Article 4: Current Trends in Pediatric PT Practice for Children with DS

Intro:

• What is the MC chromosomal condition in the US?

  • Occurs:

• DS

  • 1 per 700 live births

Intro:

• DS pts typically presents with multiple impairments such as: (6)

• Cognitive impairment

• Hypotonia

• Ligamentous Laxity

• Decreased posture control and balance

• Decreased strength 

• Increased risk of congenital heart defects

Intro:

• Impairments contribute to what?

  • Examples:

• Resulting in what? (2)

• Activity Limitations

  • Delayed Motor Dev

• Resulting:

  • Decreased ability to keep up with peers

  • Participate in play/recreational activities

Intro:

• Children c DS:

  • Have decreased rate of what?

  • Likely sit when? Likely walk when?

  • Require additional time and practice to learn what?

    • Particularly movements that require what? (3)

• Motor skill acquisition

• Sit: 12 Months; Walk: 24 Months

• Complex Motor Skills

  • Speed

  • Postural Control

  • Balance

Intro:

• PT interventions can lead to ___ in impairments and activity limitations for individuals with DS.

• T/F: Common impairments seen in DS suggest that there likely should be score set of interventions used by PT to treat children with DS. 

• Improvements

• TRUE

Purpose:

• The purpose of this study is to:

  • Report current pediatric PT practice terms of observed PT-related _____ and ___ ____ and applied assessment measures and interventions for children with DS

• Report current pediatric PT practice terms of observed PT-related impairments and activity limitations and applied assessment measures and interventions for children with DS

Methods:

• ___ participants 

• Participants received ____

• 108 participants 

• Participants received surveys

Significant Findings:

• What is the MC assessment tool:

  • This tool was frequently used to document what in children with DS younger than what age?

• Norm Referenced Pea Body Developmental Motor Scale 2ns Edition (PDMS-2)

  • Developmental Delays

  • 6 yrs and younger

Significant Findings: PDMS Gross Motor Scale

• The PDMS Gross Motor Scale COULD NOT be used to asses what?

  • BUT can be useful when included as what overtime?

• Direct effects of PT intervention

  • Global developmental measure

Significant Findings: Battelle Developmental Inventory - II and Bruininks Oseretsky Test (BOT)

• Studies have shown expected scores for children with DS and highlight need for more ____.

• Likely children WITH DS have significantly ___ scores that children WITHOUT DS.

• Research

• LOWER

Significant Findings: GMFM-88

• What is the 2nd MC uses assessment for children c DS?

• This test is intended to evaluate what?

• Originally deveoped for ___ however it is also valid, reliable, and responsive to change in gross motor function of children with DS

• GMFM-88

• Evaluate change over time in gross motor skills

• CP

Specific Findings; 6MWT

• T/F: Valid and Reliable

• What are recommended to account for learning effect?

• TRUE

• Practice Trials

Specific Findings: TUG

• Assessment of ____

• T/F: Valid and Reliable

• Balance

• TRUE

Specific Findings:

• What was the largest intervention category?

• This survey included what 3 things?

• Functional Motor Skills

• Survey:

  • Developmental skills

  • Gait

  • Transfers

• Task specific Practice is ______

BENEFICIAL

Joint Stability and Alignment:

• What is another common intervention?

• This intervention includes what 4 things?

• Joint Stability and Alignment

• 4:

  • Orthotic Garments

  • Abdominal Binder

  • Kinesiotape

  • LE Orthoses

Joint Stability and Alignment:

• Uses of LE Orthoses improves what?

  • This leads to improved what 4 things?

  • HOWEVER, it can be suggested that therapists should be cautious about orthotic use before children walk as it may do what?

• Foot and Ankle Alignment

  • 4:

    • Gross Motor Skills

    • Gait

    • Balance

    • Participation

  • Alter neuromotor dev in ankle and foot

Muscle Performance:

• What type of interventions are included for BOTH isolated muscle groups and within functional activities?

• What type of training results in strength gains in children and adolescents with DS and may lead to improved physical activity levels 

• What type of training improved functional balance and stability?

• Strength and Power Interventions

• Progressive Resistance Training

• Core Training

Quiz Question:

T/F. LE orthoses to improve foot and ankle alignment are an effective intervention for children w DS while walking, but should be used with caution if the  child has not yet learned to ambulate as it can alter the neuromotor development of the foot and ankle.

TRUE

Quiz Question:

1. Select ALL of the MC treatment methods that apply to treatment of DS

   1. Functional motor skills 

   2. Joint stability and alignment 

   3. Balance 

   4. Joint mobility 

   5. Neuromotor control 

   6. Gait speed

• Select ALL of the MC treatment methods that apply to treatment of DS

  1. Functional motor skills 

  2. Joint stability and alignment 

  3. Balance 

  4. Neuromotor control