Revised north star ambulatory assessment for young boys with Duchenne muscular dystrophy

E. Mercuri, Giorgia Coratti, S. Messina, V. Ricotti, Giovanni Baranello, Adele D'Amico, Maria Carmela Pera, Emilio Albamonte, Serena Sivo, E. S. Mazzone, Maria Teresa Arnoldi, Lavinia Fanelli, Roberto De Sanctis, Domenico M M Romeo, Gian Luca Vita, Roberta Battini, Enrico Silvio Bertini, Francesco Muntoni, M. Pane

Research output: Contribution to journalArticlepeer-review


The advent of therapeutic approaches for Duchenne muscular dystrophy (DMD) has highlighted the need to identify reliable outcome measures for young boys with DMD. The aim of this study was to develop a revised version of the North Star Ambulatory Assessment (NSAA) suitable for boys between the age of 3 and 5 years by identifying age appropriate items and revising the scoring system accordingly. Using the scale in 171 controls between the age of 2.9 and 4.8 years, we identified items that were appropriate at different age points. An item was defined as age appropriate if it was completed, achieving a full score, by at least 85% of the typically developing boys at that age. At 3 years (±3months) there were only 8 items that were age appropriate, at 3 years and 6 months there were 13 items while by the age of 4 years all 17 items were appropriate. A revised version of the scale was developed with items ordered according to the age when they could be reliably performed. The application of the revised version of the scale to data collected in young DMD boys showed that very few of the DMD boys were able to complete with a full score all the age appropriate items. In conclusion, our study suggests that a revised version of the NSAA can be used in boys from the age of 3 years to obtain information on how young DMD boys acquire new abilities and how this correlates with their peers.

Original languageEnglish
Article numbere0160195
JournalPLoS One
Issue number8
Publication statusPublished - Aug 1 2016

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)


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