Abstract
This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and randomly assigned into two groups: group A received (sensory integration therapy program plus specific physiotherapy training) and group B received (specific physiotherapy training program only). Motor coordination test measures (Balancing backward, Hopping, Jumping from side to side and Transferring boxes) to test and follow gross motor coordination, handheld dynamometer to test and follow grip control ability and kinesthesia test to test and follow awareness of joint position and movement. These measurements were taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program. Data analysis was available on the 30 Down syndrome children participating in the study. The difference between pre- and post-treatment results was more significant in Motor coordination test measures in the study group than the control group. Grip control ability and kinesthesia test demonstrate representative improvement in the study groups (p = 0.0001) while insignificant in the kinesthesia control group and significant in a grip control group. The addition of sensory integration therapy program to specific physiotherapy training is recommended in improving gross motor coordination and grip control abilities in Down syndrome, so this suggested approach may be used as a selective choice for improving posture control and hand functions in Down syndrome children.
Highlights
IntroductionThe responsibility of overexpression genes present in chromosome 21 on occurring central nervous system dysfunctions in Down syndrome children is the decrease of amount, shape and volume of the neurons, impaired neural myelination of CNS, insufficient neurotransmitter, degenerative process and more expressions of neural apoptosis and amyloidal precursor protein [1] [2]
The responsibility of overexpression genes present in chromosome 21 on occurring central nervous system dysfunctions in Down syndrome children is the decrease of amount, shape and volume of the neurons, impaired neural myelination of CNS, insufficient neurotransmitter, degenerative process and more expressions of neural apoptosis and amyloidal precursor protein [1] [2].Several factors cause the delay in gross motor coordination in Down syndrome, firstly hypotonic factor which affects abdominal muscles resulting in loss of balance during standing
This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children
Summary
The responsibility of overexpression genes present in chromosome 21 on occurring central nervous system dysfunctions in Down syndrome children is the decrease of amount, shape and volume of the neurons, impaired neural myelination of CNS, insufficient neurotransmitter, degenerative process and more expressions of neural apoptosis and amyloidal precursor protein [1] [2]. The central nervous system provides a solution to these problems by producing an abnormal co-contraction pattern of pre-programmed movement to increase balance response leading to increasing effects of disturbances. This will lead to walking, grasping and reaching becoming slower in reaction time [4]. As well as decreased bone density, cartilage hypoplasia, laxity of ligaments and hypotonia affect joint torque and contraction efficiency leading to impaired ADL activities and postural reaction [6]. In Down syndrome, there is a delay of motor control and sensory feedback leading to physical, cognitive and perceptual limitations which interfere with ADL activities [7] [8] [9]. The motor learning process is the main core based on the treatment of DS because it depends on the improvement of perception-cognition complex that is the base of motor control which is delayed in DS [12]
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