Clinical Diagnosis

Patients with DMD show normal growth and development in their early childhood. In DMD, affected boys start to show disturbance of walking and frequently fall because of muscle weakness at 4 to 5 years of age. Patients are shown to have a positive Gower's sign wherein the child climbs up his thighs to extend the hips and push his trunk up. He manages to walk but his muscle strength gradually decreases. He loses the ability to climb up stairs. Lumbar lordosis becomes more exaggerated and the waddling gait increases. Patients usually are wheelchair-bound by the age of 12. Muscle wasting progresses as the patients get older until finally respiratory or cardiac failure develops due to muscle wasting.

Serum creatine kinase (CK) is markedly increased 50 times more than the normal range in infantile DMD. This marked elevation of serum CK is the most important hallmark for the diagnosis of DMD. During the asymptomatic period, elevation of serum CK is the sole sign for DMD. Some DMD patients are accidentally identified due to elevations of AST or ALT, which are commonly examined for liver function, because serum CK elevation is accompanied with elevations of AST and ALT.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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