**6. Assessment**

Since assessment is important for guiding clinical management and for evaluating therapeutic outcomes, thorough assessment of patients with SMA is essential. Assessment should include regular assessment pertinent to children with neuromuscular disorders such as assessment of posture, muscle strength, performance, range of motion, gait assessment, respiratory assessment, and quality of life measures. Assessment of functional status and level of disability using standardized outcome measures should be also included.

#### **6.1 Joint integrity, range of motion and muscle flexibility**

Active and passive joint range of motion can be assessed using goniometry. Functional range of motion, muscle length, and soft tissue flexibility should be assessed using standard methods. Assessment of joint integrity, range of motion and muscle flexibility should be done periodically to monitor development of contractures, particularly when the patient loses ability to ambulate.
