Variables associated with upper extremity function in patients with Duchenne muscular dystrophy.
Preserving upper extremity (UE) function in patients with Duchenne muscular dystrophy (DMD) is extremely important as it is related to independence and quality of life. For clinical decision making, knowledge of variables associated with UE function is necessary. This knowledge is, however, limited. Therefore, this study aims to gain more insight into the variables associated with UE function in DMD. Data from an international web-based questionnaire on UE function, obtained from 213 DMD patients, were used. Six dependent variables regarding UE function were used in multivariable linear regression analyses. In addition, 26 independent variables regarding patient characteristics, medication, therapy, supportive aids, pain, stiffness and participation were used. Twelve independent variables showed a significant relation to UE function. Variables with a negative relation to UE function were: later disease stage, occurrence of scoliosis, higher age, use of UE splints, more frequent stiffness complaints, more limitations due to stiffness, more frequent elbow pain, and having physical therapy. A positive relation with UE function was seen for going to school or work, use of corticosteroids, higher BMI, and higher age at diagnosis. These variables explained 56-81 % of the variation of the different measures of UE function. Knowledge of variables associated with UE function is very important in the clinical management of DMD patients. The results of this study suggest that corticosteroid use and participation in school and work related activities are positively related to UE function in DMD patients, as well as reducing pain and stiffness and preventing scoliosis.
Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands. Mariska.Janssen@radboudumc.nl.
Mariska M H P
MM
Janssen
Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
Jan C M
JC
Hendriks
Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands.
Alexander C H
AC
Geurts
Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands.
Imelda J M
IJ
de Groot
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D006801:Humans; D007223:Infant; D038622:Internationality; D020407:Internet; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D020388:Muscular Dystrophy, Duchenne / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
D000305:Adrenal Cortex Hormones
Associated variables; Duchenne muscular dystrophy; Regression analysis; Upper limb