sIBM also preferentially affects the wrist flexors, biceps, and triceps.During the course of the illness, the patients mobility is progressively restricted as it becomes difficult to bend down, reach for things, and walk quickly. Many patients say they have balance problems and fall easily, as the muscles cannot compensate for an off-balanced posture. Because sIBM makes the leg muscles weak and unstable, patients are very vulnerable to serious injury from tripping or falling down. Although pain has not been traditionally part of the "textbook" description, many patients report severe muscle pain, especially in the thighs. Progressive difficulty swallowing (dysphagia) is present in 40 to 85% of IBM cases and often leads to death from aspiration pneumonia.IBM can also result in diminished capacity for aerobic exercise. This decline is most likely a consequence of the sedentary lifestyle leading to disuse muscle atrophy that is often associated with the symptoms of IBM (i.e. progressive muscle weakness, decreased mobility, and increased level of fatigue). Therefore, one focus of treatment should be the improvement of aerobic capacity.Patients with sIBM usually eventually need to resort to a cane or a walker and in most cases, a wheelchair eventually becomes a necessity. "The progressive course of s-IBM leads slowly to severe disability. Finger functions can become very impaired, such as manipulating pens, keys, buttons, and zippers, pulling handles, and firmly grasping handshakes. Arising from a chair becomes difficult. Walking becomes more precarious.
One way to decrease rates of low birth weight and premature delivery is to focus on the health of women prior to conception through reproductive education, screening and counseling regarding mental health issues and stress, and access to primary care. Racial stress
Non-Hispanic Blacks have the highest infant mortality rate in the United States (11.4 deaths per 1,000 live births compared to the national average of 5.9 deaths per 1,000 live births). Subsequently,  there has been growing research supporting the idea of racial discrimination as a risk factor for low birth weight. In one study by Collins et al., evidence suggested that African American mothers who experienced high levels of racial discrimination were at significantly higher risk of delivering a very low-birth weight baby compared to African American mothers who had not experienced racial discrimination. Black infants (13.2%) are more likely to have low birth weight compared to Asian and Pacific Islander (8.1%), American Indian and Alaska Native (7.6%), Non-Hispanic White (7.0%), and Hispanic Infants (7.1%). Environmental factors
Environmental factors, including exposure of the mother to secondhand smoke can be a factor in determining the birth weight of child. In 2014, 13% of children exposed to smoke were born with low birth weight compared with 7.5% of those children born to nonsmokers. Children born to mothers who smoked or were exposed to secondhand smoke are more likely to develop health problems earlier in life such as neurodevelopmental delays.