Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review

Preyal D Jain, Akshatha Nayak, Shreekanth D Karnad, Kaiorisa N Doctor, Preyal D Jain, Akshatha Nayak, Shreekanth D Karnad, Kaiorisa N Doctor

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.

Keywords: Balance; Development; Down syndrome; Motor function.

Conflict of interest statement

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
The study selection process shown in a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/8898616/bin/cep-2021-00479f2.jpg

References

    1. Tudella E, Pereira K, Basso RP, Savelsbergh GJP. Description of the motor development of 3–12 month old infants with Down syndrome: the influence of the postural body position. Res Dev Disabil. 2011;32:1514–20.
    1. Beqaj S, Jusaj N, Živković V. Attainment of gross motor milestones in children with Down syndrome in Kosovo - developmental perspective. Med Glas (Zenica) 2017;14:189–98.
    1. Winders P, Wolter-Warmerdam K, Hickey F. A schedule of gross motor development for children with Down syndrome. J Intellect Disabil Res. 2019;63:346–56.
    1. Riquelme Agulló I, Manzanal González B. Factors influencing motor development in children with Down syndrome. Int Med Rev Down Syndr. 2006;10:18–24.
    1. Frank K, Esbensen AJ. Fine motor and self-care milestones for individuals with Down syndrome using a retrospective chart review. J Intellect Disabil Res. 2015;59:719–29.
    1. Jung HK, Chung E, Lee BH. A comparison of the balance and gait function between children with Down syndrome and typically developing children. J Phys Ther Sci. 2017;29:123–7.
    1. de Campos AC, Rocha NA, Savelsbergh GJ. Development of reaching and grasping skills in infants with Down syndrome. Res Dev Disabil. 2010;31:70–80.
    1. Adair B, Said CM, Rodda J, Morris ME. Psychometric properties of functional mobility tools in hereditary spastic paraplegia and other childhood neurological conditions. Dev Med Child Neurol. 2012;54:596–605.
    1. Russell D, Palisano R, Walter S, Rosenbaum P, Gemus M, Gowland C, et al. Evaluating motor function in children with Down syndrome: validity of the GMFM. Dev Med Child Neurol. 1998;40:693–701.
    1. Goetschius J, Feger MA, Hertel J, Hart JM. Validating center-of-pressure balance measurements using the MatScan® pressure mat. J Sport Rehabil. 2018 Jan 1;2(1) doi: 10.1123/jsr.2017-0152. . [Epub]
    1. Palomo-Carrión R, Bravo-Esteban E, Ando-La Fuente S, López-Muñoz P, Martínez-Galán I, Romay-Barrero H. Efficacy of the use of unaffected hand containment in unimanual intensive therapy to increase visuomotor coordination in children with hemiplegia: a randomized controlled pilot study. Ther Adv Chronic Dis. 2021;12:20406223211001280.
    1. van Gameren-Oosterom HB, Fekkes M, Buitendijk SE, Mohangoo AD, Bruil J, Van Wouwe JP. Development, problem behavior, and quality of life in a population based sample of eight-year-old children with Down syndrome. PLoS One. 2011;6:e21879.
    1. Alesi M, Battaglia G, Pepi A, Bianco A, Palma A. Gross motor proficiency and intellectual functioning: a comparison among children with Down syndrome, children with borderline intellectual functioning, and typically developing children. Medicine (Baltimore) 2018;97:e12737.
    1. Malak R, Kostiukow A, Krawczyk-Wasielewska A, Mojs E, Samborski W. Delays in Motor Development in Children with Down Syndrome. Med Sci Monit. 2015;21:1904–10.
    1. Schott N, Holfelder B. Relationship between motor skill competency and executive function in children with Down’s syndrome. J Intellect Disabil Res. 2015;59:860–72.
    1. Schott N, Holfelder B, Mousouli O. Motor skill assessment in children with Down Syndrome: relationship between performance-based and teacher-report measures. Res Dev Disabil. 2014;35:3299–312.
    1. Vimercati SL, Galli M, Stella G, Caiazzo G, Ancillao A, Albertini G. Clumsiness in fine motor tasks: evidence from the quantitative drawing evaluation of children with Down Syndrome. J Intellect Disabil Res. 2015;59:248–56.
    1. Rigoldi C, Galli M, Mainardi L, Crivellini M, Albertini G. Postural control in children, teenagers and adults with Down syndrome. Res Dev Disabil. 2011;32:170–5.
    1. Villarroya MA, González-Agüero A, Moros-García T, de la Flor Marín M, Moreno LA, Casajús JA. Static standing balance in adolescents with Down syndrome. Res Dev Disabil. 2012;33:1294–300.
    1. Chen HL, Yeh CF, Howe TH. Postural control during standing reach in children with Down syndrome. Res Dev Disabil. 2015;38:345–51.
    1. Marchal JP, Maurice-Stam H, Houtzager BA, Rutgers van Rozenburg-Marres SL, Oostrom KJ, Grootenhuis MA, et al. Growing up with Down syndrome: development from 6 months to 10.7 years. Res Dev Disabil. 2016;59:437–50.
    1. Wang HY, Long IM, Liu MF. Relationships between task-oriented postural control and motor ability in children and adolescents with Down syndrome. Res Dev Disabil. 2012;33:1792–8.
    1. El-Hady SSA, El-Azim FHA, El-Talawy HAEAM. Correlation between cognitive function, gross motor skills and health – Related quality of life in children with Down syndrome. Egypt J Med Hum Genet. 2018;19:97–101.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit