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The Gowers’ maneuver in Duchenne

Early clues

Turning point

Cardiac disease

See more videos

Daniel Guillen, MD, explains why the Gowers’ maneuver is often considered a hallmark sign of DMD. Learn how this movement pattern reflects proximal muscle weakness, why it commonly appears in young boys with Duchenne, and what clinicians look for when evaluating early signs of the disease.

Why is the Gowers’ maneuver considered a hallmark sign of Duchenne?

Transcript

When we have a Gowers maneuver, it means that to get up off the ground, we need to climb over ourselves. These kids push off their knees or push off their legs and thighs to stand up.

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So getting up off the ground is a good observation to have, and there are multiple videos online that we can visit to recheck what the Gowers maneuver looks like.

The reason why this makes us think about weakness, proximal weakness in particular, is because we use our hip girdle muscles, our glutes, our thighs, to stand up straight.

So even though we may go into a leaning-over position with other muscles, when we need to use those muscles that are particularly affected in muscular dystrophy, then we need to think about the Gowers maneuver, and not exclusively to Duchenne muscular dystrophy, but very commonly we find this connection just because of the age group and the frequency of Duchenne muscular dystrophy in particular in 3- to 5-year-old boys.

That’s when we start seeing that. Sometimes even earlier. And keeping some word of caution that there are several other medical conditions that can cause a Gowers maneuver. We just use it as a parameter to explore into potential muscular dystrophy in boys that age.

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