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Facioscapulohumeral Muscular Dystrophy (FSHD)

Facioscapulohumeral Muscular Dystrophy (FSHD) is a progressive, genetic neurological condition. It is a type of muscular dystrophy affecting skeletal muscles.

  • In most cases, FSHD is inherited and is commonly passed down through generations.    

  • There are two types of FSHD; FSHD1 (95% of cases) and FSHD2 (less common, more complex genetics). 1 in every 7,500 individuals are estimated to have FSHD.

  • FSHD does not follow a standard pattern of presentation and progression. Approximately 20% of people with FSHD will require a wheelchair.

  • Typically, FSHD does not shorten a persons life expectancy

 Typical symptoms can but don’t always include:

  • Inability to pucker the lips e.g. to blow a balloon or to whistle.

  • Inability or difficulty to sip through a straw.

  • Eyes that don’t close fully during sleep.

  • Difficulty with sit-ups and pull-ups.

  • Scapular winging

  • Difficulty raising arms above shoulder height.

  • Weakness in hands and fingers.

  • Foot drop

  • Weak lower abdominal muscles, pec muscles

  • Sunken breastbone (pectus excavatum).

  • Curved spine (lordosis, kyphosis, scoliosis).

  • Chronic fatigue.

  • Pain, often severe (reported in 70% of patients).

Muscle weakness typically develops asymmetrically with the common affected muscles demonstrated in this diagram. >

What are the functional implications?

  • Difficulty with reaching overhead, grooming, lifting

  • Fatigue with ambulation and transfers

  • Risk of falls (esp. with trunk/leg weakness)

  • Facial weakness impacts communication and eating

  • May impact employment, ADLs, and community access

  • FSHD can affect all aspects of daily life, limiting personal independence and mobility.

 How can Neuro Junction assist with the management of FSHD:

For optimal management of FSHD there needs to be a multidisciplinary approach – including physiotherapists and occupational therapists.

Some examples of how our physiotherapists can assist:

  • Postural control and scapular stability

  • Core strengthening (avoid overload)

  • Gentle aerobic conditioning, Energy conservation

  • Falls prevention strategies

  • Support orthotic use (AFOs, lumbar supports, UL supports)

  • Hydrotherapy

  • Massage

  • Mobility aids

Some examples of how our occupational therapists can assist

  • Assistance with ADLs (dressing, grooming, bathing)

  • Equipment provision (e.g. shower chairs, grab rails, wheelchairs

  • Environmental adaptations

  • Fatigue management and activity pacing

  • Support for employment and community participation

Further Support for those with FSHD:

Rachel Dool