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De Los Angeles JS1, Valenzuela MM1, Koh RR1, Asutilla MM1, Viri MKK1, Agayan A1, Zarate RC1, Rojo A1, Espino AN1
1University of the East Ramon Magsaysay Memorial Medical Center, Inc., College of Allied Rehabilitation Sciences, Quezon City, Philippines
Background: Down syndrome, also known as Trisomy 21, is a genetic condition caused by the presence of an extra 21st chromosome and is associated by developmental and growth delay, characteristic facial features and mild to moderate intellectual disability.
In tests of gross motor skills, children with Down syndrome perform consistently below their normal peers; their worst performance is in static and dynamic balance or postural stability.
Purpose: This study introduces, evaluates and compares effectiveness of two interventions: the Lower Extremity and Core Strengthening Exercises in improving postural stability of school children with Down syndrome.
Methods: Fourteen students with Down syndrome, enrolled in a progressive school participated in this study. Subjects were grouped into 2 age brackets: 6 to 12 and 13 to 19 years old and then randomly assigned to either the positive control group, which received 45 to 60 minutes of Lower Extremity Strengthening exercises or the experimental group of Core Strengthening program. Both 16 session interventions, were conducted simultaneously in the school. Static and dynamic balance of subjects were evaluated pre and post treatment by Stork Stand and Functional Reach Tests. Statistical analysis was done using the independent t-test to compare the static and dynamic stability resulting after each intervention. The results of the 2 interventions were also evaluated using the paired t-test with a level of significant set at p 0.05.
Results: Results of both groups showed significant progress in the static and dynamic balance after both the Lower Extremity and Core Strengthening Exercises with p-values 0.05. Average scores in the Functional Reach Test improved by 127.08% in the lower extremity strengthening group and 80.63% in the core group. The Stork Balance Test scores recorded an 85.90% improvement in the positive control group while the experimental group reported a 186.22% progress.
However, this study found no significant difference between the positive effects of Lower extremity exercises versus Core exercises as all P-values are greater than 0.05.
Conclusion(s): Pre-treatment assessments using Stork Test and the Functional Reach test showed that gross motor skills and balance, even of school children and adolescents with Down syndrome are consistently low compared to normal developing peers. Physiotherapy and properly designed interventions are very important to this population. Further research combining lower extremity and core exercises is recommended.
Implications: This study proves that both the lower extremity and core strengthening exercises produce significant improvement in dynamic and static balance of school children with Down syndrome. Increased strength in lower extremity and stabilizer muscles can improve posture control and balance. This research also revealed that there is no significant difference between the effectiveness of the Lower Extremity and Core Strengthening Exercises in improving the postural stability of students with Down syndrome. Core and lower extremity muscles are associated to each other, thus, both interventions presented in this study contribute to better postural stability.
Keywords: Lower Extremity and Core Exercises, Improving Postural Stability, Down Syndrome
Funding acknowledgements: This study is partially funded by the University of the East Ramon Magsaysay Memorial Medical Center Inc.
In tests of gross motor skills, children with Down syndrome perform consistently below their normal peers; their worst performance is in static and dynamic balance or postural stability.
Purpose: This study introduces, evaluates and compares effectiveness of two interventions: the Lower Extremity and Core Strengthening Exercises in improving postural stability of school children with Down syndrome.
Methods: Fourteen students with Down syndrome, enrolled in a progressive school participated in this study. Subjects were grouped into 2 age brackets: 6 to 12 and 13 to 19 years old and then randomly assigned to either the positive control group, which received 45 to 60 minutes of Lower Extremity Strengthening exercises or the experimental group of Core Strengthening program. Both 16 session interventions, were conducted simultaneously in the school. Static and dynamic balance of subjects were evaluated pre and post treatment by Stork Stand and Functional Reach Tests. Statistical analysis was done using the independent t-test to compare the static and dynamic stability resulting after each intervention. The results of the 2 interventions were also evaluated using the paired t-test with a level of significant set at p 0.05.
Results: Results of both groups showed significant progress in the static and dynamic balance after both the Lower Extremity and Core Strengthening Exercises with p-values 0.05. Average scores in the Functional Reach Test improved by 127.08% in the lower extremity strengthening group and 80.63% in the core group. The Stork Balance Test scores recorded an 85.90% improvement in the positive control group while the experimental group reported a 186.22% progress.
However, this study found no significant difference between the positive effects of Lower extremity exercises versus Core exercises as all P-values are greater than 0.05.
Conclusion(s): Pre-treatment assessments using Stork Test and the Functional Reach test showed that gross motor skills and balance, even of school children and adolescents with Down syndrome are consistently low compared to normal developing peers. Physiotherapy and properly designed interventions are very important to this population. Further research combining lower extremity and core exercises is recommended.
Implications: This study proves that both the lower extremity and core strengthening exercises produce significant improvement in dynamic and static balance of school children with Down syndrome. Increased strength in lower extremity and stabilizer muscles can improve posture control and balance. This research also revealed that there is no significant difference between the effectiveness of the Lower Extremity and Core Strengthening Exercises in improving the postural stability of students with Down syndrome. Core and lower extremity muscles are associated to each other, thus, both interventions presented in this study contribute to better postural stability.
Keywords: Lower Extremity and Core Exercises, Improving Postural Stability, Down Syndrome
Funding acknowledgements: This study is partially funded by the University of the East Ramon Magsaysay Memorial Medical Center Inc.
Topic: Disability & rehabilitation
Ethics approval required: Yes
Institution: University of the East Ramon Magsaysay Memorial Medical Center, Inc.
Ethics committee: UERMMMCI Research Institute for Health Sciences Ethics Review Committee
Ethics number: RIHS ERC Code: 0452/C/V14/111
All authors, affiliations and abstracts have been published as submitted.
