Although the average life expectancy of children with DMD in Europe, America and Canada is 28 years, with some Duchenne adults reaching 30-40 years of age, this is not the case in Iran. In Iran the the majority of children with DMD have a life expectancy of teenage or early 20’s. Many children with DMD in Iran deteriorate rapidly in the early stages of the condition, due to a lack of access to physiotherapy and occupational therapy to maintain mobility. These children progress to immobility and dependence much earlier, experience increased rates of chest and urinary tract infections, emaciation, limb contractures, fractures and the spinal distortions that can lead to earlier cardiac and respiratory failure. When their families are no longer able to care for them, children with DMD are often moved to inadequately resourced institutions, where they may die alone and unattended at night- usually as a result of respiratory dysfunction and subsequent respiratory or cardiac failure.
The progression of the condition can be slowed with access to early diagnosis, early initiation of physical and pharmacological treatment, good nutrition and access to technology to support cardiac and respiratory function. When children with DMD
are supported by good physical, psychological and