1
|
Massó-Ortigosa N, Rey-Abella F, Gutiérrez-Vilahú L, Milà R, Guerra-Balic M, Oviedo GR. Analysis of the centre of pressure in bipedal stance among individuals with and without intellectual disabilities, individuals with Down syndrome and dancers with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:524-536. [PMID: 38350666 DOI: 10.1111/jir.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 10/25/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Individuals with intellectual disabilities (IDs) often present deficiencies in motor, balance and postural control. On the other hand, the practice of physical activity and dance usually reduces these deficiencies. Therefore, in this study, we aimed to compare the control of the centre of pressure (COP) in people with Down syndrome (DS) or other causes of ID in relation to people without disabilities and to observe the influence of vision and the practice of dance. METHODS This cross-sectional study analyses the COP in a static standing position with open and closed eyes in four study groups. A total of 273 people were recruited (80 adults without ID, 46 adults with DS, 120 adults with other causes of ID and 27 dancers with DS). RESULTS A greater area of oscillation and path of the COP was observed in the participants with ID compared with the participants without ID, especially in the sway area of the COP. The oscillation speed of the COP was also higher. When analysing the displacement of the COP, anteroposterior and mediolateral components, there were also differences, except when comparing the group of dancers with DS with respect to the group without ID. The visual condition only influenced the group of participants without disabilities. CONCLUSIONS The results of our study show that there is a less efficient static postural control in people with ID, as greater displacements were observed in the COP of the participants with ID. The differences in some specific variables that analyse the displacement of the COP were smaller when comparing the group of dancers with DS and the individuals without ID.
Collapse
Affiliation(s)
- N Massó-Ortigosa
- Blanquerna School of Health Science, University Ramon Llull, Barcelona, Spain
| | - F Rey-Abella
- Blanquerna School of Health Science, University Ramon Llull, Barcelona, Spain
| | - L Gutiérrez-Vilahú
- Blanquerna School of Health Science, University Ramon Llull, Barcelona, Spain
| | - R Milà
- Blanquerna School of Health Science, University Ramon Llull, Barcelona, Spain
| | - M Guerra-Balic
- Blanquerna Faculty of Psychology, Education and Sports Sciences, University Ramon Llull, Barcelona, Spain
| | - G R Oviedo
- Blanquerna School of Health Science, University Ramon Llull, Barcelona, Spain
- Blanquerna Faculty of Psychology, Education and Sports Sciences, University Ramon Llull, Barcelona, Spain
- ACTIUM Functional Anatomy Group, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| |
Collapse
|
2
|
Brugnaro BH, Pauletti MF, Lima CRG, Verdério BN, Fonseca-Angulo RI, Romão-Silva B, de Campos AC, Rosenbaum P, Rocha NACF. Relationship between sensory processing patterns and gross motor function of children and adolescents with Down syndrome and typical development: a cross-sectional study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:358-368. [PMID: 38183401 DOI: 10.1111/jir.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/10/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Children and adolescents with Down syndrome (DS) may experience impairments in sensory and motor skills that can be interrelated. The purposes of this study were (i) to compare the sensory processing patterns and gross motor function between children and adolescents with DS and with typical development (TD) and (ii) to explore associations between these areas in both DS and TD groups. METHOD This cross-sectional study involved a sample size of 25 participants with DS (mean age 10.24 ± 2.04 years) and 25 participants with TD (mean age 10.04 ± 2.82 years). The sensory processing patterns were assessed using the Sensory Profile Second Version questionnaire, and the gross motor function was measured with the Gross Motor Function Measure (GMFM-88) dimensions (D) standing, and (E) walking, running, and jumping. Differences between groups were tested using the Mann-Whitney test, and the relationship between the variables was examined using Spearman's correlation tests, with a significance level set at 5%. RESULTS Children with DS showed greater difficulties with sensory processing than TD children in Seeker (P < 0.001), Avoider (P < 0.001), Sensitivity (P < 0.001), Registration (P < 0.001), Auditory (P < 0.001), Touch (P = 0.001), Movements (P = 0.001), Oral (P = 0.028), Conduct (P = 0.005), Socioemotional (P < 0.001), and Attentional (P < 0.001) domains. Additionally, children with DS presented lower gross motor function than TD in GMFM-88, standing (P < 0.001) and walking, running, and jumping (P < 0.001). Correlations were found between greater difficulties with sensory processing in Touch and lower gross motor function in walking, running, and jumping for the DS group. CONCLUSION Our results suggest there are more difficulties in sensory processing patterns and gross motor function in children with DS than in TD. Also, there is a single association between more difficulties in sensory processing and less well-developed motor function in the DS group. Therefore, a comprehensive assessment of all these aspects should be performed in children and adolescents with DS, along with the provision of relevant interventions addressing specific needs.
Collapse
Affiliation(s)
- B H Brugnaro
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - M F Pauletti
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - C R G Lima
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - B N Verdério
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - R I Fonseca-Angulo
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - B Romão-Silva
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - A C de Campos
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - P Rosenbaum
- Department of Pediatrics, CanChild, McMaster University, Hamilton, Ontario, Canada
| | - N A C F Rocha
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| |
Collapse
|
3
|
Aleksander-Szymanowicz P, Filar-Mierzwa K, Skiba A. Effect of dance movement therapy on balance in adults with Down Syndrome. A pilot study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231220429. [PMID: 38050952 DOI: 10.1177/17446295231220429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Systematic participation in dance therapy may improve balance and reduce risk of falls. The aim of this study was to assess the effect of dance therapy on balance and risk of falls in adults with Down syndrome. Study participants comprised 23 persons with Down syndrome aged 26- 49 years who underwent dance therapy. Before and after the therapy, all participants were measured on a BioSway balance platform using three tests: postural stability, limits of stability, and M-CTSIB fall risk. Mean result was lower following intervention (2.40 ± 1.81 vs. 1.65 ± 1.32; p = .006) in the postural stability test. The limits of stability test found a statistically significant difference (26.30 ± 8.99 vs. 37.90 ± 12.54; p < .001). The results of this study only partially supported the hypothesis that dance therapy improves balancing skills in adults with Down Syndrome.
Collapse
Affiliation(s)
| | | | - Agnieszka Skiba
- Faculty of Motor Rehabilitation, University of Physical Education, Krakow, Poland
| |
Collapse
|
4
|
Takahashi H, An M, Sasai T, Seki M, Matsumura T, Ogawa Y, Matsushima K, Tabata A, Kato T. The effectiveness of dance movement therapy for individuals with Down syndrome: a pilot randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:640-654. [PMID: 37066677 DOI: 10.1111/jir.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/26/2023] [Accepted: 03/25/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) exhibit deficits in static and dynamic balance abilities and maladaptive functions. This study aimed to determine the effectiveness of dance movement therapy (DMT) group intervention in individuals with DS. METHODS The 31 participating individuals with DS, aged 5-29 years, were randomly divided into intervention (n = 16) and control (n = 15) groups. Posturography was used for static balance measurement, timed up and go test for dynamic balance measurement and the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire for adaptive function and behavioural problem measurement in participants before and after the DMT interventions. The intervention group underwent 60-min DMT intervention once a week for 10 times, while the control group had usual daily activities. RESULTS The results revealed a statistically significant difference and large effect sizes in dynamic balance [(f(1, 29) = 4.52, P = 0.04, ηp 2 = 0.14)] in the intervention group compared with the control group. There were no statistically significant differences in static balance and ASEBA scores between the groups. CONCLUSIONS This study found that the DMT interventions helped to improve the dynamic balance in individuals with DS.
Collapse
Affiliation(s)
- H Takahashi
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - M An
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - T Sasai
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - M Seki
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - T Matsumura
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - Y Ogawa
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - K Matsushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - A Tabata
- Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - T Kato
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| |
Collapse
|
5
|
Borji R, Laatar R, Zarrouk N, Sahli S, Rebai H. Cognitive-motor interference during standing stance across different postural and cognitive tasks in individuals with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104562. [PMID: 37379660 DOI: 10.1016/j.ridd.2023.104562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/10/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) presented both cognitive and motor impairments that could influence each other. Therefore, exploring cognitive-motor interference during standing stance is relevant in this population. AIMS This study explored the dual task (DT) effects on postural balance during diverse cognitive tasks and sensory manipulations in individuals with DS, compared to those with typical development (TD). METHODS AND PROCEDURES Fifteen adolescents with DS (age = 14.26 ± 1.27 years; height = 1.50 ± 0.02; weight = 46.46 ± 4.03 kg; BMI =20.54 ± 1.51 kg/m2) and thirteen with TD (age = 14.07 ± 1.11 years; height = 1.50 ± 0.05; weight = 44.92 ± 4.15 kg; BMI =19.77 ± 0.94 kg/m2) participated in this study. Postural and cognitive performances for the selective span task (SST) and the verbal fluency (VF) were recorded during single task (ST) and DT conditions. Postural conditions were: firm eyes open (firm-EO), firm eyes closed (firm-EC) and foam-EO. Motor and cognitive DT costs (DTC) were calculated and analyzed across these different cognitive and postural conditions. OUTCOMES AND RESULTS In the DS group, postural performance was significantly (p < 0.001) altered during all DT conditions, compared to the ST situation. Moreover, the motor DTC was significantly (p < 0.001) higher while performing the VF task than the SST. However, in the control group, postural performance was significantly (p < 0.001) impaired only while performing the VF test in the DT-Firm EO condition. For both groups, cognitive performances were significantly (p < 0.05) altered in all DT conditions compared to the ST one. CONCLUSION Adolescents with DS are more prone to DT effects on postural balance than those with TD.
Collapse
Affiliation(s)
- Rihab Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nidhal Zarrouk
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Laboratory 'Optimisation de la Performance Sportive, Centre National de Médecine et Sciences du Sport (CNMSS)', Tunis, Tunisia
| |
Collapse
|
6
|
Guerrero K, Umagat A, Barton M, Martinez A, Ho KY, Mann S, Hilgenkamp T. The effect of a telehealth exercise intervention on balance in adults with Down syndrome. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:385-393. [PMID: 36585748 DOI: 10.1111/jar.13068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome. METHODS Eighteen low-active participants with Down syndrome completed a 12-week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT-4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851. RESULTS Significant improvement was seen in the TUG (p = .043), FICSIT-4 (p = .019) and FRT (p = .019). All participants achieved maximum scores on the MCTSIB in pre- and post-testing. CONCLUSIONS Balance in low-active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness.
Collapse
Affiliation(s)
- Kristina Guerrero
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Alexandria Umagat
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Mark Barton
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Andrew Martinez
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Sarah Mann
- Mann Method PT and Fitness, Arvada, Colorado, USA
| | - Thessa Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| |
Collapse
|
7
|
Mann S, Spiric J, Mitchell C, Hilgenkamp TIM. Development of a Physical Therapy-Based Exercise Program for Adults with Down Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3667. [PMID: 36834362 PMCID: PMC9960831 DOI: 10.3390/ijerph20043667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
In adults with Down syndrome, the combination of low physical activity and fitness levels and the high prevalence of musculoskeletal co-morbidities stresses the need for specialized exercise programs. The goal of this research study was to develop a specialized exercise program for individuals with Down syndrome using the physical therapy approach of a systems review as the foundation. We first conducted an overview of the literature on co-morbidities in adults with Down syndrome using the systems review method to categorize these findings. We extracted recommendations for content and delivery of an exercise program based on the literature review, and finally composed a specialized exercise program for individuals with Down syndrome adhering to these recommendations.
Collapse
Affiliation(s)
- Sarah Mann
- Mann Method PT and Fitness, Arvada, CO 80005, USA
| | | | - Cailin Mitchell
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154, USA
| | | |
Collapse
|
8
|
Chen GD, Li L, McCall A, Ding D, Xing Z, Yu YE, Salvi R. Hearing impairment in murine model of Down syndrome. Front Genet 2022; 13:936128. [PMID: 35991545 PMCID: PMC9385999 DOI: 10.3389/fgene.2022.936128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Hearing impairment is a cardinal feature of Down syndrome (DS), but its clinical manifestations have been attributed to multiple factors. Murine models could provide mechanistic insights on various causes of hearing loss in DS. To investigate mechanisms of hearing loss in DS in the absence of the cadherin 23 mutation, we backcrossed our DS mice, Dp(16)1Yey, onto normal-hearing CBA/J mice and evaluated their auditory function. Body weights of wild type (WT) and DS mice were similar at 3-months of age, but at 9-months, WT weighed 30% more than DS mice. Distortion product otoacoustic emissions (DPOAE), a test of sensory outer hair cell (OHC) function negatively impacted by conductive hearing loss, were reduced in amplitude and sensitivity across all frequencies in DS mice. The middle ear space in DS mice appeared normal with no evidence of infection. MicroCT structural imaging of DS temporal bones revealed a smaller tympanic membrane diameter, oval window, and middle ear space and localized thickening of the bony otic capsule, but no gross abnormalities of the middle ear ossicles. Histological analysis of the cochlear and vestibular sensory epithelium revealed a normal density of cochlear and vestibular hair cells; however, the cochlear basal membrane was approximately 0.6 mm shorter in DS than WT mice so that the total number of hair cells was greater in WT than DS mice. In DS mice, the early and late peaks in the auditory brainstem response (ABR), reflecting neural responses from the cochlear auditory nerve followed by subsequent neural centers in the brainstem, were reduced in amplitude and ABR thresholds were elevated to a similar degree across all frequencies, consistent with a conductive hearing impairment. The latency of the peaks in the ABR waveform were longer in DS than WT mice when compared at the same intensity; however, the latency delays disappeared when the data were compared at the same intensity above thresholds to compensate for the conductive hearing loss. Future studies using wideband tympanometry and absorbance together with detailed histological analysis of the middle ear could illuminate the nature of the conductive hearing impairment in DS mice.
Collapse
Affiliation(s)
- Guang-Di Chen
- Center for Hearing and Deafness, University at Buffalo, Buffalo, NY, United States
| | - Li Li
- Center for Hearing and Deafness, University at Buffalo, Buffalo, NY, United States
| | - Andrew McCall
- Optical Imaging and Analysis Facility, School of Dental Medicine, University at Buffalo, Buffalo, NY, United States
| | - Dalian Ding
- Center for Hearing and Deafness, University at Buffalo, Buffalo, NY, United States
| | - Zhuo Xing
- The Children’s Guild Foundation Down Syndrome Research Program, Genetics and Genomics Program and Department of Cancer Genetics and Genomics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- Genetics, Genomics and Bioinformatics Program, University of New York at Buffalo, Buffalo, NY, United States
| | - Y. Eugene Yu
- The Children’s Guild Foundation Down Syndrome Research Program, Genetics and Genomics Program and Department of Cancer Genetics and Genomics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
- Genetics, Genomics and Bioinformatics Program, University of New York at Buffalo, Buffalo, NY, United States
| | - Richard Salvi
- Center for Hearing and Deafness, University at Buffalo, Buffalo, NY, United States
- *Correspondence: Richard Salvi,
| |
Collapse
|
9
|
Jain PD, Nayak A, Karnad SD, Doctor KN. Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review. Clin Exp Pediatr 2022; 65:142-149. [PMID: 34126707 PMCID: PMC8898616 DOI: 10.3345/cep.2021.00479] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/30/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. PURPOSE This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. METHODS We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. RESULTS A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. CONCLUSION The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.
Collapse
Affiliation(s)
- Preyal D Jain
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Akshatha Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shreekanth D Karnad
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kaiorisa N Doctor
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
10
|
Jain PD, Nayak A, Karnad SD. Relationship between trunk muscle strength, reaching ability and balance in children with Down syndrome - A cross-sectional study. Brain Dev 2022; 44:95-104. [PMID: 34579982 DOI: 10.1016/j.braindev.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with Down Syndrome (DS) present with neuromuscular disturbances leading to delayed developmental milestones, poor quality of movement and poor balance. The aim of this study is to discuss the role of trunk muscle strength in the functional performance of children with DS. METHODOLOGY 28 children were recruited in the study, 14 with DS and 14 age and gender-matched controls. Trunk muscle strength, reaching ability and balance were assessed using a Handheld Dynamometer, Modified Functional Reach test and Pediatric Balance Scale, respectively. RESULTS Children with DS present with poorer trunk muscle strength, reaching ability and balance as compared to typically developing (TD) children. There was a positive correlation between trunk muscle strength and lateral reaching in children with DS. A strong to moderate correlation was observed between the trunk muscle strength and balance in children with DS. DISCUSSION Children with DS demonstrated a significantly weak trunk muscle groups. Lateral reaching distance is reduced due to the poor proximal control and they present with near-normal forward reach distance attributed to compensation using the lower trunk muscles. They exhibit poor balance in the components that require a small base of support. CONCLUSION Children with DS exhibit weak trunk muscles along with lesser reaching distance and poor balance. Also, trunk muscle strength influences lateral reaching ability. Trunk muscle strength, mainly trunk extensors impacted functional balance in sitting, standing and while performing transfers.
Collapse
Affiliation(s)
- Preyal D Jain
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Akshatha Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Shreekanth D Karnad
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
11
|
Leyssens L, Van Hecke R, Moons K, Luypaert S, Danneels M, Patru J, Willems M, Maes L. Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:280-294. [PMID: 34693604 DOI: 10.1111/jar.12948] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This pilot study aimed to explore the impact of visual, auditory and vestibular dysfunctions on the postural balance performance in adults with intellectual disabilities. Additionally, a comparison was made between the subjects with intellectual disabilities and a control group concerning static and dynamic balance tasks. METHOD Thirty adults with intellectual disabilities and 25 control subjects received a postural balance assessment. Additionally, the experimental group was subjected to a visual, auditory and vestibular screening. RESULTS The experimental group performed significantly worse and/or showed more sway compared to the control group for all balance tasks (p < .01) except the timed up and go test. Within the experimental group, a significant positive correlation (rs (24) = 0.513, p = .007) was observed between the number of failed sensory screening items and the number of failed balance tasks. CONCLUSIONS These findings suggest significant involvement of peripheral sensorial deficits in the balance problems that people with intellectual disabilities often experience.
Collapse
Affiliation(s)
- Laura Leyssens
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Ruth Van Hecke
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Karlien Moons
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Sofie Luypaert
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Maya Danneels
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Julie Patru
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Melina Willems
- Department of Audiology, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.,Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
| |
Collapse
|
12
|
Zago M, Condoluci C, Manzia CM, Pili M, Manunza ME, Galli M. Multi-segmental postural control patterns in down syndrome. Clin Biomech (Bristol, Avon) 2021; 82:105271. [PMID: 33477082 DOI: 10.1016/j.clinbiomech.2021.105271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/18/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with Down Syndrome (DS) exhibit less efficient and unstable standing postural control. The specificities of somatosensorial deficits might result in a different utilization of resources and in distinct whole-body kinematic patterns, to date still unexplored. In this paper we aim at addressing multi-segmental coordination patterns in people with DS while maintaining standing balance under different visual conditions (open and closed eyes). METHODS This cross-sectional observational cohort study involved two groups of 23 patients with DS and 12 healthy controls. A 30-s standing balance test allowed to extract (i) the length of the trajectory of the center-of-pressure sway and 95% confidence ellipse area from Ground Reaction forces, and (ii) Principal Movement (PM) components from full-body motion kinematics; the latter were obtained exploiting a Principal Component Analysis-based approach, also embracing a motor-control perspective through the evaluation of the number of modifications applied by the neuromuscular controller on segments' acceleration. FINDINGS Trajectory length was significantly higher in patients; 95% ellipse confidence area did not differ between groups/condition. Postural movement components differed in people with DS from healthy controls not only in the "observable", behavioural phenotype (PM3 and PM8), but also in the amount of activation of the associated control (PM1 to PM8, over-activated in DS) in all spatial directions. INTERPRETATION Results reinforced the prevalence of a medio-lateral hip strategy (instead of an ankle strategy) in maintaining postural stability. Most important, they revealed a less frequent activation of postural patterns in all spatial directions.
Collapse
Affiliation(s)
- Matteo Zago
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.
| | | | | | - Marta Pili
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
| | - Marta Elisa Manunza
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
| |
Collapse
|
13
|
Khallaf ME, Fayed E, Sweif RE, Alsalem A. Relationship between dynamic foot-ground contact area and balance impairments in adolescents with down syndrome. J Pediatr Rehabil Med 2021; 14:425-432. [PMID: 34511516 DOI: 10.3233/prm-200764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Down Syndrome (DS) is characterized by intellectual disability, hypotonia, and joint laxity. Physical disability can be an additional problem and manifests as reduced lower limb muscle strength and impaired balance. The objectives of this study were to characterize DS dynamic foot-ground contact area and to study its relationship with balance impairment among adolescents with DS. METHODS Twenty-eight children and adolescents with DS and 28 non-DS adolescents/children were matched for age and sex. The Oxford Ankle Foot Questionnaire (parents' version) was used to measure disability related to ankle/foot problems in all subjects. A pressure-sensitive mat was used to assess the contact area and arch index. Also, a Biodex balance system was used for measuring postural stability. RESULTS There were significant differences between both groups in all domains of the Oxford Ankle Foot Questionnaire, overall contact area, and arch index (p < 0.05). Overall postural stability index was significantly decreased in subjects with DS (p < 0.05). There was a nonsignificant correlation between contact area and postural stability (p > 0.05). CONCLUSION Adolescents with DS exhibited larger mid-foot and forefoot contact areas with respect to non-DS matched children. Impairment of balance in adolescents with DS is a multifactorial problem not related to changes in the foot contact area.
Collapse
Affiliation(s)
- Mohamed E Khallaf
- Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,University of St. Augustine for Health Sciences, Austin, Texas, USA
| | - Eman Fayed
- Department of Physical Therapy for Cardio-Pulmonary Dysfunctions & Geriatrics, Misr University for Science and Technology, 6th of October City, Egypt.,Department of Physical Therapy, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Radwa E Sweif
- Department Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Abdulkarem Alsalem
- Department Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
14
|
Brugnaro BH, Oliveira MFP, de Campos AC, Pavão SL, Rocha NACF. Postural control in Down syndrome and relationships with the dimensions of the International Classification of Functioning, Disability and Health - a systematic review. Disabil Rehabil 2020; 44:2207-2222. [PMID: 33049152 DOI: 10.1080/09638288.2020.1830439] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Postural control assessment in children with Down syndrome (DS) may contribute to understanding the impact of impairments in Body Structures and Functions on Activities and Participation, providing a biopsychosocial approach to support clinical practice. The present study aimed to systematically review the literature addressing postural control in children and adolescents with Down syndrome, with a focus in the interactions among the components of the International Classification of Functioning (ICF). METHODS We conducted a tailored search in PubMed; Web of Science, SCOPUS and Science Direct databases. RESULTS We identified 20 full-texts that fulfilled the inclusion and exclusion criteria. Children and adolescents with DS showed lower postural stability across studies. The ICF components most commonly addressed were Body Structure and Function and Activity. Although the studies measured these components, they did not analyze the interrelationships of components when describing the determinants of postural control in this population. CONCLUSIONS Overall, the studies indicate that children and adolescents with DS show decreased postural stability and greater vulnerability to sensory changes than their typical peers. There is a lack of studies using the biopsychosocial approach. Only few studies have related the activity level of the participants with the variables of postural control. None of them addressed components of Participation and Environmental Factors. The poor methodological quality of the included studies limits the translation of results to clinical practice. Further studies addressing children with disabilities, such as DS, should utilize the ICF framework, thus providing a biopsychosocial approach of health in these individuals.IMPLICATIONS FOR REHABILITATIONChildren with Down syndrome show decreased postural stability and greater vulnerability to sensory changes than their typical peers.In clinical practice, when assessing postural control of individuals with DS, rehabilitation professionals should not only address components of Body Structures and Functions, but also investigate their impact on Activity and Participation.Training of postural control should address strategies that include natural environments and participation situations.The biopsychosocial approach provided by the ICF framework should be implemented in clinical practice.
Collapse
Affiliation(s)
- Beatriz Helena Brugnaro
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Maria Fernanda Pauletti Oliveira
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Carolina de Campos
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Silvia Letícia Pavão
- Departament of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná (UFPR), Curitiba, PR, Brazil
| | - Nelci Adriana Cicuto Ferreira Rocha
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| |
Collapse
|
15
|
Zago M, Duarte NAC, Grecco LAC, Condoluci C, Oliveira CS, Galli M. Gait and postural control patterns and rehabilitation in Down syndrome: a systematic review. J Phys Ther Sci 2020; 32:303-314. [PMID: 32273655 PMCID: PMC7113426 DOI: 10.1589/jpts.32.303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/21/2020] [Indexed: 12/26/2022] Open
Abstract
[Purpose] To describe (1) the current knowledge on gait and postural control in
individuals with Down syndrome in terms of spatiotemporal, kinematics and kinetics, and
(2) relevant rehabilitation strategies. [Methods] Randomized and non-randomized clinical
trials published between January 1997 and October 2019 were selected by searching four
scientific databases. We included studies on patients with Down syndrome involving gait
analysis or postural control. A custom data-extraction and appraisal form was developed to
collect the key features of each article. The PEDro Scale was used to evaluate the
methodological quality of the studies. [Results] A total of 37 out of 146 cross-sectional
and longitudinal studies were included in the review. The main abnormalities included:
reduction of gait velocity and step length, poor static balance with increased
anteroposterior and mediolateral oscillations and a larger step width. [Conclusion] A
number of compensatory patterns during movement was observed, with a direct influence on
improvements in stability and postural control throughout daily life. Intensive gait
training at an early age appears to produce long-term improvements in this population.
Future research should focus on the interaction between the motor and cognitive function,
and on the functional effects due to the exposure to an enriched environment.
Collapse
Affiliation(s)
- Matteo Zago
- Department of Electronics, Information and Bioengineering, Politecnico di Milano: Via Golgi 39, 20133, Milano, Italy
| | - Natalia Almeida Carvalho Duarte
- Department of Electronics, Information and Bioengineering, Politecnico di Milano: Via Golgi 39, 20133, Milano, Italy.,Santa Casa de Misericordia de Presidente Prudente, Brazil
| | | | | | | | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano: Via Golgi 39, 20133, Milano, Italy
| |
Collapse
|
16
|
Maïano C, Hue O, Lepage G, Morin AJS, Tracey D, Moullec G. Do Exercise Interventions Improve Balance for Children and Adolescents With Down Syndrome? A Systematic Review. Phys Ther 2019; 99:507-518. [PMID: 31089706 DOI: 10.1093/ptj/pzz012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 09/18/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Youths with Down syndrome are characterized by deficits in balance/postural stability. One way to palliate balance deficits among this population is through exercise interventions. However, to the authors' knowledge, the effects of exercise interventions designed to improve the balance of youths with Down syndrome have never been systematically reviewed. PURPOSE The purpose of this review was to summarize the findings from studies examining the effects of exercise interventions designed to improve balance in youths with Down syndrome. DATA SOURCES A systematic literature search was performed in 10 databases (Academic Search Complete, CINAHL Plus With Full-Text, Education Source, ERIC, Medline With Full-Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, Scopus, SocINDEX, and SPORTDiscus With Full-Text) on June 12, 2017. STUDY SELECTION Randomized controlled trials and controlled trials examining the effects of exercise interventions designed to improve balance in youths with Down syndrome were included. DATA EXTRACTION Two authors selected the studies and extracted their characteristics and results. Three authors assessed the risk of bias in the studies using the Cochrane Collaboration tool. DATA SYNTHESIS Eleven studies, published between 2010 and 2017, met the inclusion criteria. The findings showed that exercise interventions were more effective than control conditions for improving the static balance of children with Down syndrome and the static-dynamic balance (ie, global balance score obtained with a scale measuring both static and dynamic balance) of children and adolescents with Down syndrome. Nevertheless, the findings on dynamic balance in children and static balance in adolescents were inconclusive. LIMITATIONS With a small number of studies and their high risk of bias, the present findings must be interpreted with caution. CONCLUSIONS The reviewed exercise interventions were successful in improving the static balance of children with Down syndrome and the static-dynamic balance of children and adolescents with Down syndrome.
Collapse
Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 5 Rue Saint-Joseph, Saint Jérôme, Quebec, Canada J7Z 0B7
| | - Olivier Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Geneviève Lepage
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Danielle Tracey
- School of Education, Western Sydney University, Sydney, New South Wales, Australia
| | - Grégory Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Quebec, Canada; and Research Center, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| |
Collapse
|
17
|
Characterizing postural oscillation in children and adolescents with hereditary sensorimotor neuropathy. PLoS One 2018; 13:e0204949. [PMID: 30304007 PMCID: PMC6179247 DOI: 10.1371/journal.pone.0204949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 09/16/2018] [Indexed: 11/19/2022] Open
Abstract
Charcot Marie Tooth disease (CMT) has negative functional impact on postural control of children; however, it has not been widely studied. Stabilometry can provide insights about postural control and guide preventive interventions in immature perceptual and musculoskeletal systems as those seen in children with CMT. This cross-sectional study aimed to identify and interpret stabilometric variables that reflect the postural control of children with CMT. 53 subjects (age 6-17) were assigned to one of the two groups: CMT (15 males and 14 females with CMT) or Control (13 males and 11 females healthy). Quiet standing was tested in different conditions: with open and closed eyes on regular surface (open-regular, closed-regular) and foam surface (open-foam, closed-foam) using a force platform. The minimum of 2 and maximum of 3 trials of 30 seconds for each test condition provided the classical stabilometric variables and Romberg Quotient (RQv). CMT group showed increase of confidence ellipse area, mean velocity, mediolateral and anteroposterior velocities associated with decreased mean body oscillation frequency, as the complexity of tasks increased. CMT postural deficit was identified by greater and faster sway associated with these lower frequencies, when compared to Control.
Collapse
|
18
|
The Relationship between Shoe Fitting and Foot Health of Persons with Down Syndrome: A Case Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050983. [PMID: 29757962 PMCID: PMC5982022 DOI: 10.3390/ijerph15050983] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/08/2018] [Accepted: 05/11/2018] [Indexed: 12/01/2022]
Abstract
Background: Down syndrome is the most common chromosomal abnormality and a cause of intellectual disability. It is also associated with orthopaedic and musculoskeletal problems of the locomotive apparatus, especially of the feet. These problems are believed to have a harmful effect on health, social functioning, and mobility. In addition, these persons generally don’t have access to podiatric health services, even when their foot problems are well known, because of limited access to healthcare facilities. The goal of our research was to evaluate and compare the foot health status of study participants with and without Down syndrome and to determine whether inadequate footwear is being used with normalized reference values. Methods: A total of 105 participants with and without Down syndrome, with a mean age of 35.71 (SD = 12.93) years, were enrolled in the study. They self-reported demographic data and their clinical characteristic data were recorded. Measurements of their foot and shoe fitting were taken at all stages of the research process. Ninety-two percent of the participants with Down syndrome had foot problems. Results: Only 12 (24%) participants with Down syndrome used bilateral shoes that met the requirements of their feet compared to their controls (50 participants, 90.9% for the right foot; 46 participants, 83.6% for the left foot). Participants with Down syndrome presented statistically significant differences with respect to controls and wore incorrectly sized shoe. Conclusions: Evaluation of foot length and width may prevent development of foot deformities, as well as to improve general health.
Collapse
|
19
|
Maïano C, Hue O, Tracey D, Lepage G, Morin AJS, Moullec G. Static postural control among school-aged youth with Down syndrome: A systematic review. Gait Posture 2018; 62:426-433. [PMID: 29653404 DOI: 10.1016/j.gaitpost.2018.03.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/11/2018] [Accepted: 03/15/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Youth with Down syndrome are characterized by motor delays when compared to typically developing (TD) youth, which may be explained by a lower postural control or reduced postural tone. OBJECTIVE In the present article, we summarize research comparing the static postural control, assessed by posturography, between youth with Down syndrome and TD youth. METHODS A systematic literature search was performed in 10 databases and seven studies, published between 2001 and 2017, met our inclusion criteria. RESULTS Based on the present reviewed findings, it is impossible to conclude that children with Down syndrome present significantly lower static postural control compared to TD children. In contrast, findings showed that adolescents with Down syndrome tended to present significantly lower static postural control compared to TD adolescents when visual and plantar cutaneous inputs were disturbed separately or simultaneously. CONCLUSION The present findings should be interpreted with caution given the limitations of the small number of reviewed studies. Therefore, the static postural control among youth with Down syndrome should be further investigated in future rigorous studies examining the contribution of a range of sensory information.
Collapse
Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Gatineau, Canada; Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada.
| | - Olivier Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Danielle Tracey
- School of Education, Western Sydney University, Sydney, Australia
| | - Geneviève Lepage
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Grégory Moullec
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada; Research Center, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Montréal, Canada
| |
Collapse
|
20
|
Capio CM, Mak TCT, Tse MA, Masters RSW. Fundamental movement skills and balance of children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:225-236. [PMID: 29205624 DOI: 10.1111/jir.12458] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 10/20/2017] [Accepted: 11/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Conclusive evidence supports the importance of fundamental movement skills (FMS) proficiency in promoting physical activity and countering obesity. In children with Down Syndrome (DS), FMS development is delayed, which has been suggested to be associated with balance deficits. This study therefore examined the relationship between FMS proficiency and balance ability in children with DS, with the aim of contributing evidence to programmes that address FMS delay. METHODS Participants consisted of 20 children with DS (7.1 ± 2.9 years old) and an age-matched control group of children with typical development (7.25 ± 2.5 years). In the first part of the study, FMS (i.e. locomotor and object control) proficiency of the children was tested using the Test of Gross Motor Development-2. Balance ability was assessed using a force platform to measure centre of pressure average velocity (AV; mm/sec), path length (mm), medio-lateral standard deviation (mm) and antero-posterior standard deviation (mm). In the second part of the study, children with DS participated in 5 weeks of FMS training. FMS proficiency and balance ability were tested post-training and compared to pre-training scores. Verbal and visuo-spatial short-term memory capacities were measured at pre-training to verify the role of working memory in skill learning. RESULTS FMS proficiency was associated with centre of pressure parameters in children with DS but not in children with typical development. After controlling for age, AV was found to predict significant variance in locomotor (R2 = 0.61, P < 0.001) and object control (R2 = 0.69, P < 0.001) scores. FMS proficiency and mastery improved after FMS training, as did AV, path length and antero-posterior standard deviation (all P < 0.05). Verbal and visuo-spatial short-term memory did not interact with the effects of training. CONCLUSIONS Children with DS who have better balance ability tend to have more proficient FMS. Skill-specific training improved not only FMS sub-skills but static balance stability as well. Working memory did not play a role in the changes caused by skills training. Future research should examine the causal relationship between balance and FMS.
Collapse
Affiliation(s)
- C M Capio
- Te Huataki Waiora Faculty of Health, Sport and Human Performance, University of Waikato, New Zealand
- School of Public Health, The University of Hong Kong, Hong Kong
| | - T C T Mak
- School of Public Health, The University of Hong Kong, Hong Kong
| | - M A Tse
- School of Public Health, The University of Hong Kong, Hong Kong
| | - R S W Masters
- Te Huataki Waiora Faculty of Health, Sport and Human Performance, University of Waikato, New Zealand
- School of Public Health, The University of Hong Kong, Hong Kong
| |
Collapse
|
21
|
|
22
|
Gomes MM, Moraes R, Barela JA. Coupling between visual information and body sway in adults with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 58:9-19. [PMID: 27587352 DOI: 10.1016/j.ridd.2016.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 08/04/2016] [Accepted: 08/23/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Prior studies suggest that infants with Down syndrome (DS) need more experience to acquire a similar relationship between visual information and body sway than infants without DS. However, it is unclear how adults with DS deal with visual information to control posture. AIM To examine the coupling between visual information and body sway in adults with DS. METHODS Twenty adults with DS (25.8±4.0years) and twenty age- and sex-matched controls (25.6±4.0years) stood upright inside a "moving room" in two experimental conditions: continuous (room oscillated continuously at 0.1, 0.2, and 0.5Hz) and discrete (room moved forward or backward for a brief moment). Tridimensional body sway and moving room displacement data were registered. RESULTS Individuals with DS coupled their body sway to the imposed visual stimulus, but showed higher position variability at frequencies other than the frequency of room movement (0.48cm) and lower coherence (0.80) than controls (0.40cm and 0.90, respectively). CONCLUSIONS Adults with DS were able to couple to the visual cue, but with differences in terms of the scaling of postural responses to spatial parameters of the visual stimulus.
Collapse
Affiliation(s)
- Matheus Machado Gomes
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, EEFERP-USP, São Paulo, Brazil.
| | - Renato Moraes
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, EEFERP-USP, São Paulo, Brazil
| | - José Angelo Barela
- Institute of Physical Activity and Sport Sciences and Graduate Program in Human Movement Sciences, Cruzeiro do Sul University, São Paulo, Brazil; Institute of Bioscience, São Paulo State University, Rio Claro, Brazil
| |
Collapse
|
23
|
Carter K, Horvat M. Effect of Taekwondo Training on Lower Body Strength and Balance in Young Adults with Down Syndrome. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kathy Carter
- University of Louisville; Louisville Kentucky USA
| | | |
Collapse
|
24
|
Aranha VP, Samuel AJ, Saxena S. Reliability and sensitivity to change of the timed standing balance test in children with down syndrome. J Neurosci Rural Pract 2016; 7:77-82. [PMID: 26933350 PMCID: PMC4750347 DOI: 10.4103/0976-3147.165412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: To estimate the reliability and sensitivity to change of the timed standing balance test in children with Down syndrome (DS). Methods: It was a nonblinded, comparison study with a convenience sample of subjects consisting of children with DS (n = 9) aged 8–17 years. The main outcome measure was standing balance which was assessed using timed standing balance test, the time required to maintain in four conditions, eyes open static, eyes closed static, eyes open dynamic, and eyes closed dynamic. Results: Relative reliability was excellent for all four conditions with an Interclass Correlation Coefficient (ICC) ranging from 0.91 to 0.93. The variation between repeated measurements for each condition was minimal with standard error of measurement (SEM) of 0.21–0.59 s, suggestive of excellent absolute reliability. The sensitivity to change as measured by smallest real change (SRC) was 1.27 s for eyes open static, 1.63 s for eyes closed static, 0.58 s for eyes open dynamic, and 0.61 s for eyes closed static. Conclusions: Timed standing balance test is an easy to administer test and sensitive to change with strong absolute and relative reliabilities, an important first step in establishing its utility as a clinical balance measure in children with DS.
Collapse
Affiliation(s)
- Vencita Priyanka Aranha
- Department of Pediatric Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Asir John Samuel
- Department of Pediatric Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Shikha Saxena
- Department of Graduate Studies, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
25
|
Kim SE, Hong J, Cha JY, Park JM, Eun D, Yoo J, Jee YS. Relative appendicular skeletal muscle mass is associated with isokinetic muscle strength and balance in healthy collegiate men. J Sports Sci 2016; 34:2114-20. [PMID: 26930152 DOI: 10.1080/02640414.2016.1151922] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There are few studies on the relationship between skeletal muscle mass and balance in the young ages. We investigated the relationship between appendicular skeletal muscle mass, isokinetic muscle strength of lower extremity, and balance among healthy young men using relative skeletal muscle index. Thirty men were grouped according to relative appendicular skeletal muscle mass index: higher skeletal muscle group (n = 15) and lower skeletal muscle group (n = 15). Static and dynamic balance abilities were measured using the following: a test where participants stood on one leg with eyes closed, a modified Clinical Test of Sensory Interaction on Balance (mCTSIB) with eyes open and eyes closed, a stability test, and limits of stability test. The muscle strength of lower extremities was measured with an isokinetic analyser in hip, knee, and ankle joints. Participants with higher appendicular skeletal muscle mass were significantly more stable in maintaining dynamic balance than those with lower appendicular skeletal muscle mass. Moreover, appendicular skeletal muscle mass index was positively correlated with dynamic balance ability. Participants with higher appendicular skeletal muscle mass had stronger strength in the lower extremity, and there were significant differences in the isokinetic torque ratios between groups. From these results, it can be inferred that higher appendicular skeletal muscle mass relates to muscle strength and the alteration in the peak torque ratio of the lower extremity, contributing to the maintenance of balance.
Collapse
Affiliation(s)
- Sung-Eun Kim
- a Department of Physiology , College of Medicine, Kyung Hee University , Seoul , Republic of Korea
| | - Ju Hong
- b Department of Exercise Physiology and Prescription, Graduate School of Health Promotion , Hanseo University , Seosan , Republic of Korea
| | - Jun-Youl Cha
- c Department of Physical Education , Graduate School of Chungnam National University , Daejeon , Republic of Korea
| | - Jung-Min Park
- c Department of Physical Education , Graduate School of Chungnam National University , Daejeon , Republic of Korea
| | - Denny Eun
- b Department of Exercise Physiology and Prescription, Graduate School of Health Promotion , Hanseo University , Seosan , Republic of Korea
| | - Jaehyun Yoo
- d Department of Health Management , Sahmyook University , Seoul , Republic of Korea
| | - Yong-Seok Jee
- b Department of Exercise Physiology and Prescription, Graduate School of Health Promotion , Hanseo University , Seosan , Republic of Korea
| |
Collapse
|
26
|
Chen HL, Yeh CF, Howe TH. Postural control during standing reach in children with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:345-351. [PMID: 25590172 DOI: 10.1016/j.ridd.2014.12.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/12/2014] [Accepted: 12/13/2014] [Indexed: 06/04/2023]
Abstract
The purpose of the present study was to investigate the dynamic postural control of children with Down syndrome (DS). Specifically, we compared postural control and goal-directed reaching performance between children with DS and typically developing children during standing reach. Standing reach performance was analyzed in three main phases using the kinematic and kinetic data collected from a force plate and a motion capture system. Fourteen children with DS, age and gender matched with fourteen typically developing children, were recruited for this study. The results showed that the demand of the standing reach task affected both dynamic postural control and reaching performance in children with DS, especially in the condition of beyond arm's length reaching. More postural adjustment strategies were recruited when reaching distance was beyond arm's length. Children with DS tended to use inefficient and conservative strategies for postural stability and reaching. That is, children with DS perform standing reach with increased reaction and execution time and decreased amplitudes of center of pressure displacements. Standing reach resembled functional balance that is required in daily activities. It is suggested to be considered as a part of strength and balance training program with graded task difficulty.
Collapse
Affiliation(s)
- Hao-Ling Chen
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chun-Fu Yeh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsu-Hsin Howe
- Department of Occupational Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, United States
| |
Collapse
|
27
|
Verma A, Samuel AJ, Aranha VP. The four square step test in children with Down syndrome: Reliability and concurrent validity. J Pediatr Neurosci 2015; 9:221-6. [PMID: 25624923 PMCID: PMC4302540 DOI: 10.4103/1817-1745.147573] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: To estimate test-retest reliability, inter-rater reliability and validation of a method for measuring balance by stepping over four squares, four square step test (FSST) in children with Down syndrome (DS). Methods: A sample of 13 children with DS was recruited for the cross-sectional study. They were asked to perform FSST and the time taken was noted. For estimating test-retest reliability, FSST was done by principal investigator twice and Inter-rater reliability was assessed by principal investigator and second investigator with an interval of 7 days. FRT was used as the criterion dynamic balance measure to validate FSST. The data was tabulated and analysed statistically. Results: The test-retest reliability and inter-rater reliability of FSST are ICC(1,1) = 0.70 (0.64-0.90) and ICC(2,1) = 0.78 (0.62-0.91) respectively. The Bland-Altman limits of agreement were also satisfied. Concurrent validity between FRT and FSST with Spearman's ρ = −0.58 (−0.86 to −0.13). Conclusion: FSST has moderate to good concurrent validity and good reliability among the children with Down syndrome.
Collapse
Affiliation(s)
- Ajai Verma
- Department of Pediatric Physiotherapy, Alva's College of Physiotherapy, Moodabidri, Karnataka, India
| | - Asir John Samuel
- Department of Pediatric Physiotherapy, Maharishi Markandeswar Institute of Physiotherapy and Rehabilitation (MMIPR), Maharishi Markandeswar University, Mullana, Haryana, India
| | - Vencita Priyanka Aranha
- Department of Pediatric Physiotherapy, Maharishi Markandeswar Institute of Physiotherapy and Rehabilitation (MMIPR), Maharishi Markandeswar University, Mullana, Haryana, India
| |
Collapse
|
28
|
Almuhtaseb S, Oppewal A, Hilgenkamp TIM. Gait characteristics in individuals with intellectual disabilities: a literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2858-2883. [PMID: 25105568 DOI: 10.1016/j.ridd.2014.07.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/07/2014] [Indexed: 06/03/2023]
Abstract
Gait is a functionally highly relevant aspect of motor performance. In the general population poorer gait increases the risk of falls and is a predictor for future disability, cognitive impairment, institutionalization and/or mortality. People with intellectual disabilities (ID) show a delayed motor development, which brings to attention the abnormalities that might accompany gait in this population throughout childhood and adulthood. Therefore, this paper aims (a) to provide a focused review of the available literature on gait characteristics in individuals with ID and (b) to gain insight into available instrumentations measuring gait in this population. We searched the database of PubMed for relevant articles and the reference lists of included articles, resulting in 44 included articles. Forty one studies reported gait characteristics during over-ground walking and six studies during perturbed walking conditions. Most studies investigated syndrome-specific ID populations, only five studies investigated the general ID population. The studies show that gait abnormalities are evident during over-ground walking in the ID population, both in people with genetic syndromes and with ID without genetic syndromes. During perturbed conditions people with ID altered their gait with stability-enhancing adaptations. Abnormalities in gait may be partly explained by physical features, but the interrelatedness between gait and cognition may also be an explanation for the gait abnormalities seen in the ID population. Further research regarding gait characteristics of the ID population, and its relation to cognitive functioning, and adverse health outcomes is needed.
Collapse
Affiliation(s)
- Sanaa Almuhtaseb
- Institute of Sport Science and Sport, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Alyt Oppewal
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Ipse de Bruggen, P.O. Box 7027, 2701 AA Zoetermeer, The Netherlands.
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Abrona, Amersfoortseweg 56, 3712 BE Huis ter Heide, The Netherlands
| |
Collapse
|
29
|
Villarroya MA, González-Agüero A, Moros T, Gómez-Trullén E, Casajús JA. Effects of whole body vibration training on balance in adolescents with and without Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3057-3065. [PMID: 23872530 DOI: 10.1016/j.ridd.2013.06.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/11/2013] [Accepted: 06/13/2013] [Indexed: 06/02/2023]
Abstract
The present study aimed to determine whether a whole body vibration training program (WBV) is able to improve static standing balance in adolescents with and without Down syndrome (DS). Thirty adolescents with DS aged 11-20 years (DSG) and 27 adolescent, age/sex matched, without DS (CG) joined the study. Participants of each group were divided into two comparable groups, those who performed WVB (in DSG: VDSG; in CG: VCG) and those who did not perform WVB (in DSG: nVDSG; in CG: nVCG). Static-standing-balance under four conditions (C1: open-eyes/fixed-foot-support; C2: closed-eyes/fixed-foot-support; C3: open-eyes/compliant-foot-support; C4: closed-eyes/compliant-foot-support) was examine, before and after a 20-week WBV training program. For balance study, Postural-Parameters (PPs), based on center of pressure (COP) oscillations (anterior/posterior and medial/lateral COP excursion and COP mean velocity), and PPs ratios among the four conditions were calculated. After WBV training, no significant differences were found in any parameter in the VCG and nVCG and neither in the nVDSG, but there was a decrease of mean values in the analyzed PPs under C4, with significant differences in medial/lateral COP excursion and COP mean velocity, and a significant decrease in the ratio C4/C1 of the mean velocity in VDSG. Therefore, WBV training had positive effects in the balance of DS adolescents although only under specific conditions, with vision and somatosensory input altered. The positive results of this study are encouraging and open a wide field of research, looking for the most efficient program for this population.
Collapse
Affiliation(s)
- M Adoración Villarroya
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, University of Zaragoza, Spain.
| | | | | | | | | |
Collapse
|
30
|
Posture control after 5 months body balance training in Down syndrom children and youth. Physiotherapy 2013. [DOI: 10.2478/physio-2013-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AbstractAim of the study: The aim of this study was to verify whether the 5-month training exercises using specific balance exercises of the authorial program improves body balance control in children with Down syndrome (DS).Materials and methods: The purpose of this study was the verification if the 5-months posture control exercises training by original program relays to posture control in Down syndrome (DS) children and youth. The subjects were 8 DS persons: 4 males and 4 females, aged 13-24. Two 20-seconds consecutive trails of natural bipedal standing position on 2 force platforms AccuSway (AMTI), one under each foot, were performed during research. On the basis of COP (centre of pressure) time series the following indices were computed: range, variability, velocity and area of COP shifts. There were 2 sessions of the research: one just before and the second just after 5-month lasting specific posture control training based on the original exercise program.Results: The results revealed decreasing of the COP velocity of right lower limb and the COP range in anterior-posterior direction of both lower limbs after the training, comparing to the values from the first research session.Conclusions: It is concluded that the specific posture control training by the presenting of the original exercises program influenced the posture control improving it and the program can be used in therapy of DS children and youth.
Collapse
|