Which sequence accurately describes the typical progression of hip extensors, quadriceps, and dorsiflexors in Duchenne muscular dystrophy?

• A. Quadriceps, dorsiflexors, hip extensors
• B. Dorsiflexors, hip extensors, quadriceps
• C. Hip extensors, quadriceps, dorsiflexors
• D. Hip extensors, dorsiflexors, quadriceps

Answer: (C)

In Duchenne muscular dystrophy, weakness typically moves from proximal to distal, so the muscles closest to the body's center are affected first. The hip extensors are part of that proximal group and often show weakness early, which impairs standing up from a chair and initial gait stability. As the disease progresses, the quadriceps (thigh muscles essential for knee extension during stance and gait) weaken next, leading to further limitations in walking and rising from the floor. Later, the dorsiflexors (ankle front-lift muscles) become involved, resulting in foot drop and altered foot clearance during walking.

This sequence—hip extensors first, followed by quadriceps, and then dorsiflexors—aligns with the typical proximal-to-distal progression seen in Duchenne and explains the common pattern of functional decline.