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The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy

Year 2025, Volume: 9 Issue: 1, 85 - 91, 31.01.2025
https://doi.org/10.30621/jbachs.1513965

Abstract

Background and Purpose: This study aimed to investigate the relation between body mass index (BMI) and gait characteristics and performance in a cohort with DMD.
Methods: Weight and height were measured to calculate BMI. BMI z-scores were used to categorise weight. Height, weight, and BMI were standardised to sex- and age-corrected z-scores based on the Turkish population. The gait characteristics were evaluated with Gait Assessment Scale for Duchenne Muscular Dystrophy (DMD-GAS) and Quality and Independence of Gait Classification Scale for Duchenne Muscular Dystrophy (QIGS-DMD). The gait performance was assessed by the 6-minute walk test and the 10-meter walk/run test. The correlation between body composition and gait parameters was analysed.
Results: Eighty-six children with DMD (age:109.9026.53 months, BMI:18.803.13 kg/m2) were included in the study. Among the participants, 40.7% had a BMI above the normal range. There were moderate correlations between DMD-GAS and height, weight, and BMI (r=-0.36, r=-0.44, r=-0.36, respectively) and moderate correlations between QIGS-DMD and height, weight, and BMI (r:0.43, r:0.48, r:0.35, respectively) (p<0.01).
Conclusion: The current findings revealed that excessive weight gain affects the characteristics, quality, and independence of gait in children with DMD which indicated the importance of weight control during the ambulatory period of the disease.

Ethical Statement

Ethical approval was obtained from the Ethics Committee of the Hacettepe University (GO 22/1125). The study adheres to the mandates of the Declaration of Helsinki.

References

  • Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol 2010;9(1):77-93.
  • Emery AE, Muntoni F, Quinlivan R. Duchenne muscular dystrophy: Oxford Monographs on Medical G; 2015.
  • Aydın Yağcıoğlu G, Yılmaz Ö, Alemdaroğlu Gürbüz İ, Bulut N, Karaduman A, Özkal Ö, et al. Examination of the relationship between foot-body posture and balance and gait in Duchenne muscular dystrophy. Ir J Med Sci 2023;192(4): 1883-1888.
  • Doglio L, Pavan E, Pernigotti I, Petralia P, Frigo C, Minetti C. Early signs of gait deviation in Duchenne muscular dystrophy. Eur J Phys Rehabil Med 2011;47(4):587-94.
  • Sutherland DH, Olshen R, Cooper L, Wyatt M, Leach J, Mubarak S, et al. The pathomechanics of gait in Duchenne muscular dystrophy. Dev Med Child Neurol 1981;23(1):3-22.
  • Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Rel Res 1993;288:122-5.
  • Sienko Thomas S, Buckon CE, Nicorici A, Bagley A, McDonald CM, Sussman MD. Classification of the gait patterns of boys with Duchenne muscular dystrophy and their relationship to function. J Child Neurol. 2010;25(9):1103-9.
  • Willig TN, Carlier L, Legrand M, Riviere H, Navarro J. Nutritional assessment in Duchenne muscular dystrophy. Dev Med Child Neurol 1993;35(12):1074-82.
  • Martigne L, Salleron J, Mayer M, Cuisset J-M, Carpentier A, Neve V, et al. Natural evolution of weight status in Duchenne muscular dystrophy: a retrospective audit. Br J 2011;105(10):1486-91.
  • Davidson ZE, Ryan MM, Kornberg AJ, Sinclair K, Cairns A, Walker KZ, et al. Observations of body mass index in Duchenne muscular dystrophy: a longitudinal study. Eur J Clin Nutr 2014;68(8):892-7.
  • Markham L, Spicer R, Khoury P, Wong B, Mathews K, Cripe LH. Steroid therapy and cardiac function in Duchenne muscular dystrophy. Pediatric cardiology. 2005;26:768-71.
  • Biggar W, Harris V, Eliasoph L, Alman B. Long-term benefits of deflazacort treatment for boys with Duchenne muscular dystrophy in their second decade. Neuromuscul Disord 2006;16(4):249-55.
  • Chew K, Carey K, Ho G, Mallitt K-A, Widger J, Farrar M. The relationship of body habitus and respiratory function in Duchenne muscular dystrophy. Respir Med 2016;119:35-40.
  • Billich N, Adams J, Carroll K, Truby H, Evans M, Ryan MM, et al. The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy. Nutrients 2022;14(16):3304.
  • Goemans N, Wong B, Van den Hauwe M, Signorovitch J, Sajeev G, Cox D, et al. Prognostic factors for changes in the timed 4-stair climb in patients with Duchenne muscular dystrophy, and implications for measuring drug efficacy: A multi-institutional collaboration. PLoS One 2020;15(6):e0232870.
  • Sawnani H, Thampratankul L, Szczesniak RD, Fenchel MC, Simakajornboon N. Sleep disordered breathing in young boys with Duchenne muscular dystrophy. J Pediatr 2015;166(3):640-5. e1.
  • Bushby K, Connor E. Clinical outcome measures for trials in Duchenne muscular dystrophy: report from International Working Group meetings. Clin Investig 2011;1(9):1217.
  • Yağcıoğlu GA, Gürbüz İA, Topuz S, Yılmaz Ö. Development of a new instrument to evaluate gait characteristics of individuals with Duchenne Muscular Dystrophy: Gait Assessment Scale for Duchenne Muscular Dystrophy, and its validity and reliability. Early Hum Dev 2023;185:105843.
  • Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51(1):1-14.
  • Organization WH, Organization WH. WHO Multicentre Growth Reference Study Group: WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: WHO. 2006;2007.
  • Aydın Yağcıoğlu G. Duchenne Musküler Distrofi’li Hastalarda Yürüyüş Değerlendirme Ölçeği ile Yürüyüş Kalite ve Bağımsızlığı Sınıflandırma Skalası’nın Geliştirilmesi ve Geçerlilik ve Güvenilirliğinin İncelenmesi. 2021.
  • McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, et al. The 6‐minute walk test and other clinical endpoints in Duchenne muscular dystrophy: reliability, concurrent validity, and minimal clinically important differences from a multicenter study. Muscle Nerve 2013;48(3):357-68.
  • McDonald CM, Henricson EK, Han JJ, Abresch RT, Nicorici A, Elfring GL, et al. The 6‐minute walk test as a new outcome measure in Duchenne muscular dystrophy. Muscle Nerve 2010;41(4):500-10.
  • Mukaka MM. A guide to appropriate use of correlation coefficient in medical research. Malawi Med J 2012;24(3):69-71.
  • Akoglu H. User's guide to correlation coefficients. Turkish J Emerg Med 2018;18(3):91-3.
  • Weber DR, Hadjiyannakis S, McMillan HJ, Noritz G, Ward LM. Obesity and endocrine management of the patient with Duchenne muscular dystrophy. Pediatrics 2018;142(Suppl 2):S43-S52.
  • Canapari CA, Barrowman N, Hoey L, Walker SW, Townsend E, Tseng BS, et al. Truncal fat distribution correlates with decreased vital capacity in Duchenne muscular dystrophy. Pediatr Pulmonol 2015;50(1):63-70.
  • Rodríguez-Cruz M, Sanchez R, Escobar RE, Cruz-Guzmán OdR, López-Alarcón M, Bernabe García M, et al. Evidence of insulin resistance and other metabolic alterations in boys with Duchenne or Becker muscular dystrophy. Int J Endocrinol 2015;2015.
  • McDonald CM, Abresch RT, Carter GT, Fowler Jr WM, Johnson ER, Kilmer DD, et al. Profiles of neuromuscular diseases. Duchenne muscular dystrophy. Am J Phys Med Rehabil 1995;74(5 Suppl):S70-92.
  • Hills AP, Parker AW. Gait characteristics of obese children. Arch Phys Med Rehabil 1991;72(6):403-7.
  • Galli M, Cimolin V, Rigoldi C, Condoluci C, Albertini G. Effects of obesity on gait pattern in young individuals with Down syndrome. Int J Rehabil Res 2015;38(1):55-60.
  • Elshemy SA. Comparative study: Parameters of gait in Down syndrome versus matched obese and healthy children. Egypt J Med Hum Genet 2013;14(3):285–91.
  • Donlevy GA, Garnett SP, Cornett KM, McKay MJ, Baldwin JN, Shy RR, et al. Association Between Body Mass Index and Disability in Children With Charcot-Marie-Tooth Disease. Neurology 2021;97(17):e1727-e36.
  • Meyns P, Van Gestel L, Bar-On L, Goudriaan M, Wambacq H, Aertbeliën E, et al. Children with spastic cerebral palsy experience difficulties adjusting their gait pattern to weight added to the waist, while typically developing children do not. Front Hum Neurosci 2016;10:657.
  • Del Porto H, Pechak C, Smith D, Reed-Jones R. Biomechanical effects of obesity on balance. Int J Exerc Sci 2012;5(4):301-20.
  • Bayram E, Topcu Y, Karakaya P, Bayram MT, Sahin E, Gunduz N, et al. Correlation between motor performance scales, body composition, and anthropometry in patients with duchenne muscular dystrophy. Acta Neurol Belg 2013;113(2):133-7.
  • Sussman MD, Sienko SE, Buckon CE, Hilton C, De Mattos CB, d'Amato C. Efficacy of corticosteroid in decreasing scoliosis and extending time to loss of ambulation in a single clinic: an effectiveness trial. J Child Orthop 2020;14(5):421-32.
  • Vuillerot C, Braillon P, Fontaine-Carbonnel S, Rippert P, André E, Iwaz J, et al. Influence of a two-year steroid treatment on body composition as measured by dual X-ray absorptiometry in boys with Duchenne muscular dystrophy. Neuromuscul Disord 2014;24(6):467-73.
  • Matthews E, Brassington R, Kuntzer T, Jichi F, Manzur AY. Corticosteroids for the treatment of Duchenne muscular dystrophy. Cochrane Database Syst Rev 2016;2016(5):CD003725.

The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy

Year 2025, Volume: 9 Issue: 1, 85 - 91, 31.01.2025
https://doi.org/10.30621/jbachs.1513965

Abstract

References

  • Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol 2010;9(1):77-93.
  • Emery AE, Muntoni F, Quinlivan R. Duchenne muscular dystrophy: Oxford Monographs on Medical G; 2015.
  • Aydın Yağcıoğlu G, Yılmaz Ö, Alemdaroğlu Gürbüz İ, Bulut N, Karaduman A, Özkal Ö, et al. Examination of the relationship between foot-body posture and balance and gait in Duchenne muscular dystrophy. Ir J Med Sci 2023;192(4): 1883-1888.
  • Doglio L, Pavan E, Pernigotti I, Petralia P, Frigo C, Minetti C. Early signs of gait deviation in Duchenne muscular dystrophy. Eur J Phys Rehabil Med 2011;47(4):587-94.
  • Sutherland DH, Olshen R, Cooper L, Wyatt M, Leach J, Mubarak S, et al. The pathomechanics of gait in Duchenne muscular dystrophy. Dev Med Child Neurol 1981;23(1):3-22.
  • Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Rel Res 1993;288:122-5.
  • Sienko Thomas S, Buckon CE, Nicorici A, Bagley A, McDonald CM, Sussman MD. Classification of the gait patterns of boys with Duchenne muscular dystrophy and their relationship to function. J Child Neurol. 2010;25(9):1103-9.
  • Willig TN, Carlier L, Legrand M, Riviere H, Navarro J. Nutritional assessment in Duchenne muscular dystrophy. Dev Med Child Neurol 1993;35(12):1074-82.
  • Martigne L, Salleron J, Mayer M, Cuisset J-M, Carpentier A, Neve V, et al. Natural evolution of weight status in Duchenne muscular dystrophy: a retrospective audit. Br J 2011;105(10):1486-91.
  • Davidson ZE, Ryan MM, Kornberg AJ, Sinclair K, Cairns A, Walker KZ, et al. Observations of body mass index in Duchenne muscular dystrophy: a longitudinal study. Eur J Clin Nutr 2014;68(8):892-7.
  • Markham L, Spicer R, Khoury P, Wong B, Mathews K, Cripe LH. Steroid therapy and cardiac function in Duchenne muscular dystrophy. Pediatric cardiology. 2005;26:768-71.
  • Biggar W, Harris V, Eliasoph L, Alman B. Long-term benefits of deflazacort treatment for boys with Duchenne muscular dystrophy in their second decade. Neuromuscul Disord 2006;16(4):249-55.
  • Chew K, Carey K, Ho G, Mallitt K-A, Widger J, Farrar M. The relationship of body habitus and respiratory function in Duchenne muscular dystrophy. Respir Med 2016;119:35-40.
  • Billich N, Adams J, Carroll K, Truby H, Evans M, Ryan MM, et al. The Relationship between Obesity and Clinical Outcomes in Young People with Duchenne Muscular Dystrophy. Nutrients 2022;14(16):3304.
  • Goemans N, Wong B, Van den Hauwe M, Signorovitch J, Sajeev G, Cox D, et al. Prognostic factors for changes in the timed 4-stair climb in patients with Duchenne muscular dystrophy, and implications for measuring drug efficacy: A multi-institutional collaboration. PLoS One 2020;15(6):e0232870.
  • Sawnani H, Thampratankul L, Szczesniak RD, Fenchel MC, Simakajornboon N. Sleep disordered breathing in young boys with Duchenne muscular dystrophy. J Pediatr 2015;166(3):640-5. e1.
  • Bushby K, Connor E. Clinical outcome measures for trials in Duchenne muscular dystrophy: report from International Working Group meetings. Clin Investig 2011;1(9):1217.
  • Yağcıoğlu GA, Gürbüz İA, Topuz S, Yılmaz Ö. Development of a new instrument to evaluate gait characteristics of individuals with Duchenne Muscular Dystrophy: Gait Assessment Scale for Duchenne Muscular Dystrophy, and its validity and reliability. Early Hum Dev 2023;185:105843.
  • Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51(1):1-14.
  • Organization WH, Organization WH. WHO Multicentre Growth Reference Study Group: WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: WHO. 2006;2007.
  • Aydın Yağcıoğlu G. Duchenne Musküler Distrofi’li Hastalarda Yürüyüş Değerlendirme Ölçeği ile Yürüyüş Kalite ve Bağımsızlığı Sınıflandırma Skalası’nın Geliştirilmesi ve Geçerlilik ve Güvenilirliğinin İncelenmesi. 2021.
  • McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, et al. The 6‐minute walk test and other clinical endpoints in Duchenne muscular dystrophy: reliability, concurrent validity, and minimal clinically important differences from a multicenter study. Muscle Nerve 2013;48(3):357-68.
  • McDonald CM, Henricson EK, Han JJ, Abresch RT, Nicorici A, Elfring GL, et al. The 6‐minute walk test as a new outcome measure in Duchenne muscular dystrophy. Muscle Nerve 2010;41(4):500-10.
  • Mukaka MM. A guide to appropriate use of correlation coefficient in medical research. Malawi Med J 2012;24(3):69-71.
  • Akoglu H. User's guide to correlation coefficients. Turkish J Emerg Med 2018;18(3):91-3.
  • Weber DR, Hadjiyannakis S, McMillan HJ, Noritz G, Ward LM. Obesity and endocrine management of the patient with Duchenne muscular dystrophy. Pediatrics 2018;142(Suppl 2):S43-S52.
  • Canapari CA, Barrowman N, Hoey L, Walker SW, Townsend E, Tseng BS, et al. Truncal fat distribution correlates with decreased vital capacity in Duchenne muscular dystrophy. Pediatr Pulmonol 2015;50(1):63-70.
  • Rodríguez-Cruz M, Sanchez R, Escobar RE, Cruz-Guzmán OdR, López-Alarcón M, Bernabe García M, et al. Evidence of insulin resistance and other metabolic alterations in boys with Duchenne or Becker muscular dystrophy. Int J Endocrinol 2015;2015.
  • McDonald CM, Abresch RT, Carter GT, Fowler Jr WM, Johnson ER, Kilmer DD, et al. Profiles of neuromuscular diseases. Duchenne muscular dystrophy. Am J Phys Med Rehabil 1995;74(5 Suppl):S70-92.
  • Hills AP, Parker AW. Gait characteristics of obese children. Arch Phys Med Rehabil 1991;72(6):403-7.
  • Galli M, Cimolin V, Rigoldi C, Condoluci C, Albertini G. Effects of obesity on gait pattern in young individuals with Down syndrome. Int J Rehabil Res 2015;38(1):55-60.
  • Elshemy SA. Comparative study: Parameters of gait in Down syndrome versus matched obese and healthy children. Egypt J Med Hum Genet 2013;14(3):285–91.
  • Donlevy GA, Garnett SP, Cornett KM, McKay MJ, Baldwin JN, Shy RR, et al. Association Between Body Mass Index and Disability in Children With Charcot-Marie-Tooth Disease. Neurology 2021;97(17):e1727-e36.
  • Meyns P, Van Gestel L, Bar-On L, Goudriaan M, Wambacq H, Aertbeliën E, et al. Children with spastic cerebral palsy experience difficulties adjusting their gait pattern to weight added to the waist, while typically developing children do not. Front Hum Neurosci 2016;10:657.
  • Del Porto H, Pechak C, Smith D, Reed-Jones R. Biomechanical effects of obesity on balance. Int J Exerc Sci 2012;5(4):301-20.
  • Bayram E, Topcu Y, Karakaya P, Bayram MT, Sahin E, Gunduz N, et al. Correlation between motor performance scales, body composition, and anthropometry in patients with duchenne muscular dystrophy. Acta Neurol Belg 2013;113(2):133-7.
  • Sussman MD, Sienko SE, Buckon CE, Hilton C, De Mattos CB, d'Amato C. Efficacy of corticosteroid in decreasing scoliosis and extending time to loss of ambulation in a single clinic: an effectiveness trial. J Child Orthop 2020;14(5):421-32.
  • Vuillerot C, Braillon P, Fontaine-Carbonnel S, Rippert P, André E, Iwaz J, et al. Influence of a two-year steroid treatment on body composition as measured by dual X-ray absorptiometry in boys with Duchenne muscular dystrophy. Neuromuscul Disord 2014;24(6):467-73.
  • Matthews E, Brassington R, Kuntzer T, Jichi F, Manzur AY. Corticosteroids for the treatment of Duchenne muscular dystrophy. Cochrane Database Syst Rev 2016;2016(5):CD003725.
There are 39 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Research Article
Authors

Güllü Aydın Yağcıoğlu 0000-0003-1658-7697

Numan Bulut 0000-0001-5427-1103

İpek Gürbüz 0000-0001-5556-6608

Öznur Tunca Yılmaz 0000-0002-0855-9541

Publication Date January 31, 2025
Submission Date July 10, 2024
Acceptance Date January 12, 2025
Published in Issue Year 2025 Volume: 9 Issue: 1

Cite

APA Aydın Yağcıoğlu, G., Bulut, N., Gürbüz, İ., Tunca Yılmaz, Ö. (2025). The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy. Journal of Basic and Clinical Health Sciences, 9(1), 85-91. https://doi.org/10.30621/jbachs.1513965
AMA Aydın Yağcıoğlu G, Bulut N, Gürbüz İ, Tunca Yılmaz Ö. The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy. JBACHS. January 2025;9(1):85-91. doi:10.30621/jbachs.1513965
Chicago Aydın Yağcıoğlu, Güllü, Numan Bulut, İpek Gürbüz, and Öznur Tunca Yılmaz. “The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy”. Journal of Basic and Clinical Health Sciences 9, no. 1 (January 2025): 85-91. https://doi.org/10.30621/jbachs.1513965.
EndNote Aydın Yağcıoğlu G, Bulut N, Gürbüz İ, Tunca Yılmaz Ö (January 1, 2025) The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy. Journal of Basic and Clinical Health Sciences 9 1 85–91.
IEEE G. Aydın Yağcıoğlu, N. Bulut, İ. Gürbüz, and Ö. Tunca Yılmaz, “The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy”, JBACHS, vol. 9, no. 1, pp. 85–91, 2025, doi: 10.30621/jbachs.1513965.
ISNAD Aydın Yağcıoğlu, Güllü et al. “The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy”. Journal of Basic and Clinical Health Sciences 9/1 (January 2025), 85-91. https://doi.org/10.30621/jbachs.1513965.
JAMA Aydın Yağcıoğlu G, Bulut N, Gürbüz İ, Tunca Yılmaz Ö. The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy. JBACHS. 2025;9:85–91.
MLA Aydın Yağcıoğlu, Güllü et al. “The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy”. Journal of Basic and Clinical Health Sciences, vol. 9, no. 1, 2025, pp. 85-91, doi:10.30621/jbachs.1513965.
Vancouver Aydın Yağcıoğlu G, Bulut N, Gürbüz İ, Tunca Yılmaz Ö. The Relationship Between Body Mass Index and Gait Characteristics and Gait Performance of Children With Duchenne Muscular Dystrophy. JBACHS. 2025;9(1):85-91.