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Assessment and Physiotherapy managment of 1 year DMD Child














Name : XYZ 
Diagnosis :DMD
 AGE /Sex : xyz /M 
Corrected age. 1years 3 Months 5days
 Physical and Functional Assessment 
 Muscle Tone : Hypotonic with slight atrophic appearance of upper limb and Shoulder Gridle muscles Chest expansion :- 
 Calf muscle girth :-
 MMT Grading:- 3 /5 Gross major muscle strength of upper limb ,
 2/ 5 Gross major muscle lower limb and muscle except hamstring and Gluteal are more Weak Core muscle :- 2/ 5 
 GFMF SCORE 57% 1MAY 2022 These scoring is done with use of 3 dimension it can be vary when all the dimensions will be used NOTE :- 
these MMT Grading can be variable depend on the child mood and behavior since the child having some Hyperactive movement in that situation we can't figure out these grading is absolutely perfect

 Tightness Mild Tightness of
 Bilateral internal rotator of hip and hip flexor 
 Weakness : Gross major muscle weakness of bilateral upper limb and lower ,
core and truncal muscle 
 Hamstring and Gluteal are more Weak than other muscle 
 Bilateral limb muscle more weak than bilateral upper limb Static 
 He is able to maintain sitting posture for sometime without support But yet not achieved sitting position independently 
 Dynamic 

 He used to play in sitting position like pull and push ..Throwing ball and object He is doing different angle reach over the shoulder level All he is doing under the supervision .

he used to sit on high level bench or chair while feet off the floor without hand support able to maintain independently and also can do some reach out under the supervision

 He is doing kicking in sitting position but not in frequently High sitting to standing with therapist support
 Note :-he has backward fall tendency but not in frequent it can be overcome once he achieved good enough static and dynamic sitting position and core strength Transition Pivoting Roll over Creeping but not absolute competent Able to get up from bed with minimal support ot holding bed sheet , pajama Rolling - Competent 
 Pivoting - Competent 
 Get to sit -partially Competent 
 Sitting without support -incompetent 
 Quadruped:   Incompetent 
 Heel sitting. With front support Able to hold for limited time Kneeling with support with therapist support or front supported 
Half kneeling : he is trying to take out his leg in half kneeling from high kneeling with therapist support

 Standing - back support with help of Orthosis SOLID AFO Fine motor He used to plug out different shape and size object like form sticky tape
 He has these different grip grasp ( prehension) but not absolute competent Cylinderical Palmar Spherical grasp Tip to thumb Hook or snap hand function activity : pick up corn shape sorter activity


 theraputty – rolling tearing
 , cutting , paper tearing soft – hard
 picking coin drop to other bucket
 pushing and pulling 
 squeez smile ball 

 Short term Goal

 Get to sit from floor 
 Creep forward for 2-5 meter Attain quadruped himself and maintain for 2-3 min 
 Static and Dynamic sitting posture
 Transition- supine -Side sitting- quadruped Long term goal Major group of Muscle strengthening upper limb and lower limb 
 Core muscle strengthening Back support Standing with help of Orthosis with therapist support or without support 
 Once he achieved good enough knee control we can transfer him on rollator 

 Transition 
 Quadruped - Heel sitting - Kneeling - Half kneeling - Standing Sit to stand with support or without support using different size of bench or chair 

 Cross leg sit to stand with help of bloaster



author 
Dr.Akshay Raj Chandra 
 senior Consultant Neuro Pediatric Physiotherapist  (DELHI NCR BASED )
ph +917827068869
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