Type of field | Optional/Required field | Field accessible by patients | |
---|---|---|---|
Personal datab | |||
Firs name | To fill | Required | Yes |
Last name | To fill | Required | Yes |
Email address | To fill | Optional | Yes |
Date of birth | Date | Required | Yes |
Phone number | To fill | Optional | Yes |
City of birth | To fill | Required | Yes |
Country of birth | Dropdown menu | Required | Yes |
City of residence | To fill | Optional | Yes |
Country of residence | Dropdown menu | Optional | Yes |
Sex | Male/Female choice | Required | Yes |
Height (cm) | To fill | Optional | Yes |
Weight (kg) | To fill | Optional | Yes |
1.Demographic datac | |||
Case code | Automatically generated | Required | No |
Age | Generated from personal data | Required | Yes |
Country of birth | Generated from personal data | Required | Yes |
Sex | Generated from personal data | Required | Yes |
Height | Generated from personal data | Optional | Yes |
Weight | Generated from personal data | Optional | Yes |
Body mass index | Generated from personal data | Optional | Yes |
2.Diagnosis | |||
First diagnostic centre | Dropdown menu | Required | No |
Diagnosing age | To fill | Required | No |
Diagnosed disease | Dropdown menu | Required | No |
Diagnosing through biopsy | Yes/No choice | Required | No |
Diagnosing through genetic testing | Yes/No choice | Required | No |
Genetic mutations | Allele 1 Dropdown menu | Required | No |
Allele 2 Dropdown menu | Required | No | |
Reference sequence used | To fill | Optional | No |
3.Clinical data | |||
Second wind | Yes/No/NA choice | Required | Yes |
Myoglobinuria | Yes/No/NA choice | Required | Yes |
Systems with disease (affected organs) | Dropdown menu | Required | No |
Difficulties in maintaining physical activities | Yes/No choice | Required | No |
Weakness | Yes/No choice | Required | No |
Muscle wasting | Yes/No choice | Required | No |
Disease severity | Dropdown menu | Optional | No |
Lab data | |||
Forearm test | Performed/Not performed | Required | No |
Basal serum CK levels | To fill | Optional | No |
Other tests (specify) | To fill | Optional | No |
Exercise testing | |||
VO2 peak | To fill | Optional | No |
%HRmax predicted | To fill | Optional | No |
VO2 peak power output | To fill | Optional | No |
Lab demonstrated second wind | To fill | Optional | No |
Other tests (specify) | To fill | Optional | No |
4.Concomitant diseases | |||
Diabetes | Yes/No/NA choice | Optional | No |
Coronary Artery Disease | Yes/No/NA choice | Optional | No |
Hypertension | Yes/No/NA choice | Optional | No |
Cancer | Yes/No/NA choice | Optional | No |
COPD | Yes/No/NA choice | Optional | No |
Acute renal failure | Yes/No/NA choice | Optional | No |
Chronic renal failure | Yes/No/NA choice | Optional | No |
Hyperuricemia or Gout | Yes/No/NA choice | Optional | No |
Anemia or Hyperbilirubinemia | Yes/No/NA choice | Optional | No |
Other comorbidity | To fill | Optional | No |
5.Other genetic factors | |||
ACE Genotype | I/I, I/D, D/D or N/D choice | Optional | No |
ACTN3 Genotype | R/R, R/X, X/X or N/D choice | Optional | No |
AMPD1 Genotype | Q/Q, Q/X, X/X or N/D choice | Optional | No |
PGC Genotype | G/G, G/S, S/S or N/D choice | Optional | No |
Other Genotype | To fill | Optional | No |
6.Self-reported functional data | |||
Limitations | Yes/No/NA choice | Optional | Yes |
WHO DAS 2.0 | To fill (Score) | Optional | Yes |
QOL SF 36 | To fill (Score) | Optional | Yes |
QOL Bouchard | To fill (Score) | Optional | Yes |
IPAQ | To fill (Score) | Optional | Yes |
FSS | To fill (Score) | Optional | Yes |
Other (specify) | To fill | Optional | Yes |
7.Previous/ongoing treatments | |||
Drugs | |||
Pain Relief | Yes/No/NA choice | Optional | Yes |
ACE Inhibitors | Yes/No/NA choice | Optional | Yes |
Diuretics | Yes/No/NA choice | Optional | Yes |
Cardiovascular Drugs | Yes/No/NA choice | Optional | Yes |
Insulin or Antidiabetics | Yes/No/NA choice | Optional | Yes |
Muscle Relaxants | Yes/No/NA choice | Optional | Yes |
Psychoactive Drugs | Yes/No/NA choice | Optional | Yes |
Allopurinol: | Yes/No/NA choice | Optional | Yes |
Other (specify) | To fill | Optional | Yes |
Special diet | |||
Sucrose | Yes/No/NA choice | Optional | Yes |
Carbohydrate rich | Yes/No/NA choice | Optional | Yes |
Protein rich | Yes/No/NA choice | Optional | Yes |
Lipid rich | Yes/No/NA choice | Optional | Yes |
Other (specify) | To fill | Optional | Yes |
Supplements | |||
B6 | Yes/No/NA choice | Optional | Yes |
Creatine | Yes/No/NA choice | Optional | Yes |
CoQ or Idebenone | Yes/No/NA choice | Optional | Yes |
Other vitamins | Yes/No/NA choice | Optional | Yes |
BCAA | Yes/No/NA choice | Optional | Yes |
Carnitine | Yes/No/NA choice | Optional | Yes |
Other (specify) | Yes/No/NA choice | Optional | Yes |
Rehabilitation program | Yes/No/NA choice | Optional | Yes |
Other treatments (specify) | To fill | Optional | Yes |
8.Services provided | |||
Currently working | Yes/No/NA choice | Optional | Yes |
Benefited from specific healthcare | Yes/No/NA choice | Optional | Yes |
Changed job because disease | Yes/No/NA choice | Optional | Yes |
Employer modified environment because disease | Yes/No/NA choice | Optional | Yes |