FSHD Brochure_

Appendix 3: Checklist
Physiotherapy for FSHD
Common consequences with FSHD
Muscles and movement
I experience it as
a problem
Often stumbling or falling yes / no yes / no
Problems moving independently yes / no yes / no
Speaking unclearly yes / no yes / no
Difficulty chewing and/or swallowing yes / no yes / no
Often choking on saliva or food yes / no yes / no
Muscle weakness (different on both sides) yes / no yes / no
Pain yes / no yes / no
Cold (to the touch) limbs yes / no yes / no
Blue/white discolouration of toes and fingers yes / no yes / no
Tingling or loss of feeling in hands/arms/legs yes / no yes / no
Dropping things and/or difficulty lifting objects yes / no yes / no
Difficulty combing hair yes / no yes / no
The heart
Palpitations yes / no yes / no
Dizziness yes / no yes / no
Breathing
Recurring pneumonia yes / no yes / no
Having to breathe often and heavily yes / no yes / no
Poor fitness and stamina yes / no yes / no
Little cough force yes / no yes / no
Sleeping and drowsiness
Fatigue yes / no yes / no
Sleepiness during the day yes / no yes / no
Restless sleep yes / no yes / no
Scary or intense dreams yes / no yes / no
Headache on awakening yes / no yes / no
Care and facilities
Self-care (brushing teeth, washing, dressing and undressing)
yes / no
I experience my
environment as a
problem
yes / no
Care or help at home yes / no yes / no
Use of aids/resources yes / no yes / no
Communication and social contacts
Social contacts (entering into new contacts or maintaining
them)
Lack of understanding or acceptance of illness from
the environment
Daily activities
Work (finding work, keeping work, difficulty of work,
suitability of work)
yes / no
yes / no
yes / no
yes / no
yes / no
yes / no
School or study yes / no yes / no
Participation in sports or hobbies yes / no yes / no
Participation in housekeeping yes / no yes / no
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