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Table 1 Definition of patient/parent self-evaluated clinical severity stages

From: Comparative cost of illness analysis and assessment of health care burden of Duchenne and Becker muscular dystrophies in Germany

Stage Clinical characteristics of DMD and BMD boys/men
I Early ambulatory with mild impairment: Gowers’ maneuver, waddling gait, walking on toes, problems with climbing stairs.
II Late ambulatory with high impairment: Walking becomes increasingly difficult, more problems climbing stairs and getting up from the floor, part-time wheelchair use.
III Early non-ambulatory: Loss of ambulation, active manual wheelchair use possible, independent standing and sitting still possible for some time.
IV Late non-ambulatory: Independent electric wheelchair use but decline of upper limb function and ability to sit independently.
V Non-ambulatory with confinement to bed: Loss of independent mobility, hand function preserved on a low level.
  1. According to self-evaluated clinical symptoms and motor function DMD and BMD patients were divided into corresponding subgroups to reveal potential correlations between these functional stages and the burden of illness. Modification after Bushby K et al., The Lancet Neurology, 2010 [3].