Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2021.00479    [Accepted]
Published online June 11, 2021.
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 
Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
Correspondence: 
Akshatha Nayak, Email: akshatha.nd@manipal.edu
Received: 16 April 2021   • Revised: 16 May 2021   • Accepted: 30 May 2021
Abstract
Background
Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular co-contraction, 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 1096 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, pull 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 inter-individual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.
Key Words: Balance, Development, Down syndrome, Motor function


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