• Change in mobility [ Time Frame: Baseline to 12 months ]
  Mobility will be measured using the 100 Meter Timed Test (100m) in which the participant is asked to complete 2 laps around 2 cones set 25 meters apart as quickly as safely possible, running if able, and the time in seconds is recorded.
• Change in motor performance [ Time Frame: Baseline to 12 months ]
  The North Star Assessment for Dysferlinopathy (NSAD) is a functional scale specifically designed to measure motor performance in individuals with LGMD. It consists of 29 items that are considered clinically relevant items from the North Star Ambulatory Assessment and the Motor Function Measure 20 with a maximum score of 54 and higher scores indicate higher functional abilities.
• Change in upper limb function characteristics [ Time Frame: Baseline to 12 months ]
  The Performance of Upper Limb 2.0 (PUL) scale measures the progression of weakness and natural history of functional decline in Duchenne muscular dystrophy. There are 22 scored items; a score of 42 indicates the highest level of independent function and 0 the lowest.
• Change in workspace volume [ Time Frame: Baseline to 12 months ]
  Workspace volume (WSV) will be measured using ACTIVE, an interactive video game which will calculate the combination of upper extremity and trunk strength and function in cubic meters.
• Change in Forced vital capacity (FVC) [ Time Frame: Baseline to 12 months ]
  Volume of air forcefully exhaled will be measured using Spirometry performed in a sitting position using standardized equipment
• Changes in Forced expiratory volume (FEV1) [ Time Frame: Baseline to 12 months ]
  Volume of air forcefully exhaled in one second will be measured using Spirometry performed in a sitting position using standardized equipment
• Change in activity limitations [ Time Frame: Baseline to 12 months ]
  ACTIVLIM is a patient-reported measure of activity limitations for individuals with upper and/or lower limb impairments, which measures the ability to perform daily activities.
• Change in upper extremity disability [ Time Frame: Baseline to 12 months ]
  The Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) questionnaire measures levels of disability in an individual's upper extremity.
• Change in self-reported physical health [ Time Frame: Baseline to 12 months ]
  PROMIS Physical Health is part of a set of patient-reported measures developed by a National Institute of Health that evaluates general physical health by assessing fatigue, pain intensity, pain interference, physical function, sleep disturbance, dyspnea, gastrointestinal symptoms, itch, pain behavior, pain quality, sexual function, and sleep related impairment.
• Change in self-reported mental health [ Time Frame: Baseline to 12 months ]
  PROMIS Mental Health is part of a set of patient-reported measures developed by a National Institute of Health that evaluates general mental health by assessing anxiety, depression, alcohol use, anger, cognitive function, life satisfaction, meaning and purpose, positive affect, psychosocial illness impact, self-efficacy for managing chronic conditions, smoking, and substance use
• Change in self-reported social health [ Time Frame: Baseline to 12 months ]
  PROMIS Social Health is part of a set of patient-reported measures developed by a National Institute of Health that evaluates general social health by assessing ability to participate in social roles and activities, companionship, satisfaction with social roles and activities, social isolation, and social support.
• Change in whole body health [ Time Frame: Baseline to 12 months ]
  The Quality of Life in Genetic Neuromuscular Disease Questionnaire was developed to measure whole-body health impact in neuromuscular diseases.
• Change in overall health [ Time Frame: Baseline to 12 months ]
  Domain Delta Questionnaire is a patient reported measure that assesses overall health over the previous 12 months.

The genetic heterogeneity has been a barrier to broad natural history efforts, with prior investigations often limited to single gene mutations. Much attention is paid to the variability within individual mutations (e.g. distal presentations), as opposed to defining the best strategy for measuring change in overall LGMD disease burden. This presents a major dilemma for LGMD rare disease research: how to balance diverse genes leading to overlapping phenotypes, versus variants in the same gene leading to divergent phenotypes. What is clear, is as a group, LGMDs are chronic and progressive leading to significant lifetime morbidity and represent a large unmet clinical need.

Recent developments in the investigator's genetic understanding of LGMD and molecular approaches to therapy have led to proposed gene replacement therapies for at least three of the LGMD mutations. Several of these gene replacement therapies are currently in pre-clinical/phase 1 testing, leading to an urgent need for natural history data. In addition, non-specific therapies which target muscle mass or function are being tested in other muscular dystrophies and may prove beneficial for LGMD.

• Limb Girdle Muscular Dystrophy
• Muscular Dystrophies

• CAPN3 (LGMD2A)
  Clinical Assessments, Biomarkers
• DYSF (LGMD2B)
  Clinical Assessments, Biomarkers
• ANO5 (LGMD2L)
  Clinical Assessments, Biomarkers
• DNAJB6 (LGMD1D)
  Clinical Assessments, Biomarkers
• Sarcoglycan (LGMD2D) (LGMD2E) (LGMD2C) (LGMD2F)
  Clinical assessments

Inclusion Criteria:

• Age between 4-65 at enrollment
• Clinically affected (defined as weakness on bedside evaluation in either a limb-girdle pattern, or in a distal extremity)
• A genetically or functionally confirmed mutation in ANO5, CAPN3, DYSF, DNAJB6 or SGCA-G.
• Ambulatory

Exclusion Criteria:

• Non-ambulatory at the time of enrollment.
• Any other illness that would interfere with the ability to undergo safe testing or would interfere with interpretation of the results in the opinion of the site investigator.

• Newcastle University
• University of California, Irvine
• University of Kansas
• University of Colorado, Denver
• Nationwide Children's Hospital
• Washington University School of Medicine
• University of Iowa
• Hugo W. Moser Research Institute at Kennedy Krieger, Inc.
• University of Florida
• Brigham and Women's Hospital