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      Delays in Motor Development in Children with Down Syndrome

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          Abstract

          Background

          Children with Down syndrome (DS) present with delays in motor development. The reduced size of the cerebrum, brain maturation disorders, and pathophysiological processes lead to motor development delay. The aim of this study was to examine the gross motor function and estimate what motor abilities are significantly delayed in children with Down syndrome even if they attend physical therapy sessions. Another purpose of the study was to assess the functional balance.

          Material/Methods

          The study group consisted of 79 children with DS (42 boys, 37 girls), average age 6 years and 3 months ±4 years and 6 months. Participants were divided into 3 groups according to (i) age: <3 years old, 3–6 years old, and >6 years old; and (ii) motor impairment scale: mild (SNR 1), moderate (SNR 2), and severe (SNR 3). Children were assessed using the Gross Motor Function Measure-88 (GMFM-88) and Pediatric Balance Scale (PBS).

          Results

          None of the assessed children developed all the functions included in GMFM-88. The standing position was achieved at the specified age by 10% of children in the first age group (<3 years old) and 95% of children aged 3–6 years. Similarly, the walking ability was performed by 10% of children under 3 years old and by 95% of children aged 3–6 years. The median score of PBS was 50 points (min. 34 p. – max. 56 p.). There was a statistically significant correlation between PBS scores and GMFM-88 scores, r=0.7; p<0.0001, and between balance scores and GMFM – 88 E (walking, running, jumping) (r=0.64; p<0.0001).

          Conclusions

          Motor development, especially standing position and walking ability, is delayed in children with Down syndrome. Balance and motor functions are correlated with each other, so both aspects of development should be consider together in physical therapy of children with Down syndrome.

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          Most cited references47

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          Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment.

          The Pediatric Balance Scale (PBS), a modification of Berg's Balance Scale, was developed as a balance measure for school-age children with mild to moderate motor impairments. The purpose of this study was to determine the test-retest and interrater reliability of the PBS. To determine test-retest reliability, 20 children (aged five to 15 years) with known balance impairments were tested by one examiner on the PBS. Ten pediatric physical therapists independently scored 10 randomly selected videotaped test sessions. There was no significant difference in total test scores [intraclass correlation coefficient (ICC) model 3,1 = 0.998] or individual items (Kappa Coefficients, k = 0.87 to 1.0; Spearman Rank Correlation Coefficients, r = 0.89 to 1.0) measured by one therapist on two occasions. No significant difference among ratings by different physical therapists was found on the PBS for total test score (ICC 3,1 = 0.997). The PBS has been demonstrated to have good test-retest and interrater reliability when used with school-age children with mild to moderate motor impairments.
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            Neuroanatomy of Down's syndrome: a high-resolution MRI study.

            Down's syndrome, the most common genetic cause of mental retardation, results in characteristic physical and neuropsychological findings, including mental retardation and deficits in language and memory. This study was undertaken to confirm previously reported abnormalities of regional brain volumes in Down's syndrome by using high-resolution magnetic resonance imaging (MRI), determine whether these volumetric abnormalities are present from childhood, and consider the relationship between neuroanatomic abnormalities and the cognitive profile of Down's syndrome. Sixteen children and young adults with Down's syndrome (age range=5-23 years) were matched for age and gender with 15 normal comparison subjects. High-resolution MRI scans were quantitatively analyzed for measures of overall and regional brain volumes and by tissue composition. Consistent with prior imaging studies, subjects with Down's syndrome had smaller overall brain volumes, with disproportionately smaller cerebellar volumes and relatively larger subcortical gray matter volumes. Also noted was relative preservation of parietal lobe gray and temporal lobe white matter in subjects with Down's syndrome versus comparison subjects. No abnormalities in pattern of brain asymmetry were noted in Down's syndrome subjects. The results largely confirm findings of previous studies with respect to overall patterns of brain volumes in Down's syndrome and also provide new evidence for abnormal volumes of specific regional tissue components. The presence of these abnormalities from an early age suggests that fetal or early postnatal developmental differences may underlie the observed pattern of neuroanatomic abnormalities and contribute to the specific cognitive and developmental deficits seen in individuals with Down's syndrome.
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              Down's syndrome: a genetic disorder in biobehavioral perspective.

              Down's syndrome is a genetic disorder that can lead to mental retardation of varying degrees. How this chromosomal abnormality causes mental retardation remains an open question. This paper reviews what is currently known about the neural and cognitive features of Down's syndrome, noting the growing evidence of disproportionate impairment of specific systems such as the hippocampal formation, the prefrontal cortex and the cerebellum. The development of animal models of these defects offers a way of ultimately connecting the genetic disorder to its cognitive consequences.
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                Author and article information

                Journal
                Med Sci Monit
                Med. Sci. Monit
                Medical Science Monitor
                Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                International Scientific Literature, Inc.
                1234-1010
                1643-3750
                2015
                01 July 2015
                : 21
                : 1904-1910
                Affiliations
                [1 ]Department of Rheumatology and Rehabilitation, Poznań University of Medical Science, Poznań, Poland
                [2 ]Department of Clinical Psychology, Poznań University of Medical Science, Poznań, Poland
                Author notes
                Corresponding Author: Roksana Malak, e-mail: rmalak@ 123456ump.edu.pl
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Article
                893377
                10.12659/MSM.893377
                4500597
                26132100
                dcec928d-d514-4a25-ae4c-802c63853977
                © Med Sci Monit, 2015

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License

                History
                : 23 December 2014
                : 12 February 2015
                Categories
                Clinical Research

                down syndrome,motor skills,neurotransmitter agents
                down syndrome, motor skills, neurotransmitter agents

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