Lower limb muscle strength impairment in late-onset and adult myotonic dystrophy type 1 phenotypes

Muscle Nerve. 2017 Jul;56(1):57-63. doi: 10.1002/mus.25451. Epub 2016 Nov 25.

Abstract

Introduction: Lower limb strength has never been characterized separately for late-onset and adult myotonic dystrophy type 1 (DM1) phenotypes.

Methods: The purpose of this study was to: (1) describe and compare lower limb strength between the 2 DM1 phenotypes; and (2) compare the impairment profiles obtained from 2 assessment methods [manual (MMT) and quantitative (QMT) muscle testing] among 107 patients.

Results: Both MMT and QMT showed more pronounced weakness in the adult phenotype. In the late-onset phenotype, although MMT showed normal strength, QMT revealed a loss of 11.7%-20.4%. Participants with grade 1 or 2 on the Muscle Impairment Rating Scale had weakness detected using QMT, which suggests earlier muscle impairment than MMT alone would suggest.

Conclusions: To avoid muscle wasting, physical activity recommendations should be made for the late-onset phenotype and in the early stages of the disease for the adult phenotype. MMT is not recommended for use in clinical trials. Muscle Nerve 56: 57-63, 2017.

Keywords: lower limb; myotonic dystrophy type 1 (DM1); outcome measures; phenotype comparison; quantitative muscle testing; strength.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Electromyography
  • Female
  • Humans
  • Isometric Contraction / physiology
  • Lower Extremity / innervation*
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Muscle Weakness / etiology*
  • Muscle, Skeletal / physiopathology*
  • Myotonic Dystrophy / complications*
  • Severity of Illness Index
  • Young Adult