The aim of this study was to determine the motor abilities in children with Down syndrome and examine which areas are significantly delayed. This study also assessed functional balance as a feature of quality of movement. A small sample size of 79 children were recruited and divided into groups according to:
- age: <3 years old, 3-6 years old, >6 years old and
- motor impairment rating scale: mild, moderate and severe.
All children attended physical therapy sessions once per week for 2 years. The aim of these sessions were to:
- develop psychomotor abilities
- assist with the development of quality motor function
- normalise muscle tone.
- train balance reaction and
- postural maintenance
Children were assessed using the Gross Motor Function Measure-88 (GMFM-88) and body balance was estimated by Pediatric Balance Scale (PBS). "There was no control as the original validation sample of GMFM-88 included children aged from 5 months to 16 years, so the score of GMFM-88 is the percentage of the score of the original validation group."
The results of the present study revealed none of the children with Down syndrome, in the group aged 3-6 years old developed 100% of the motor functions as evaluated by GMFM-88 (Typical development by 5 years is when all GMFM-88 functions are developed). The ability to stand upright was achieved in 95% of children in this study at 3 - 6 years, however only 10% of children <3 years were able to stand. The researchers discussed how standing position is achieved after acquiring postural alignment between the head, torso and hip and this may be difficult for children with Down Syndrome because it engages trunk flexors and extensors and these muscle synergies may often be hypotonic. Walking developed later in infants with Down Syndrome than typically developing infants. Most children included in this study began walking when they were 3 years and older. The authors suggested this delay may be a result of their poor balance (cerebellar hypoplasia), joint laxity and hypotonia.
The aim of care in children with Down syndrome should be to help improve functional balance, postural alignment, muscle tone and symmetry. This may assist with minimizing delays in motor abilities that are developed in childhood.
Written by Carla Vescio, Chiropractor