welcome to DuchenneXchange
- a positively charged Duchenne muscular dystrophy community.- join today!
- log in
Pathomechanics of Gowers’ Sign: A Video Analysis of a Spectrum of Gowers’ Maneuvers
source: Clinical Orthopaedics and Related Research
year: 2012
authors: Richard F. Chang, Scott J. Mubarak
summary/abstract:Background:
Gowers’ sign is a screening test for muscle weakness, typically seen in Duchenne muscular dystrophy but also seen in numerous other conditions. The mildest presentations and the variations of Gowers’ sign are poorly described in the literature but are important to recognize to help with early diagnosis of a neuromuscular problem.
Questions/purposes:
We therefore (1) defined the characteristics of the mildest forms and the compensatory mechanism used, (2) categorized the spectrum of this sign as seen in various neuromuscular diseases, and (3) provide educational videos for clinicians.
Methods:
We videotaped 33 patients with Gowers’ sign and three healthy children. Weakness was categorized as: mild = prolonged or rise using single-hand action; moderate = forming prone crawl position and using one or two hands on thigh; severe = more than two thigh maneuvers, rising with additional aid, or unable to rise.
Results:
The earliest changes were exaggerated torso flexion, wide base, and equinus posturing, which reduce hip extension moment, keep forces anterior to the knee, and improve balance. Patients with moderate weakness have wide hip abduction, shifts in pelvic tilt, and lordosis, which reduce knee extension moment, improve hamstrings moment arm, and aide truncal extension. The classic Gowers’ sign (severe) exaggerates all mechanisms.
Conclusions:
The classically described Gowers’ sign is usually a late finding. However more subtle forms of Gowers’ sign including mild hand pressure against the thigh and prone crawl position should be recognized by clinicians to initiate additional diagnostic tests.
DOI: 10.1007/s11999-011-2210-6
read more
rareRelated
-
Gower’s Sign in Children with Muscular DystrophyDifferent steps taken by a patient to st...
-
Bone Health in Children with Duchenne Muscular Dystrophy: A ReviewDuchenne muscular dystrophy (DMD) patien...
-
The Relationship between Bone Mineral Density and Cardiovascular Function in Duchenne Muscular Dystrophy: A Retrospe...Objective: The objective of this retros...
-
Delayed onset of ambulation in boys with Duchenne muscular dystrophy: Potential use as an endpoint in clinical trial...Abstract Individuals with Duchenne musc...
-
Bone health and osteoporosis management of the patient with Duchenne muscular dystrophyDuchenne muscular dystrophy is associate...
-
Regression of Hamstring Flexibility and Performance in Children With Duchenne Muscular DystrophyInvestigator investigated that regressio...
-
Endocrine and Bone Health – Jarod Wonghttps://www.youtube.com/watch?v=CEvT4KCL...