SEGMENTAL TRUNK CONTROL OF DOWN SYNDROME INFANTS FOLLOWED IN AN EARLY INTERVENTION PROGRAM

M. Duque Weber¹, A.L. Righetto Greco², A.P. Zanardi da Silva³, E. Tudella³

¹Federal University of Sao Carlos, Department of Physiotherapy, Sao Carlos, Brazil, ²Federal University of Uberlandia, Department of Physiotherapy, Uberlândia, Brazil, ³Federal University of Sao Carlos, Department of Physiotherapy, São Carlos, Brazil

Background: Infants with Down Syndrome (DS) presented a variety of impairments in body functions and structures, such as trunk muscle hypotonia. Consequently, they have difficulty maintaining trunk control and independent sitting posture. Therefore, it is important to understand how the development of segmental trunk control in these infants occurs, so that early intervention can be carried out in order to enhance activities and participation.

Purpose: To characterize the development of segmental trunk control of infants with DS and healthy term infants.

Methods: Twelve infants were evaluated, divided into two groups: four with DS and eight typical. In the SD group (gestational age 37.5±1.2 weeks; birth weight 3.0±2.8), infants one, two, and three were evaluated from 3 to 9 months, and infant four from 6 to 9 months. In the typical group (gestational age 39.4±1.4 weeks; birth weight 2.9±1.2 kilograms), four infants were evaluated from 4 to 5 months, and four from 6 to 9 months. To assess trunk control, the Segmental Assessment of Trunk Control (SATCo) was used. Relative (%) and absolute (n) frequencies of infants who reached each functional level of trunk control were used.

Results: From three to five months, three infants with DS were evaluated. Infants one and two (66.6%) had cervical control at three months. Infant two (33.3%) acquired superior thoracic control at four months, while the others (66.6%) at five months. On the other hand, 75% of typical infants had superior chest control at four months. At six months, infant four entered the intervention program with only cervical control. At seven months, infants one, two, and three (75%) had medium thoracic control and infant four (25%) had superior thoracic control. In the typical group, 50% of infants had low back control at six months. Infants one, two, and four (75%) achieved lower thoracic and upper lumbar control at eight and nine months, respectively. Infant three stands out from the others for having acquired lower mid-thoracic and lumbar control at eight and nine months, respectively. In the typical group, 75% of infants had complete trunk control at eight months.

Conclusions: The development of segmental control of the trunk of infants with DS was progressive, but at a varied rhythm, even though they were all in intervention. Cervical control was acquired as expected for age. Control in the thoracic and lumbar regions showed a slower rhythm of development when compared to typical infants. The early inclusion of infants with DS in the intervention was able to enhance the development of trunk control. This study encourages the literature to produce longitudinal studies with a larger sample of infants with DS, strengthening evidence-based clinical practice.

Implications: The results of the present study may support the importance of early intervention and minimize the impacts of impairments in body functions and structures, and limitations in the activities of infants with DS. Infants with DS should be followed up in early intervention programs emphasizing intervention strategies focused on trunk control.

Funding acknowledgements: The work was unfunded.

Keywords:
Down syndrome
Infant development
Posture control

Topics:
Paediatrics
Neurology

Did this work require ethics approval? No

Reason: Approval from the University's Ethics Committee was not necessary, as those responsible for the patients included in the program previously authorized any evaluation/intervention carried out through an Informed Consent Term from the care unit.