Investigation of the relationship between upper extremity proprioception and upper extremity functions in children with Duchenne muscular dystrophy.

BACKGROUND AND

OBJECTIVE

Upper-extremity proprioception contributes to coordinated reaching and grasping, which are critical for functional independence; however, evidence on upper-limb proprioception in children with Duchenne muscular dystrophy (DMD) remains limited. Therefore, we aimed to compare wrist proprioception in children with DMD versus healthy peers and to examine its relationship with upper-limb function.

METHODS

Cross-sectional observational study conducted at a pediatric neuromuscular clinic, enrolling children aged 6-15 years who were able to sit independently. Wrist proprioception at 45° flexion was assessed using verbal description, position verification, and ipsilateral/contralateral matching under two conditions (eyes open and eyes closed). Absolute angular error was calculated for each condition, and the open - closed difference was derived as the within-subject change between conditions; angles were measured using a goniometer. Secondary outcomes included elbow/wrist ROM limitation, grip strength, PUL 2.0, ABILHAND-Kids, and ACTIVLIM.

RESULTS

Sixty-two children participated (42 DMD, 20 controls); 80.9% of the DMD group were ambulatory. Compared with controls, the DMD group had poorer wrist proprioception, showing larger EO - EC differences and higher EC errors (all p < .001), except for contralateral matching where the within-group EO - EC change was not significant (p = .156). Only location verification and ipsilateral matching correlated with elbow ROM limitation (p = .007-0.002), wrist ROM limitation (both p < .001), hand dexterity (ABILHAND-Kids p = .005-0.006), participation (ACTIVLIM p = .012-0.006), and upper-limb performance (PUL total p = .002-0.004).

DISCUSSION: Children with DMD exhibit wrist proprioceptive deficits that are associated with joint ROM limitations and with measures of upper-limb performance and participation, supporting the inclusion of proprioceptive assessment in rehabilitation planning to help maintain distal function.