A limited physical exam and strength testing will be used to derive a FSHD clinical severity score. The severity score ranks weakness in the face, shoulders, arms, distal, and proximal lower extremities on a 10 point scale.

A limited physical exam and strength testing will be used to derive a FSHD clinical severity score. The severity score ranks weakness in the face, shoulders, arms, distal, and proximal lower extremities on a 15 point scale.

The Manual Muscle Testing is a modified Medical Research Council 13-point and is used with standardized positions for each grade and each muscle following the recommendations of the FSH-DY Group. Shoulder abduction and flexion, elbow flexion and extension, wrist flexion and extension, fingers flexion and extension, hip flexion and abd/adduction, knee flexion and extension, ankle plantarflexion and dorsiflexion strength will be measured bilaterally

Quantitative Muscle Assessment is performed using a fixed myometry testing system, with a force transducer attached by an inelastic strap to a metal frame.

A fall and exercise questionnaire will assess average monthly falls and near falls, and average weekly amount of exercise. A fall assessment will be completed weekly for 3 months after the first visit. Subjects will be asked to respond to a call every week, for 12 consecutive weeks, that asks about any falls they have had over the past week.

The work questionnaire is a standard questionnaire asking about the effect of FSHD on work/occupation.

The PROMIS57 is an instrument developed by the NIH PROMIS initiative. It generates scores for physical function, and the impact of physical limitations on daily life.

The Upper Extremity Functional Index 15 (UEFI15) is a validated patient reported measure for adults with upper extremity dysfunction. This index measures upper extremity dysfunction. 20 questions are combined into a total score, the score is transformed into a normalized score with 80 representing normal, and lower scores representing increasing disability.

The Facial Disability Index (FDI) is a short 5 items questionnaire which assesses the physical impact of facial weakness. The five questions are summed into total score which transformed onto a percentage scale, with 100 representing normal, and lower scores representing increasing disability.

IOPI is a means to quantify lip, tongue, and buccal strength using a validated tool with published ranges for normative data for lingual measurements.

Muscle MRI studies will be performed on a 1.5 Tesla equipment at baseline,12 and 24 months

Sitting and bedside spirometry allow to obtain forced vital capacity and forced respiratory volume in 1 second, two standardized outcomes commonly used to evaluate respiratory function in clinical follow up and clinical trials.

The Sydney Swallow Questionnaire (SSQ) is a 17 question, self-report inventory, which was developed to measure symptomatic severity of oral-pharyngeal dysphagia as reported by the affected patient. The questionnaire uses a 100mm long visual analogue scale (VAS) for all but one question.

The Multidimensional Dyspnea Profile (MDP) is a questionnaire which assesses overall breathing discomfort, sensory qualities, and emotional responses in laboratory and clinical settings. The MDP assesses dyspnea during a specific time or a particular activity (focus period) and is designed to examine individual items that are theoretically aligned with separate mechanisms.