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Duarte Machado E, Cole MH, Miller L, McGuckian TB, Wilson PH. The efficacy of dance interventions for the activity and participation of individuals with cerebral palsy - a systematic review and meta-analysis. Disabil Rehabil 2024; 46:1485-1501. [PMID: 37122166 DOI: 10.1080/09638288.2023.2200259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 04/04/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE The aim of this review was to examine the efficacy of dance interventions for individuals with cerebral palsy (CP), measured at any level of the International Classification of Functioning, Disability and Health (ICF). METHODS A systematic review and meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search of peer-reviewed articles was performed using six electronic databases. RESULTS Fourteen studies were included in this review, nine of which were also included in the meta-analysis. The meta-analyses yielded a large overall effect for cognitive, motor, and social-emotional function outcomes, with a high degree of heterogeneity between outcome effects, attributable to differences in study design. CONCLUSION Although recent studies provide support for the acceptance and efficacy of dance interventions for people with CP, the systematic review revealed significant limitations in study design (only 2 randomised control trials). High-quality research that measures outcomes across all dimensions of the ICF, and particularly at the level of participation, are needed to improve the level of empirical support for dance-based interventions.
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Affiliation(s)
- Eduardo Duarte Machado
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Michael H Cole
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Australia
| | - Thomas B McGuckian
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Peter H Wilson
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
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Lima EF, Brugnaro BH, Rocha NACF, Pavão SL. Effectiveness and Evidence Level of Dance on Functioning of Children and Adolescents with Neuromotor Impairments: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1501. [PMID: 36674254 PMCID: PMC9859262 DOI: 10.3390/ijerph20021501] [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: 10/27/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES The aim of this paper is to investigate the effects of dance therapy in children with neuromotor impairments (CNI), organizing the outcomes according to International Classification of Functioning Disability and Health (ICF) domains, and to investigate if there is adequate evidence of effectiveness to recommend dance as a therapy. METHODS Electronic searches were conducted in December 2021. We include studies assessing the effects of dance in CNI up to 18 years. Data extraction included studies' populations, intervention features, and main outcomes. We classified outcomes according to the ICF framework. We used the Cochrane collaboration's tool, modified by effective practice and organization of care (EPOC), to assess the methodological quality. The GRADE synthesized the body of evidence. RESULTS Twelve studies were included, with most of them addressing the body structure and function and activity components of ICF. Only three studies addressed components of participation, and four of personal factors. All these studies reported the positive effects of dance. Nevertheless, all of them presented high risk of bias. We found very low evidence level for improvement of body structure and function and activity components. CONCLUSION Dance therapy presents low evidence level for improvements of body structure and function and activity in CNI. Further studies with low risk of bias and larger samples are needed.
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Affiliation(s)
- Elisangela F. Lima
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba 80060-000, Brazil
| | - Beatriz H. Brugnaro
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos, São Carlos 13565-905, Brazil
| | - Nelci Adriana C. F. Rocha
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos, São Carlos 13565-905, Brazil
| | - Silvia L. Pavão
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba 80060-000, Brazil
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3
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Xia C, Jing Q, Chen G, Sun M, Lu J. Association between Participation of Children with Disabilities and the Child, Family, and Environmental Factors in Shanghai, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:615. [PMID: 36612936 PMCID: PMC9819672 DOI: 10.3390/ijerph20010615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Participation is essential to a child's health and well-being, whereas children with disabilities may lack the associated benefits because of physical restrictions. This study aims to examine the association between the participation of children with disabilities and the child, family, and environmental factors. A total of 433 children with disabilities aged 3-18 and their family caregivers were included. Three binary logistic regression models were respectively established to identify the significant factors associated with children's home, school, and community participation. Our main empirical results showed that among 433 children with disabilities, 44.3%, 47.6%, and 58.7% of them never or seldom participated in home, school, and community activities. Child and family factors were found to be dominantly associated with children's participation, and significant factors associated with the home, school, and community participation of children were different, including children's disability type, sleep problems and emotional stability, caregivers' education, mental HRQOL, rehabilitation belief, and number of children in the family. These results highlight that the participation of children with disabilities in mainland China urgently needs to be enhanced, and further research might be focused on validating the causal relationships between participation and significant child and family factors identified in this study.
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Affiliation(s)
- Cong Xia
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Qi Jing
- School of Management, Weifang Medical University, Weifang 261053, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261053, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Mei Sun
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261053, China
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Quality of Life, Participation, and Individualized Support in a Community-Based Yoga Class: A Case Series. Pediatr Phys Ther 2022; 34:556-562. [PMID: 35943398 DOI: 10.1097/pep.0000000000000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess quality of life and participation in children with disabilities following a community-based yoga class, to examine the feasibility of implementing a community-based program with individualized support, and to make recommendations for the development of future programs. SUMMARY OF KEY POINTS Four children participated in a 10-week yoga class, with doctor of physical therapy students providing individualized physical and behavioral support. Children improved in components of the Children's Assessment of Participation and Enjoyment (CAPE) following the program; however, changes in quality of life on the Pediatric Quality of Life Inventory (PedsQL) were inconsistent. Parents provided feedback regarding the family's experience and reported that the children improved behavior, communication, and relationships following the yoga class. WHAT THIS CASE ADDS TO EVIDENCEBASED PRACTICE A community-based yoga class for children with disabilities using individualized support is feasible and can improve participation and enjoyment in recreational activities.
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Adorno ET, Dos Santos DCDJ, DeJesus BM, Passos AA, Teixeira-Machado L. Dance, functioning and quality of life in children with Down syndrome and autism spectrum disorder dance, functioning and quality of life in Down syndrome and autism spectrum disorder. Clin Child Psychol Psychiatry 2022; 27:967-977. [PMID: 34965160 DOI: 10.1177/13591045211061795] [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]
Abstract
This study investigated dance practice in psychosocial and functional aspects, and quality of life in children with Down syndrome and autism spectrum disorder. Children with DS and ASD, between 3 and 12 years old, attended a dance program during 16 sessions/lessons, lasting 60 min, twice a week, in suitable place. Functional Independence Measure (FIM), Childhood Autism Rating Scale SF-36 quality of life survey, and Knowledge, Attitude and Practice Inquiry (KAP Inquiry) were applied before and after dance classes. Eleven participants concluded the study. Functional independence changes were observed in relation to self-care, sphincter control, locomotion, and communication domains. Children' "quality of life" reported by parents showed changes in functional capacity, vitality, mental health, physical and social aspects, and general state of health domains. These findings suggest that regular dance practice can underlie psychosocial adjustments in children with DS and ASD.
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Affiliation(s)
| | | | - Beatriz M DeJesus
- Graduate Program in Physiological Sciences, 74391Federal University of Sergipe, São Cristóvão, Brazil
| | - Adrielle A Passos
- Graduate Program in Applied Health Sciences, 74391Federal University of Sergipe, Lagarto, Brazil
| | - Lavínia Teixeira-Machado
- Graduate Program in Applied Health Sciences, 74391Federal University of Sergipe, Lagarto, Brazil.,Department of Education in Health, 74391Federal University of Sergipe, Lagarto, Brazil
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Must A, Bandini LG, Curtin C, Rancaño KM, Eliasziw M, Tybor DJ, Stanish H. A Pilot Dance Intervention to Encourage Physical Activity Engagement for Adolescent Girls with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084661. [PMID: 35457537 PMCID: PMC9031306 DOI: 10.3390/ijerph19084661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/31/2022] [Accepted: 04/07/2022] [Indexed: 12/04/2022]
Abstract
Adolescent girls with intellectual disabilities (ID) are at risk for low physical activity (PA) participation due to their limited opportunities. Purpose: To evaluate the feasibility and preliminary efficacy of a 12-week dance intervention to promote engagement in moderate-to-vigorous PA (MVPA) and increase cardiorespiratory fitness. Methods: The 12-week intervention included two 75-min weekly dance sessions. Continuous heart-rate (HR) monitoring assessed time spent below/at/above each girl’s target HR zone. Cardiorespiratory fitness was measured by the 6-min walk test (6MWT). Survey items assessed participant enjoyment and participant and parent satisfaction. Results: The mean (SD) age of 18 adolescent girls was 17.3 (2.7) years. Overall, girls attended 88% of sessions and spent 52.3% of each session in MVPA. Mean MVPA was unchanged across the 12 weeks, but the pattern differed across the three sites. We observed a non-significant pre-post increase of 74.6 feet on the 6MWT. Post-intervention surveys indicated that most girls liked the program, perceived improved fitness, and wished to continue dancing. The majority also reported a preference for a girls-only dance program exclusively for those with ID. Conclusion: Our findings suggest that dance is viable for promoting PA for girls with ID. More frequent exercise training is likely needed to improve cardiorespiratory fitness.
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Brown EL, Gannotti ME, Veneri DA. Including Arts in Rehabilitation Enhances Outcomes in the Psychomotor, Cognitive, and Affective Domains: A Scoping Review. Phys Ther 2022; 102:6515752. [PMID: 35084031 DOI: 10.1093/ptj/pzac003] [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: 03/23/2021] [Revised: 09/25/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to analyze the published literature regarding the use of art in the context of rehabilitation for consideration in physical therapy. METHODS The CINAHL, PsycArticles, APA PsycInfo, Art Index, Music Index, Cochrane Reviews, and PubMed electronic databases were accessed. Inclusion and exclusion criteria were established and utilized to determine study eligibility. Study details were extracted from each article by researchers using a systematic format. Summation of journal type, participants, dosing and type of intervention, setting and interventionist, outcome domains, and study results were included. RESULTS Out of 1452 studies, 76 were included for extraction. Of these studies, most had outcome measures aligned with the psychomotor and affective domains of learning (n = 66). Very few studies had outcome measures with psychomotor and cognitive domains (n = 2) or psychomotor, affective, and cognitive outcome measures (n = 8). Regarding the arts used, music, dance, or both were used in 77 instances. Fewer studies reported using creative arts therapy, singing, theater, writing, and rhythm (n = 17). Of the 76 studies analyzed, 74 reported a within-group treatment effect. CONCLUSION The arts effectively enhance physical therapist practice; therefore, it is recommended that physical therapists continue to seek collaboration with art professionals and explore the use of arts in practice. IMPACT Findings demonstrate that combining the arts with physical therapist practice amplifies not only psychomotor but affective and cognitive outcomes as well. The arts have applicability across broad populations (eg, chronic pain, neurologic dysfunction, respiratory conditions). This study supports that physical therapist education and practice should embrace the arts as a collaborative modality to promote enhanced psychomotor, affective, and cognitive outcomes.
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Affiliation(s)
- Emma L Brown
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Mary E Gannotti
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Diana A Veneri
- Department of Physical Therapy, Sacred Heart University, Fairfield, Connecticut, USA
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Quinzi F, Vannozzi G, Camomilla V, Piacentini MF, Boca F, Bortels E, Kathrein E, Magyar A, Verdone F, Sbriccoli P. Motor Competence in Individuals with Down Syndrome: Is an Improvement Still Possible in Adulthood? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042157. [PMID: 35206339 PMCID: PMC8872009 DOI: 10.3390/ijerph19042157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 02/04/2023]
Abstract
In children, motor competence (MC) and the amount of physical activity are tightly interconnected. In adults with Down syndrome (DS), MC has been poorly addressed, resulting in a limited understanding of the possibility to improve MC over time. Here, we aim to: (1) investigate MC in adults with DS by comparing them with a group of typically developed peers and (2) verify the effect of an adapted karate program on MC. Adults with DS (DSG; n = 57) and typically developed adults (TDG; n = 21) performed the Test of Gross Motor Development version 3 (TGMD-3). The total TGMD-3 score (TOTTGMD-3), the locomotor (LOCTGMD-3), and object control (OBJTGMD-3) scores were computed. After a 40 week adapted karate program, DSG (n = 37) underwent the post-training TGMD-3 assessment. Compared to TDG, DSG showed lower TOTTGMD-3 (DSG: 45.5 ± 17.3; TDG: 77.3 ± 9.5), LOCTGMD-3 (DSG: 22.2 ± 10.0; TDG: 36.2 ± 7.6) and OBJTGMD-3 (DSG: 23.3 ± 10.9; TDG: 41.1 ± 5.6). After the training, TOTTGMD-3, LOCTGMD-3 and OBJTGMD-3 increased by 35.6%, 30.0% and 40.7%, respectively. Our results suggest that MC acquisition does not evolve into a mature form in adulthood in individuals with DS. Moreover, a brief exposure to an adapted karate program induces an increase in motor competence in DS, even in adulthood.
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Affiliation(s)
- Federico Quinzi
- Department of Human Movement and Health Science, University of Rome “Foro Italico”, 00135 Rome, Italy; (F.Q.); (V.C.); (M.F.P.); (P.S.)
| | - Giuseppe Vannozzi
- Department of Human Movement and Health Science, University of Rome “Foro Italico”, 00135 Rome, Italy; (F.Q.); (V.C.); (M.F.P.); (P.S.)
- Correspondence: ; Tel.: +39-0636733522
| | - Valentina Camomilla
- Department of Human Movement and Health Science, University of Rome “Foro Italico”, 00135 Rome, Italy; (F.Q.); (V.C.); (M.F.P.); (P.S.)
| | - Maria Francesca Piacentini
- Department of Human Movement and Health Science, University of Rome “Foro Italico”, 00135 Rome, Italy; (F.Q.); (V.C.); (M.F.P.); (P.S.)
| | - Florin Boca
- Romanian Karate Federation, 022103 Bucharest, Romania;
| | - Eric Bortels
- I-Karate Global Federation—IKANDO, 3500 Hasselt, Belgium;
| | | | - Adrian Magyar
- Hungarian Karate Federation, 1146 Budapest, Hungary;
| | - Fabio Verdone
- Italian Karate Federation—FIJLKAM, 00122 Rome, Italy;
| | - Paola Sbriccoli
- Department of Human Movement and Health Science, University of Rome “Foro Italico”, 00135 Rome, Italy; (F.Q.); (V.C.); (M.F.P.); (P.S.)
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Oreskovic NM, Agiovlasitis S, Patsiogiannis V, Santoro SL, Nichols D, Skotko BG. Brief report: Caregiver perceived physical activity preferences of adults with Down syndrome. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:910-915. [PMID: 35106891 DOI: 10.1111/jar.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/08/2021] [Accepted: 01/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adults with Down syndrome commonly have low levels of physical activity and face social barriers to engaging in physical activity, including boredom and companionship concerns. Adults with Down syndrome are at increased risk for several co-occurring medial conditions known to benefit from physical activity, including obesity and dementia. METHOD This study surveyed 140 caregivers of adults with Down syndrome to determine the physical activity preferences of their adult with Down syndrome. RESULTS Dancing was the most frequently caregiver-reported physical activity preference for adults with Down syndrome, followed by walking and active video gaming. Rowing, using an elliptical machine, and jogging were the least preferred activities. Most caregivers reported that their adult with Down syndrome has a companion available for physical activity. CONCLUSION Promoting dance in adults with Down syndrome, a caregiver-reported preferred form of physical activity, may help improve physical activity levels and decrease sedentary behaviours in this population.
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Affiliation(s)
- Nicolas M Oreskovic
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Vasiliki Patsiogiannis
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stephanie L Santoro
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Dominica Nichols
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brian G Skotko
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Raghupathy MK, Divya M, Karthikbabu S. Effects of Traditional Indian Dance on Motor Skills and Balance in Children with Down syndrome. J Mot Behav 2021; 54:212-221. [PMID: 34233594 DOI: 10.1080/00222895.2021.1941736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of the study was to examine the effects of traditional Indian dances like Bharatanatyam, Kuchipudi and Kathak on motor skills and balance in children with Down syndrome compared to neuromuscular training. In this randomised double-arm design, 36 children with Down syndrome aged 6-10 years and with a score of <5 in Beighton's hypermobility test participated in either Indian classical dance (n = 18) or neuromuscular training (n = 18). Both the groups practised an hour-long session a day, three days a week for six weeks in six special-schools. Test of Gross Motor Development-2 (TGMD-2), Four Square Step Test (FSST) and paediatric balance scale were the outcome measures. After six weeks of training, there is a significant group difference of change score in the Gross Motor Quotient standard score of TGMD-2 [experimental: 30.47 vs. control: 11.1], locomotor subset of TGMD-2 [experimental: 11.1 vs. control: 4.35] and FSST [experimental: 4.29 vs. control: 2.41], but not in the paediatric balance scale [experimental: 3.59 vs. control: 3.76]. The traditional Indian dance substantially improved the locomotor skills of children with Down syndrome than that of neuromuscular exercises. Both the dance and neuromuscular training equally impacted the balance capacity.
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Affiliation(s)
- Manasa Kolibylu Raghupathy
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
| | - Mohan Divya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
| | - Suruliraj Karthikbabu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
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Wentz EE, Looper J, Menear KS, Rohadia D, Shields N. Promoting Participation in Physical Activity in Children and Adolescents With Down Syndrome. Phys Ther 2021; 101:6124775. [PMID: 33517447 DOI: 10.1093/ptj/pzab032] [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: 01/28/2020] [Revised: 10/14/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022]
Abstract
UNLABELLED Children with Down syndrome (DS) often have lower physical activity (PA) levels compared with their peers with typical development, and face challenges to being physically active such as medical comorbidities, access issues, and societal stigma. Physical therapists are experts in exercise prescription and PA and are thus uniquely qualified to successfully promote participation in children with DS, in spite of inherent challenges. Our perspective is that a shift in physical therapy service delivery is needed. We suggest that physical therapists change the focus of their interventions for children with DS from underlying impairments such as low tone or joint laxity or from developing motor skills in isolation and "correct" movement patterns. Instead, physical therapists should allow the PA preferences and the environmental contexts of the children and adolescents they are working with to direct the treatment plan. In this way, physical therapist intervention becomes more child centered by concentrating on developing the specific skills and strategies required for success in the child's preferred PA. In this article, we consider the role of pediatric physical therapists in the United States, as well as in low- and middle-income countries, in promoting and monitoring PA in children with DS from infancy through adolescence. Examples of physical therapist interventions such as tummy time, movement exploration, treadmill training, bicycle riding, and strength training are discussed, across infancy, childhood, and adolescence, with a focus on how to successfully promote lifelong participation in PA. LAY SUMMARY Physical therapists are experts in exercise and physical activity and are thus uniquely qualified to promote participation in children with Down syndrome. Instead of focusing on impairments or "correct" movement patterns, physical therapists are encouraged to allow the child and the child's environment to direct the treatment plan.
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Affiliation(s)
- Erin E Wentz
- SUNY Upstate Medical University, Syracuse, New York, USA
| | - Julia Looper
- School of Physical Therapy, University of Puget Sound, Puget Sound, Washington, USA
| | - Kristi S Menear
- School of Education, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora, Melbourne, Victoria, Australia
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12
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Ptomey LT, Willis EA, Sherman JR, White DA, Donnelly JE. Exploring the effectiveness of an 18-month weight management intervention in adults with Down syndrome using propensity score matching. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:221-233. [PMID: 31944472 PMCID: PMC8451028 DOI: 10.1111/jir.12713] [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: 05/08/2019] [Revised: 12/02/2019] [Accepted: 01/06/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Down syndrome (DS) is one of the most common birth defects in the USA associated with high levels of overweight and obesity. Unique characteristics of adults with DS that may contribute to the high levels of obesity are high rates of hypothyroidism, poor muscle tone, altered gait and lower resting metabolic rate. Due to these factors, it is unknown if the same weight management interventions that are effective in adults with intellectual or developmental disability (IDD) without DS are as effective in those with DS. Therefore, the purpose of this secondary analysis was to compare changes in weight, diet and physical activity between participants with DS-related and non-DS-related IDD participating in an 18-month weight management trial. METHODS We used propensity score methods to adjust baseline variables of overweight/obese adults with and without DS participating in an 18-month effectiveness trial with 6 months weight loss and 12 months weight maintenance. Participants followed one of two reduced calorie diet plans, obtained 150 min of moderate-vigorous intensity physical activity (MVPA) per week, and logged dietary intake daily. A health educator held monthly at-home visits with participants and a caregiver to give feedback on intervention compliance. RESULTS Out of the 124 participants that met the criteria for inclusion, 21 were diagnosed with DS and 103 with non-DS-related IDD. Twenty out of 21 participants with DS were successfully matched. Clinically significant weight loss was seen at 18 months in participants with DS (-5.2%) and non-DS-related IDD (-6.8%), with no difference between groups (P = 0.53). Significant reductions in energy intake were seen across the 18-month intervention in both DS and non-DS-related IDD groups with between-group differences at 12 months only (1119 vs. 1492 kcal/day, respectively; P = 0.003). Although MVPA did not increase in either group across the intervention, those with non-DS-related IDD had higher levels of MVPA compared with those with DS across 18 months. CONCLUSION Participants with DS lost a clinically significant amount of weight across the 18-month intervention. Compared with those with non-DS-related IDD, those with DS lost similar amounts of weight, had similar decreases in energy intake and participated in less MVPA across the 18-month intervention. Although individuals with DS have physiological factors that may contribute to obesity, weight management interventions designed for individuals with IDD may be equally effective in this population.
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Affiliation(s)
- L T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, KS
| | - E A Willis
- Center for Health Promotions and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J R Sherman
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, KS
| | - D A White
- Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, MO
| | - J E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, KS
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