The nurse notices that a school-age child stands up from the floor using both hands and knees to help him achieve a standing position. This finding is an indicator of which of the following muscular dystrophies?
1. Duchenne
2. Becker
3. Myotonic
4. Lumbar girdle
Duchenne
Rationale: In Duchenne muscular dystrophy, weakness begins near the trunk then progresses to the extremities. By school age, the child has an unsteady gait and needs to use the Gower's maneuver to rise up from the floor. This maneuver involves the child getting on hands and knees, raising the rear end, and then achieving a standing position. Becker muscular dystrophy does not manifest until the person is in the teen years or young adulthood. Myotonic muscular dystrophy is the most common adult form of muscular dystrophy. Lumbar girdle muscular dystrophy affects the pelvis and shoulder area but has no particular diagnostic indicator.
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