In the early stages, boys with Duchenne muscular dystrophy show signs of muscle weakness, such as difficulties running, jumping, climbing stairs and getting up from the floor. They can show a Gower’s manoeuvre (needing to support themselves with hands on thighs as they get up from the floor), and a waddling gait (walking on their toes with arched lower back).
With the progression of the muscle weakness, boys become unable to walk as far or as fast as other children, and may fall down. They are still able to climb stairs, but typically bring the second foot up to join the first rather than going foot over foot.
Later, when walking becomes increasingly difficult, boys may experience more problems climbing stairs and getting up from the floor.
Steroids have significantly changed the natural course of Duchenne muscular dystrophy. They help to maintain the muscle strength and function over a certain period of time, and can delay the time when the boys may require a wheelchair. It is therefore difficult to define when boys will start using a wheelchair, as this might be different from one boy to another.
However, boys will usually need a wheelchair by the age of about eight to 11 years (sometimes a little earlier or later). At first, they will probably use the wheelchair only for long distances. Later, they are likely to need to use the wheelchair full-time. At this stage, they may experience difficulties raising their arms above shoulder level.
With further progression of muscle weakness, the maintenance of good posture is increasingly difficult and complications are more likely. The condition is severe enough to shorten life-expectancy but nowadays, with high standards of medical care, most young men with Duchenne muscular dystrophy reach adulthood.
Family support is essential and specialists may be needed to address specific issues of learning and behaviour.