Development of motor planning for dexterity tasks in trisomy 21

Determinants of hand function in children and adolescent with Down Syndrome-A scoping review

BACKGROUND

Down Syndrome (DS) is a genetic condition. Physical characteristics like short stature, hypotonia, small, and thick hands result in decreased grip and pinch strength and quality of fine motor tasks.

PURPOSE

The purpose of this review is to summarize the evidence of upper extremity physical characteristics and its influence on hand function in DS population.

STUDY DESIGN

A scoping review.

METHODOLOGY

A comprehensive electronic literature search was conducted through PubMed, CINAHL, Cochrane Library. The search was limited to articles written in English and published between 2010 to 2021. Additionally, books were referred for a better understanding of the hand function in DS. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) was adopted to develop the protocol.

RESULTS

Following a detailed review of 28 articles meeting the inclusion criteria, fetuses with a diagnosis of DS are reported to have shortening of humerus on sonographic markers wherein 9% of fetuses had below 5th percentile shortening. Additionally, literature reports that during reaching there was increased trunk rotation (effect size = 0.88). DS population had 60% less grip strength, 33% less palmar pinch strength ,20% less key pinch strength and poor manual dexterity (CI = 4.5-5.5).

CONCLUSION

Findings of this review concludes that physical characteristics of the upper extremity have an influence on hand function performance in children and adolescents with DS.However, only arm length and hand span have been quantified and correlated with grip strength. Further work must focus on correlation of upper extremity anthropometry and overall hand function in children and adolscents with DS.

Analysis of Heart Rate, Perception of Physical Effort and Performance of Individuals with Down Syndrome Submitted to a Protocol of Virtual Games for Home-Based Telerehabilitation

Down syndrome (DS) is a genetic condition associated with impairments in several body systems, which may negatively influence the habit of practicing physical activities (PAs), increasing sedentary habits and the risk of comorbidities. Additionally, difficulty in accessing services, financial limitations and lack of interest may interfere with the practice of PAs. Considering the necessity of developing effective treatment alternatives, to increase the possibility of access and the interest of participants, we conducted a study using telerehabilitation with a virtual task to promote PA and analyze the motor performance of DS individuals. Our protocol consisted of 11 sessions of the virtual game called MoveHero. A total of 34 individuals with DS and 34 individuals with typical development participated in the study. Heart rate (HR) and rating of perceived effort (RPE) were collected at rest and during the game. Our results show that virtual reality presents a great possibility to promote PA and a way out of a sedentary lifestyle for DS individuals, considering the enhancement in HR and RPE found during the protocol for both groups. Moreover, our results show positive outcomes regarding motor performance, with significant improvement in the task with practice, demonstrating that individuals with DS are able to improve their motor proficiency with adequate stimuli in the virtual environment.