Physiotherapy of children with Down syndrome

Agnieszka Adameczek, Bożena Werner

Agnieszka Adameczek, Bożena Werner – Physiotherapy of children with Down syndrome. Fizjoterapia Polska 2007; 7(4); 381-391

Abstract
Down syndrome is a disease entity associated with a characteristic phenotype and, frequently, congenital defects of organs and systems. A structural pathology of the central nervous system leads to psychomotor retardation and mental impairment later in life. The aim of the article is to present contemporary ideas about the rehabilitation of children with Down syndrome at different ages, from infancy to school age. Regular rehabilitation commenced in the first months of life and continued at pre-school and school age is necessary for better development. The aim of the physiotherapy of infants and pre-school children is to improve muscular tone and psychomotor development. The aim of the physiotherapy of children with Down syndrome at school age is to improve quality of movements and physical capacity. The most popular physiotherapeutic methods used in children with Down syndrome are the NDT-Bobath method and the Vojta method combined with the educational methods of Veronica Sherborne, sensory integration and hippotherapy. The NDT-Bobath method uses key points of control to leads movements of the child, stimulate normal motor responses and inhibit pathological responses. The Vojta method uses stimulation areas to facilitate postural and motor patterns. The Sherborne method essentially aids the development of the child by movement, physical contact and emotional contact with an exercise partner. Sensory integration therapy delivers an adequate amount of stimuli so that the child can spontaneously react and form normal adaptive responses, integrating the stimuli. During hippotherapy, the child exercises during slow-paced horse-ridding.
Key words:
Down syndrome, Vojta, NDT-Bobath
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Physiotherapy of a child with Down syndrome and congenital heart disease – case study

Agnieszka Adameczek, Bożena Werner

Agnieszka Adameczek, Bożena Werner – Physiotherapy of a child with Down syndrome and congenital heart disease – case study. Fizjoterapia Polska 2008; 8(1); 72-82

Abstract
Background. Children with Down Syndrome operated for organ defects in the first months of life and undergoing early regular physiotherapy develop better than children who are so treated at an older age. This paper presents the psychomotor development and outcomes of comprehensive rehabilitation during the first two years of life of a boy with Down syndrome and a congential heart defect. Case description. The boy had Down syndrome and a congenital heart anomaly in the form ventricular and atrial septal defect. The boy underwent regular rehabilitation from the second month of life. Initially, the Vojta method was used, followed by pulmonary rehabilitation in the perioperative period, and the NDT-Bobath, Sherborne, and sensory integration methods were introduced in the tenth month of life. Gross motor skills (head lifting, turning, sitting, pulling oneself to stand up, crawling on all fours, walking with assistance and walking unassisted, running), social skills, self-sufficiency (smilling at parents, eating solids, drinking from a cup, following objects with the eyes, grasping a hanging rattle) and communication skills were traced until the 27th month of life. Conclusions. Children with Down syndrome who undergo regular rehabilitation commenced in the first months of life and receive proper care achieve better psychomotor developmental outcomes owing to the developmental plasticity, memory plasticity and regeneration possibilities of humen nervous tissue.
Key words:
child physiotherapy, psychomotor development, Down syndrome
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