Santos Martins J1, D. S. Moura MC1, Hazime F2, Maria Amado João S2, Hydee Hasue R2
1University of São Paulo, Department of Physical Therapy, Communication Sciences and Disorders, and Occupational Therapy, São Paulo, Brazil, 2University of São Paulo, São Paulo, Brazil
Background: Hypotonia in individuals with Down Syndrome (DS) is associated with deficits in postural control. After the use of the strap “Happy Strap®”, it was empirically observed an increase in hip stability and an improvement in balance of children with SD in sitting, walking and running activities.
Purpose: We aimed to determine the immediate effects of using Happy Strap® on static balance in children with DS compared to children with typical development (TD).
Methods: 28 children participated in this study (14 with DS, aged 4 to 8 years; mean age 5 in both groups). Postural control were evaluated with a force platform in four conditions randomly distributed (orthostatism with and without the strap directly on the platform or on a foam on top of the platform; 3 repetitions of 10 seconds in each condition). The variables area (cm2), anterior-posterior (A/P) and medial-lateral (M/L) range (cm), velocity (cm/s) and frequency of the center of pressure (COP) sway were analyzed. Test-t was performed for comparison between groups or between conditions with and without the strap. The level of significance was 0.05.
Results: In the evaluation between groups children with SD had higher sway frequencies. There was a significant difference in the A/P frequency of the sway on the foam without the strap (p=0.044) and with (p=0.050), M/L frequency on the foam without (p=0.042) and with the strap (0.049). The use of the foam worsened postural control in the group with SD in the A/P range with the strap (p=0.012), in the M/L range with the strap (p = 0.004), in the area without the strap (p = 0.010) , in A/P velocity with (p = 0.002) and without the strap (p = 0.017) and in the M/L velocity with the strap (p = 0.009). In the DT group there was worsening in the A/P range with (p=0.008) and without the strap (p=0.002), in the M/L rang with (p=0.001) and without the strap (p=0.004), in the area without the strap (p=0.004), in the M/L frequency with (p=0.032) and without the strap (p=0.013). There was a decrease in the M/L range on the platform with the strap in the in the group with SD (p=0.046).
Conclusion(s): In the comparison between groups, it was found that children with SD present a higher frequency of COP sway than those with DT, corroborating with previous findings. There was worsening of the postural control of children with DS and DT when we manipulated the sensory test conditions; placing them on an unstable surface, either with or without the strap. This suggests that the protocol used in the test is sensitive. Happy Strap® improved static balance for children with SD considering the rang of COP sway.
Implications: Postural control is essential for motor development and performing simple and complex daily tasks. When we improve the static balance of children with DS by using Happy Strap®, we may improve too their motor performance, performance in tasks, participation in activities, social interaction, independence and autonomy.
Keywords: Down Syndrome, Postural control, Children
Funding acknowledgements: The present study was supported by University of São Paulo.
Purpose: We aimed to determine the immediate effects of using Happy Strap® on static balance in children with DS compared to children with typical development (TD).
Methods: 28 children participated in this study (14 with DS, aged 4 to 8 years; mean age 5 in both groups). Postural control were evaluated with a force platform in four conditions randomly distributed (orthostatism with and without the strap directly on the platform or on a foam on top of the platform; 3 repetitions of 10 seconds in each condition). The variables area (cm2), anterior-posterior (A/P) and medial-lateral (M/L) range (cm), velocity (cm/s) and frequency of the center of pressure (COP) sway were analyzed. Test-t was performed for comparison between groups or between conditions with and without the strap. The level of significance was 0.05.
Results: In the evaluation between groups children with SD had higher sway frequencies. There was a significant difference in the A/P frequency of the sway on the foam without the strap (p=0.044) and with (p=0.050), M/L frequency on the foam without (p=0.042) and with the strap (0.049). The use of the foam worsened postural control in the group with SD in the A/P range with the strap (p=0.012), in the M/L range with the strap (p = 0.004), in the area without the strap (p = 0.010) , in A/P velocity with (p = 0.002) and without the strap (p = 0.017) and in the M/L velocity with the strap (p = 0.009). In the DT group there was worsening in the A/P range with (p=0.008) and without the strap (p=0.002), in the M/L rang with (p=0.001) and without the strap (p=0.004), in the area without the strap (p=0.004), in the M/L frequency with (p=0.032) and without the strap (p=0.013). There was a decrease in the M/L range on the platform with the strap in the in the group with SD (p=0.046).
Conclusion(s): In the comparison between groups, it was found that children with SD present a higher frequency of COP sway than those with DT, corroborating with previous findings. There was worsening of the postural control of children with DS and DT when we manipulated the sensory test conditions; placing them on an unstable surface, either with or without the strap. This suggests that the protocol used in the test is sensitive. Happy Strap® improved static balance for children with SD considering the rang of COP sway.
Implications: Postural control is essential for motor development and performing simple and complex daily tasks. When we improve the static balance of children with DS by using Happy Strap®, we may improve too their motor performance, performance in tasks, participation in activities, social interaction, independence and autonomy.
Keywords: Down Syndrome, Postural control, Children
Funding acknowledgements: The present study was supported by University of São Paulo.
Topic: Paediatrics; Neurology; Paediatrics
Ethics approval required: Yes
Institution: University of São Paulo (USP)
Ethics committee: Ethics and Research Committee of Clinical Hospital of USP
Ethics number: 11498013.6.0000.0068
All authors, affiliations and abstracts have been published as submitted.
