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Weakness is symmetric, progressive, and proximal (on or close to the torso), usually affecting the hip girdle and shoulder girdle muscles. [1] [3] Hip weakness can manifest as a waddling gate. [1] Shoulder weakness can manifest as winged scapulas. [1] Muscle contractures, especially of the Achilles tendon, and scoliosis can also occur. [1]
Diabetes most commonly causes damage to the long nerves that supply the feet and lower legs, causing numbness, tingling and pain (diabetic polyneuropathy). Although these symptoms may also be present, the pain and weakness of proximal diabetic neuropathy often onset more quickly and affect nerves closer to the torso. [citation needed]
Those with femoral nerve dysfunction may present problems of difficulties in movement and a loss of sensation. [medical citation needed] The patient, in terms of motor skills, may have problems such as quadriceps wasting, loss of knee extension and a lesser extent of hip flexion given the femoral nerve involvement of the iliacus and pectineus muscles. [3]
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Frailty can have various symptoms including muscle weakness (reduced grip strength), slower walking speed, exhaustion, unintentional weight loss, and frequent falls. [ 3 ] [ 4 ] Older people with certain medical conditions such as diabetes , heart disease and dementia , are also more likely to have frailty.
[7] sIBM is a rare disease, with a prevalence ranging from 1 to 71 individuals per million. [8] [9] Weakness comes on slowly (over months to years) in an asymmetric manner and progresses steadily, leading to severe weakness and wasting of arm and leg muscles. IBM is more common in men than women. [10]
By definition, all limb girdle muscular dystrophies (LGMD) cause progressive proximal weakness, [3] meaning weakness of the muscles on or close to the torso that worsens over time. Explicitly, LGMD preferentially affects muscles of the hip girdle, thigh, shoulder girdle, and/or upper arm. [8] [6] The muscle weakness is generally symmetric. [11]
The "waddling" is due to the weakness of the proximal muscles of the pelvic girdle. [1] The patient uses circumduction to compensate for gluteal weakness. [2] Conditions associated with a myopathic gait include pregnancy, congenital hip dysplasia, muscular dystrophies and spinal muscular atrophy.
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