Muscular Dystrophies & Spinal Muscular Atrophy Practice Test

The standards of care for Duchenne muscular dystrophy are arranged to match how medical needs change as the disease progresses, which naturally falls into three major stages.

First, when a child is still ambulatory, the focus is on preserving walking ability as long as possible and starting systematic surveillance. This includes timely use of therapies that slow progression, such as corticosteroids, regular physical therapy to maintain range of motion, ongoing respiratory and cardiac monitoring, scoliosis surveillance, and multidisciplinary support to support growth, nutrition, and school functioning.

As walking becomes limited and the person transitions away from ambulation, emphasis shifts to maintaining respiratory and cardiac health, preventing and managing scoliosis, and supporting mobility with appropriate devices and therapies. Respiratory muscle training, airway clearance techniques, noninvasive ventilation as needed, continued cardiac monitoring, and orthopedic care become central, along with ongoing nutrition and psychosocial support.

In the late stage, when respiratory failure risk rises and mobility is greatly reduced, care centers on advanced respiratory support, preventing infections, nutrition, and quality-of-life considerations, with a focus on comfort, palliative care, and caregiver support, while continuing to monitor cardiac health and other complications.

This three-stage structure mirrors the major clinical transitions in DMD—preserving ambulation, losing ambulation with escalating respiratory and cardiac care, and managing late-stage complications—so it remains the most accurate framework.