Do 4-6 year olds with Duchenne muscular dystrophy typically experience a lot of fatigue?

• A. True
• B. False
• C. Not known
• D. Sometimes

Answer: (B)

In Duchenne muscular dystrophy, the pattern of weakness and endurance changes as the child ages. In the 4- to 6-year-old range, proximal muscle weakness is present with signs like toe walking or Gowers’ sign, but they are not known for pervasive, daily fatigue. They may tire with longer activities or during sustained effort, yet overall daily energy and play capacity often remain reasonable for short bursts. Fatigue tends to become more evident as the disease progresses and endurance-required tasks become more demanding, rather than being a hallmark early feature. So saying these young children typically experience a lot of fatigue doesn’t fit the typical early presentation, making it the less likely characterization. If fatigue is unusually severe, consider other contributing factors such as sleep issues, pain, cardiopulmonary involvement, or anemia.