Patients with Duchenne and Becker muscular dystrophies are not more asymmetrical than healthy controls on timed performance of upper limb tasks

This study aimed to investigate possible asymmetries and relationships between performance of dominant and non-dominant upper limbs (UL) in patients with Duchenne and Becker muscular dystrophies (DMD/BMD), to compare UL performance of patients and healthy subjects and to investigate the relationship between timed performance of UL and age, motor function and muscle strength in DMD/BMD patients. Sixteen patients with DMD and 3 with BMD were evaluated with Jebsen-Taylor Test (timed performance), Vignos scale and Dimension 3 of Motor Function Measure (motor function), and Medical Research Council scale (muscle strength) on a single session. ANOVA showed no asymmetry between dominant and non-dominant UL, except in the writing subtest, in patients and in healthy controls. There were relationships between dominant and non-dominant UL performances. Correlations between timed performance, motor function and muscle strength were found, but age was not correlated with these variables. These findings may reduce the assessment time, prevent fatigue and provide more accurate clinical reasoning involving UL in DMD/BMD treatment.本研究旨在探究杜兴氏肌营养不良症（Duchenne muscular dystrophy, DMD）与贝克型肌营养不良症（Becker muscular dystrophy, BMD）患者优势上肢与非优势上肢（upper limbs, UL）的功能表现是否存在不对称性及相关性，对比患者与健康受试者的上肢功能表现，并分析DMD/BMD患者上肢计时性能与年龄、运动功能及肌肉力量之间的关联。本研究单次测评共纳入16例DMD患者与3例BMD患者，采用杰普森-泰勒手功能测试（Jebsen-Taylor Test，用于上肢计时性能评估）、维戈斯量表（Vignos scale）、运动功能评定量表（Motor Function Measure, MFM）维度3评估运动功能，以及医学研究理事会肌力评定量表（Medical Research Council scale, MRC量表）评估肌肉力量。方差分析（Analysis of Variance, ANOVA）结果显示，无论患者组还是健康对照组，优势上肢与非优势上肢的功能表现均无显著不对称性，仅书写分项测试例外。研究发现优势上肢与非优势上肢的功能表现存在相关性，同时上肢计时性能与运动功能、肌肉力量之间存在显著关联，但年龄与上述变量无明显相关性。本研究结果可缩短DMD/BMD患者上肢功能评估时长、减少受试疲劳，并为DMD/BMD治疗中涉及上肢的临床诊疗决策提供更为精准的依据。