Evaluation of postural control in children and adolescents with down syndrome aged eight to twelve years old
Introduction: Down Syndrome is a genetic disorder caused by the presence of the third copy of chromosome 21 (total or partial). The syndrome occurs in approximately one out of every 700 – 1000 newborns per year.
Objective:To analyze postural control (PC) of children and adolescents with Down Syndrome (DS) and to compare differences regarding age, sex, nutritional status, and physical activity (PA) levels.
Methods: In this cross-sectional study, a convenience sample composed of 21 children and adolescents (9 girls) was categorized according to age: G1 (8 to 9 years old; n = 8), G2 (10 years old; n = 7), and G3 (11 to 12 years old; n = 6), Score-Z: eutrophic (n = 9) and overweight (n = 12), and PA level: practitioners (n = 7) and non-practitioners (n = 14). PC was assessed in the force platform (FP), in the standing position, with feet together during 30 seconds. The variables analyzed were the center of pressure area (COP) and the mean velocities of anteroposterior and mediolateral oscillation (VEL-AP and VEL-ML). Shapiro-Wilk test was used to test the normality of data. Kruskal-Wallis, Dunn’s, and Mann Whitney tests were performed to analyze associations with PC. Statistical significance was set at p<0.05.
Results: The median COP, VEL-AP and VEL-ML were 3.55 [2.13 – 6.82] , 2.81 [2.32 – 3.16], and 2.98 [2.42 – 3.43], respectively. There were no differences in PC regarding sex, body mass index and PA level. The adolescents in G3 presented lower values of VEL-AP (G1=2,88 [2,82 – 3,21]; G2= 2,94 [2,35 – 3,39]; G3= 2,27 [2 – 2,3]) and VEL-ML (G1= 3,22 [3,14 – 3,68]; G2= 2,91 [2,52 – 3,63]; G3= 2,34 [2,1 – 2,39]).
Conclusion: Sex, nutritional status, and PA level did not affect COP area and AP-VEL and ML-VEL. However, strategies were affected by age, as observed by differences in velocity, but did not affect the COP area.
Castro-Piñero J, Carbonell-Baeza A, Martinez-Gomez D, Gómez-Martínez S, Cabanas-Sánchez V, Santiago C, et al. Follow-up in healthy schoolchildren and in adolescents with Down syndrome: psycho-environmental and genetic determinants of physical activity and its impact on fitness, cardiovascular diseases, inflammatory biomarkers and mental health; the UP&DOWN Study. BMC Public Health. 2014;14:400. DOI: https://doi.org/10.1186/1471-2458-14-400
Coppedê F. Risk factors for Down syndrome. Arch Toxicol. 2016;90(12):2917-29.
Sobey CG, Judkins CP, Sundararajan V, Phan TG, Drummond GR, Srikanth VK. Risk of Major Cardiovascular Events in People with Down Syndrome. Plos One. 2015;10(9):e0137093. DOI: https://doi.org/10.1371/journal.pone.0137093
Bull MJ, Committee on Genetics. Health supervision for children with Down Syndrome. Pediatrics. 2011;128(2):393-406.
Matute-Llorente A, González-Aguero A, Gómez-Cabello A, Vicente-Rodríguez G, Casajús JA. Decreased levels of physical activity in adolescents with down syndrome are related with low bone mineral density: a cross-sectional study. BMC Endocr Dis. 2013;13:22. DOI: https://doi.org/10.1186/1472-6823-13-22
Rigoldi C, Galli M, Mainard L, Crivellini M, Albertini G. Postural control in children, teenagers and adults with Down syndrome. Res Dev Disabil. 2011;32(1):170-5. DOI: https://doi.org/10.1016/j.ridd.2010.09.007
Malak R, Kotwicka M, Krawczyk-Waslelewska A, Mojs E, Samborski W. Motor skills, cognitive development and balance functions of children with Down syndrome. Ann Agric Environ Med. 2013;20(4):803-6.
Karmiloff-Smith A, Al-Janabi T, D’Souza H, Groet J, Massand E, Mok K, et al. The importance of understanding individual differences in Down syndrome. F1000 Res. 2016;5:F1000. DOI: http://dx.doi.org/10.12688/f1000research.7506.1
Cabeza-Ruiz R, García-Massó X, Centeno-Prada RA, Beas-Jiménez JD, Colado JC, González LM. Time and frequency analysis of the static balance in young adults with Down syndrome. Gait Posture. 2011;33(1):23-8. DOI: http://dx.doi.org/10.1016/j.gaitpost.2010.09.014
Verbeque E, Vereeck L, Hallemans A. Postural sway in children: a literature review. Gait Posture. 2016;49:402-10. DOI: http://dx.doi.org/10.1016/j.gaitpost.2016.08.003
Villarrasa-Sapina I, Massó XG, Anó PA, Lucerga CG, Gonzalez LM, Lurbe E. Differences in intermittent postural control between normal weight and obese children. Gait Posture. 2016; 49:1-6. DOI: http://dx.doi.org/10.1016/j.gaitpost.2016.06.012
World Health Organization (WHO). WHO AnthroPlus software license agreement: on the use of the WHO AnthroPlus for personal computers. Software for assessing growth of the world's children and adolescents. Geneva: WHO, 2009.
Silva RCR, Malina RM. Level of physical activity in adolescents from Niterói, Rio de Janeiro, Brazil. Cad. Saúde Pública. 2000;16(4):1091-7. DOI: http://dx.doi.org/10.1590/S0102-311X2000000400027
Dutra GF, Kaufmann CC, Pretto ADB, Albernaz EP. Television viewing habits and their influence on physical activity and childhood overweight. J Pediatr (RIO J). 2015;91(4): 346-51. DOI: http://dx.doi.org/10.1016/j.jped.2014.11.002
Farias Junior JC, Lopes AS, Florindo AA, Hallal PC. Validade e reprodutibilidade dos instrumentos de medida da atividade física do tipo self-report em adolescentes: uma revisão sistemática. Cad Saúde Pública. 2010;26(9):1669-91. DOI: http://dx.doi.org/10.1590/S0102-311X2010000900002
Crocker PRE, Bailey DA, Faulkner RA, Kowalski KC, McGrath R. Measuring general levels of physical activity: preliminary evidence for the Physical Activity Questionnaire for Older Children. Med Sci Sports Exerc. 1997;29(10):1344-9. DOI: http://dx.doi.org/10.1097/00005768-199710000-00011
Mancini M, Horak FB. The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med. 2010;46(2):239-48.
Duarte M, Freitas SMSF. Revisão sobre posturografia baseada em plataforma de força para avaliação do equilíbrio. Rev Bras Fisioter. 2010;14(3):183-92. DOI: http://dx.doi.org/10.1590/S1413-35552010000300003
Candotti CT, Nunes SEB, Noll M, Freitas K, Macedo CH. Effects of a postural program for children and adolescents after eight months of practice. Rev Paul Pediatr. 2011;29(4):577-83. DOI: http://dx.doi.org/10.1590/S0103-05822011000400017
Scoppa F, Capra R, Gallamini M, Shiffer R. Clinical stabilometry standardization: Basic definitions – Acquisition interval – Sampling frequency. Gait Posture. 2012;37(2):290-2. DOI: https://doi.org/10.1016/j.gaitpost.2012.07.009
Seron BB, Silva RAC, Greguol M. Efeitos de dois programas de exercício na composição corporal de adolescentes com síndrome de Down. Rev Paul Pediatr. 2014;32(1):92-8. DOI: http://dx.doi.org/10.1590/S0103-05822014000100015
Hendrix CG, Prins MR, Dekkers H. Developmental coordination disorder and overweight and obesity in children: a systematic review. Obes Rev. 2014;15(5):408-23. DOI: http://dx.doi.org/10.1111/obr.12137
Rimmer JH, Yamaki K, Davis BM, Wang E, Vogel LC. Obesity and overweight prevalence among adolescents with disabilities. Prev Chronic Dis. 2011;8(2):A41.
Niehues JR, Gonzales AI, Lemos RR, Bezerra PP, Haas P. Prevalence of Overweight and Obesity in Children and Adolescents from the Age Range of 2 to 19 Years Old in Brazil. Int J Pediatr. 2014;2014:583207. DOI: http://dx.doi.org/10.1155/2014/583207
Lobstein R, Jackson-Leach R. Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025. Pediatr Obes. 2016;11(5):321-5. DOI: http://dx.doi.org/10.1111/ijpo.12185
Bertapelli F, Pitetti K, Agiovlasitis S, Guerra-Junior G. Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences and interventions: a literature review. Res Dev Disabil. 2016; 57:181-92. DOI: http://dx.doi.org/10.1016/j.ridd.2016.06.018
Maiano C, Normand CL, Aimé A, Bégarie J. Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: a systematic review. Res Dev Disabil. 2014; 35(8):1914-26. DOI: http://dx.doi.org/10.1016/j.ridd.2014.04.014
Pitetti K, Baynard T, Agiovlasitis S. Children and aolescents with Down syndrome, physical fitness and physical activity. J Sport Health Sci. 2013;2(1):47-57. DOI: https://doi.org/10.1016/j.jshs.2012.10.004
Phillips AC, Holland AJ. Assessment of objectively measured physical activity levels in individuals with intellectual disabilities with and without Down’s syndrome. Plos One. 2011; 6(12):e28618. DOI: https://doi.org/10.1371/journal.pone.0028618
Matute-Llorente A, González-Agüero A, Gómez-Cabello A, Vicente-Rodríguez G, Casajús JA. Physical activity and cardiorespiratory fitness in adolescents with Down syndrome. Nutr Hosp. 2013; 28(4):1151-5. DOI: https://doi.org/10.3305/nh.2013.28.4.6509
Izquierdo-Gomez R, Martínez-Gómez D, Acha A, Veiga OL, Villagra A, Diaz-Cueto M. Objective assessment of sedentary time and physical activity throughout the week in adolescents with Down syndrome. Res Dev Disabil. 2014;35(2):482-9. DOI: https://doi.org/10.1016/j.ridd.2013.11.026
Silva CMA, Cunha TT, Pfeifer LI, Tedesco AS, Sant’Anna MMM. Percepção de pais e terapeutas ocupacionais sobre o brincar da criança co paralisia cerebral. Rev Bras Educ Espec. 2016;22(2):221-32. DOI: http://dx.doi.org/10.1590/S1413-65382216000200006
Gordia AP, Quadros TMB, Silva LR, Santos GM. Conhecimento de pediatras sobre a atividade física na infância e adolescência. Rev Paul Pediatr. 2015;33(4):400-6. DOI: http://dx.doi.org/10.1016/j.rpped.2015.02.001
American College of Sports Medicine. ACSM’s guidelines for exercise testing and presciption. 8th ed. 2009.
Baccouch R, Rebai H, Sahli S. Kung-fu versus swimming training and the effects on balance abilities in young adolescents. Phys Ther Sport. 2015;16(4): 349-54. DOI: http://dx.doi.org/10.1016/j.ptsp.2015.01.004
Lemos LFC, David AC, Mota CB. Development of postural balance in Brazilian children aged 4-10 years compared to young adult. Rev Bras Cineantropom Desempenho Hum. 2016;18(4):419-28. DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n4p419
Sousa AMM, Barros JF, Sousa BM. Postural control in children with typical development and children with profound hearing loss. Int J Gen Med. 2012;5: 433-9. DOI: http://dx.doi.org/10.2147/IJGM.S28693
Hsu Y, Kuan C, Young Y. Assessing the development of balance function in children using stabilometry. Int J Pediatr Otorhinolaryngol. 2009;73(5):737-40. DOI: http://dx.doi.org/10.1016/j.ijporl.2009.01.016
Smith AW, Ulmer FF, Wong DP. Gender Differences in Postural Stability Among Children. J Hum Kinet. 2012;33:25-32. DOI: http://dx.doi.org/10.2478/v10078-012-0041-5
Zemel BS, Pipan M, Stallings VA, Hall W, Schadt K, Freedman DS, et al. Growth Charts for Children With Down Syndrome in the United States. Pediatrics. 2015;136 (5):e1204-11. DOI: http://dx.doi.org/10.1542/peds.2015-1652
Freire F, Thon RA, Costa LT, Duarte E, Gorla JI. Crescimento somático de crianças e adolescentes brasileiros com síndrome de Down. J Hum Growth Dev. 2015; 25(1):102-7. DOI: http://dx.doi.org/10.7322/jhgd.96787
Zimmer M, Desch L. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186-9. DOI: http://dx.doi.org/10.1542/peds.2012-0876
CODE OF CONDUCT FOR JOURNAL PUBLISHERS
Publishers who are Committee on Publication Ethics members and who support COPE membership for journal editors should:
- Follow this code, and encourage the editors they work with to follow the COPE Code of Conduct for Journal Edi- tors (http://publicationethics.org/files/u2/New_Code.pdf)
- Ensure the editors and journals they work with are aware of what their membership of COPE provides and en- tails
- Provide reasonable practical support to editors so that they can follow the COPE Code of Conduct for Journal Editors (http://publicationethics.org/files/u2/New_Code.pdf_)
- Define the relationship between publisher, editor and other parties in a contract
- Respect privacy (for example, for research participants, for authors, for peer reviewers)
- Protect intellectual property and copyright
- Foster editorial independence
Publishers should work with journal editors to:
- Set journal policies appropriately and aim to meet those policies, particularly with respect to:
– Editorial independence
– Research ethics, including confidentiality, consent, and the special requirements for human and animal research
– Transparency and integrity (for example, conflicts of interest, research funding, reporting standards
– Peer review and the role of the editorial team beyond that of the journal editor
– Appeals and complaints
- Communicate journal policies (for example, to authors, readers, peer reviewers)
- Review journal policies periodically, particularly with respect to new recommendations from the COPE
- Code of Conduct for Editors and the COPE Best Practice Guidelines
- Maintain the integrity of the academic record
- Assist the parties (for example, institutions, grant funders, governing bodies) responsible for the investigation of suspected research and publication misconduct and, where possible, facilitate in the resolution of these cases
- Publish corrections, clarifications, and retractions
- Publish content on a timely basis