In addressing the needs of a 10-year-old child with Duchenne muscular dystrophy, which problem is most important to address?

In the context of a 10-year-old child with Duchenne muscular dystrophy (DMD), addressing the decreased ability to walk independently is of paramount importance. DMD is characterized by progressive muscle weakness and degeneration, which significantly affects mobility.

As the condition progresses, many children with DMD experience difficulties with walking and may eventually become wheelchair-bound. This loss of mobility can have profound implications on their overall quality of life, social interactions, and participation in developmental activities typical for their age. Therefore, interventions aimed at preserving mobility, enhancing function, and maintaining the ability to walk as long as possible are critical.

While increasing joint mobility and addressing ligamentous laxity can be important for maintaining functional movement, these interventions do not directly address the most significant functional loss faced by the child — the ability to walk independently. Decreased sensation in the lower extremities is also less relevant in the context of DMD, as sensory deficits are not a primary concern with this condition. Hence, prioritizing the maintenance of independent ambulation directly supports the child's physical capabilities and overall well-being.