However, plantar flexor strength was found to be a stronger predictor of loss in ambulatory function. Modest correlations (r = 0.19-0.34) were found between the decline in strength and functional performance over 2 yrs. Conclusions This study describes the loss of lower limb strength in a large cohort of Duchene muscular dystrophy children for 2 yrs. The findings support that lower limb strength alone cannot account for the decline in performance on functional tests, and the role of other contributing factors, such as compensatory strategies, should be considered.

Original languageEnglish (US)
Pages (from-to)734-740
Number of pages7
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number10
StatePublished - Oct 1 2018


  • Duchenne Muscular Dystrophy
  • Function
  • Quantitative Myometry
  • Strength

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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