Down syndrome is one of the many genetic disorders affecting the physical and mental abilities of the newly born. Kids with Down syndrome have difficulty in performing activities like sitting, crawling and standing. But with Physiotherapy, children with Down Syndrome can grow up to have a healthy, happy and productive life. Physiotherapists play a major role in the treatment of infants and children with Down Syndrome. The treatment is mainly focused on improving strength, balance, coordination, postural control and physical fitness to help them reach their milestones.
What is Down syndrome?
Down syndrome is a genetic autosomal chromosome disorder where an extra genetic material from chromosome 21 is transferred to a newly formed embryo causing changes in the development of the embryo and fetus resulting in physical and mental abnormalities.
What causes Down Syndrome?
A human body has 23 pairs (46) of Chromosomes (which carry genetic material); during conception, Whereas in Down’s syndrome, the chromosome 21 fails to pair normally resulting in an extra genetic material (47 chromosomes instead of 46).
The exact cause is still unknown, but the risk factors are:
- Late pregnancy (women age 35 or older)
- Brother / Sister with Down Syndrome
- Another baby with Down Syndrome.
What are the signs of Down Syndrome?
Babies with Down Syndrome will have:
- Typical facial features like flat face, small and flat ears, slanting eyes and a small mouth.
- A short neck and short arms and legs.
- Low muscle tone (effects the abilities to co-contract the muscles and maintain posture) and more flexible joints (resulting in increased risk of joint dislocations
- Below average intelligence.
How is Down Syndrome diagnosed?
It is generally diagnosed in the first and second trimesters of pregnancy by blood tests and ultrasound. The other specific tests include:
- Amniocentesis: To obtain a sample of amniotic fluid.
- Chorionic villus sampling: To obtain cells from Placenta.
What is the treatment for Down Syndrome?
Infants with Down Syndrome will experience developmental delays and difficulties in sitting, crawling, walking, talking etc. There is a need for a multidisciplinary team with Physiotherapists, occupational therapists, speech therapists, pediatricians etc to treat infants/kids and adults with Down Syndrome. Physiotherapists play a major role in the treatment of Down’s syndrome. Intervention should be started at an early age for better outcomes. The primary goal will be to reduce the compensatory movements and improve the gait pattern whereas the secondary goal will be to use techniques to improve the muscle tone; strength and stability of the joints which will help them in achieving the motor milestones.
The physiotherapy treatment for Down Syndrome can be divided in to
Early intervention: Early pediatric physiotherapy will help in developing motor skills such as sitting, crawling and standing. The most common techniques used by Physiotherapists are:
- Postural muscle strengthening by push-pull activities, movement in different directions,
- Movement patterns training by obstacle crawling; throwing balls at specific directions and targets in sitting; kneeling, half kneeling and standing.
- Gait (walk) training: Walking forward, backward, sideways and animal walks (duck, cat etc), walking on straight line.
Intervention for Older Children: Physiotherapists works on developing fine and complex motor skills. The most common techniques used are:
- Fine motor skills: Drawing circles, cube and peg boards, writing, finding shapes in a picture,
- Tactile perception: Touching different textures, touching shapes and identifying them.
- Postural awareness: Pointing out at body parts and touching them; turning left and right, swinging.
- Treadmill and Hydrotherapy and many other techniques.
Improving sensory and motor function by developing balance, improving fine and gross motor functions are important in children with Down syndrome because they can increase independence in activities of daily living. Say yes to Physiotherapy to bring a change in the lives of ones suffering from Down Syndrome.
Dr. Sanjay Poojari (PT),