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Changes in upper limb activity could be detected over 6\u00a0months and continued to decrease significantly over 12\u00a0months, but not 24\u00a0months. Upper limb strength decreased significantly over 12 and 24\u00a0months. FVC declined significantly over 12\u00a0months, but not 24\u00a0months.<jats:italic>FF<jats:sub>T2<\/jats:sub><\/jats:italic>increased over 12 and 24\u00a0months, although not with statistical significance. A significant increase in C\u2010CSA was observed at 12 but not 24\u00a0months. Blood SMN protein levels were stable over 12 and 24\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>These data demonstrate that the MFM32, MyoGrip, MyoPinch, and ActiMyo<jats:sup>\u00ae<\/jats:sup>enable the detection of a significant decline in patients with Type 2 and 3 SMA over 12 or 24\u00a0months.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51281","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T08:12:24Z","timestamp":1608883944000},"page":"359-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":109,"title":["Natural history of Type 2 and 3 spinal muscular atrophy: 2\u2010year NatHis\u2010SMA study"],"prefix":"10.1002","volume":"8","author":[{"given":"M\u00e9lanie","family":"Annoussamy","sequence":"first","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"},{"name":"Sysnav Vernon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea M.","family":"Seferian","sequence":"additional","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurore","family":"Daron","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Neuromusculaires CHU de Li\u00e8ge Liege Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"P\u00e9r\u00e9on","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence Maladies Neuromusculaires Atlantique\u2010Occitanie\u2010Cara\u00efbes H\u00f4pital H\u00f4tel\u2010Dieu Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude","family":"Cances","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Neuromusculaires H\u00f4pital des Enfants Toulouse France"},{"name":"Unit\u00e9 de Neurologie P\u00e9diatrique H\u00f4pital des Enfants Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Vuillerot","sequence":"additional","affiliation":[{"name":"Service de r\u00e9\u00e9ducation p\u00e9diatrique infantile L'Escale H\u00f4pital M\u00e8re Enfant CHU\u2010Lyon Bron France"},{"name":"Neuromyogen Institute CNRS UMR 5310 INSERM U1217 Universit\u00e9 de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesbeth","family":"De Waele","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology University Hospitals Leuven Leuven Belgium"},{"name":"Department of Development and Regeneration KU Leuven Kulak Kortrijk Kortrijk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Laugel","sequence":"additional","affiliation":[{"name":"Neurop\u00e9diatrie INSERM CIC 1434 CHU Strasbourg Hautepierre Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Schara","sequence":"additional","affiliation":[{"name":"Paediatric neurology and Neuromuscular Center University of Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Gidaro","sequence":"additional","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Lilien","sequence":"additional","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"},{"name":"Department of Paediatrics MDUK Oxford Neuromuscular Centre University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0045-7505","authenticated-orcid":false,"given":"Jean\u2010Yves","family":"Hogrel","sequence":"additional","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Carlier","sequence":"additional","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Fournier","sequence":"additional","affiliation":[{"name":"Institute of Myology GH Piti\u00e9 Salp\u00eatri\u00e8re Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Lowes","sequence":"additional","affiliation":[{"name":"Center for Gene Therapy Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ksenija","family":"Gorni","sequence":"additional","affiliation":[{"name":"PDMA Neuroscience and Rare Disease F. 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