The gastrointestinal problems may need medical attention at times. Labor and delivery may be complicated by muscle abnormalities in the uterus, and the obstetrician should be informed about a patient's myotonic dystrophy status and care. Early signs of Duchenne, which usually occur between the ages of 2 and 6, include frequent falling, difficulty getting up from a sitting or lying position, and a waddling gait. Another hallmark is the apparent enlargement of the calf and sometimes other muscles, which is really due to an accumulation of fat and connective tissue in the muscle. In Duchenne muscular dystrophy, posture changes as the child grows.
Progression varies somewhat from child to child.
The use of orthopedic devices and physical therapy can prolong the ability to walk. Frequently, however, a wheelchair will be needed by age 12. Breathing becomes affected during the later stages of Duchenne, leading to respiratory infections. These are often successfully treated with antibiotics and respiratory therapy. Severe respiratory and heart problems mark the disease's final stages, usually in the boy's teens or early 20s.