Why do children with Duchenne muscular dystrophy often have a waddling gait?

Children with Duchenne muscular dystrophy often exhibit a waddling gait primarily due to the progressive weakness of the proximal muscles, specifically those in the pelvic girdle.12

These proximal muscles are responsible for holding large components of the body mass against the force of gravity and stabilizing the pelvis during movement. As the disease causes the degeneration of these essential muscle groups, the body loses the necessary support to maintain a stable, balanced posture while walking. This instability forces the child to compensate by shifting their weight and moving the pelvis in a characteristic waddling motion to maintain balance and forward momentum.132

This weakness is a hallmark of the condition, which arises from a genetic mutation that prevents the production of the protein dystrophin, leading to the eventual replacement of muscle tissue with fibrous scar tissue and fat.32