WHAT ARE THE SIGNS AND SYMPTOMS OF DUCHENNE?

Icon of gowers sign
Gowers' Sign
icon everyday activities
Difficulty getting up
Icon of delayed walking
Muscle pain and stiffness

Difficulty getting up from a lying or sitting position

Patients with Duchenne may use their hands to help them move their legs up from the floor into a standing position. This action is known as Gowers' sign and is likely due to reduced muscle strength in the lower limbs.1

Frequent falls

Patients with Duchenne suffer from poor balance. This leads to an increased risk of falling down.1

A wobbly way of walking

By school age, many patients living with Duchenne develop a wobbly way of walking.2

Toe walking

Because of stiffness in their leg and foot tendons, patients with Duchenne may walk on their toes.1

Large calf muscles

Patients affected by Duchenne often have larger-than-normal calf muscles. This is because of pseudohypertrophy, also known as false enlargement, which is the buildup of fibrous tissues onto the calf muscles.1,2

Trouble running and jumping

As Duchenne progresses and begins to affect the lower limbs, a patient may struggle running and jumping. For many patients, this begins to happen around age 7.2,3

Muscle pain and stiffness

Duchenne is associated with muscle degeneration, although muscle atrophy does not affect nerves and therefore is not painful. However, muscle stiffness can be painful.2

Duchenne may result in additional physical symptoms that aren’t listed here. Remember to communicate any and all symptoms with your child’s healthcare team.

SYMPTOMS DEVELOP AS DUCHENNE PROGRESSES

A patient's DMD symptoms will appear over time, some more gradually than others. Usually, larger muscles, such as thighs, will be affected first and smaller muscles, like hands, affected later as the disease progresses.1

Stages of Duchenne symptom progression

Early Ambulatory
(Ability to walk)3-5

  • Enlarged calf muscles
  • Can climb stairs, but may struggle
  • Might be toe walking
  • Difficulty running
  • Waddling gait
  • Gowers' sign

Diagnosis to age 7

Late Ambulatory6

  • Walking becomes increasingly difficult
  • Difficulty raising arms or carrying certain items, like a backpack

Ages 6 to 9

Early Non-Ambulatory7

  • May be able to self-propel for some time
  • Able to maintain posture
  • May begin transitioning to a wheelchair
  • Arm weakness

Ages 10 to 14

Late Non-Ambulatory8

  • Difficulty chewing and swallowing
  • Wheelchair restricted
  • Shortness of breath
  • Swelling in feet and legs

Ages 15+

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1. What are the signs and symptoms of Duchenne? Action Duchenne website. https://www.actionduchenne.org/FAQs/signs-and-symptoms-of-duchenne. Accessed April 6, 2018. 2. Signs and symptoms. Muscular Dystrophy Association (MDA) website. https://www.mda.org/disease/duchenne-muscular-dystrophy/signs-and-symptoms. Accessed April 6, 2018. 3. Diagnosis & early phase. Parent Project Muscular Dystrophy website. https://www.parentprojectmd.org/care/care-guidelines/by-stage/early-ambulatory. Accessed May 2, 2018. 4. Progression. Parent Project Muscular Dystrophy website. https://www.parentprojectmd.org/about-duchenne/what-is-duchenne/progression. Accessed May 3, 2018. 5. Stages of Duchenne. Duchenne UK website. https://www.duchenneuk.org/Pages/FAQs/Category/stages-of-duchenne. Accessed May 3, 2018. 6. Transitional phase. Parent Project Muscular Dystrophy website. https://www.parentprojectmd.org/care/care-guidelines/by-stage/late-ambulatory. Accessed May 3, 2018. 7. Loss of ambulation. Parent Project Muscular Dystrophy website. https://www.parentprojectmd.org/care/care-guidelines/by-stage/early-non-ambulatory. Accessed May 3, 2018. 8. Adult stage. Parent Project Muscular Dystrophy website. https://www.parentprojectmd.org/care/care-guidelines/by-stage/late-non-ambulatory. Accessed May 3, 2018.