Dual-task performance as a clinical marker of upper limb decline in Duchenne muscular dystrophy

Abstract

Objective

To compare upper extremity performance of ambulant children with Duchenne muscular dystrophy and typically developing peers under single- and dual-task conditions, and to examine its associations with mobility and balance.

Design

Cross-sectional observational study.

Setting

Data were collected at the Pediatric Neurology Department and the Pediatric Rehabilitation Unit of the Faculty of Physical Therapy and Rehabilitation.

Participants

Twenty ambulant boys with Duchenne muscular dystrophy (6–12 years) and 19 age-matched typically developing peers.

Intervention

Not applicable.

Main measures

Upper extremity performance was assessed using the Nine-Hole Peg Test under single-task, motor dual-task, and cognitive dual-task conditions. Functional mobility and balance, as well as clinical scales, were also evaluated.

Results

Children with Duchenne muscular dystrophy performed significantly slower than typically developing peers under cognitive dual-task conditions (p < 0.001) and under motor dual-task conditions for the left hand (p = 0.032). Slower dual-task performance was moderately associated with poorer balance and trunk control. Cognitive dual-task performance showed high diagnostic accuracy for identifying Duchenne muscular dystrophy (area under curve = 0.91–0.96).

Conclusions

Dual-task paradigms may reveal functional vulnerability in upper-limb performance in ambulant children with Duchenne muscular dystrophy that is not evident during single-task testing. Increased cognitive–motor demands appear to exacerbate functional difficulties beyond muscle weakness. These findings suggest that dual-task assessment may complement conventional clinical evaluations and provide additional insight for rehabilitation planning.

Graphical abstract

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