Keep it simple: comparing functional assessments in individuals with Down syndrome.

Abstract

A number of assessments exist that evaluate function in ambulatory adults. However, these assessments take for granted the cognitive abilities required for the participant to understand what is being asked of them in order to demonstrate their functional abilities. It has been shown that individuals with Down syndrome (DS) demonstrate lower functional levels when asked to perform additional tasks while walking. Therefore, measurements of function may not be reflective of actual function if the assessment requires additional tasks in those with DS. It is for these reasons the current investigation sought to evaluate four common functional assessments, two with [modified Berg balance test (mBERG) and Functional Gait Assessment (FGA)] and two without [Timed Up and Go (TUG) and Established Populations for Epidemiologic Study in the Elderly (EPESE)] complex tasks. Adults with DS (n=19) completed four functional assessments, which were later compared using bivariate Pearson correlation coefficients. There were large associations between simple assessments (TUG-EPESE: r=-0.525, P=0.021) and complex assessments (FGA-mBERG: r=0.612, P=0.005), respectively. The TUG also inversely correlated with the FGA (r=-0.476, P=0.039), and the EPESE had a large association with mBERG (r=0.508, P=0.027). The mBERG may be the best test to replicate real-world scenarios through its tasks, although it may also be confounded by the cognitive load required to perform the movements as asked. The TUG and EPESE may be more appropriate as mobility assessments because they require very little cognitive attention when completing the tasks. True assessments of mobility ought to err on the side of simple so to not confuse the outcomes with executive functionality.