Children with Down syndrome, or DS, typically develop orthopedic problems that arise from genetic irregularities in their bones, muscles and joints. Patients develop an irregular posture and compensatory movement patterns due to hypotonia, or weak muscle tone, and loose ligaments. Early intervention physical therapy, however, proactively builds strength in the appropriate muscle groups and is crucial to help individuals minimize compensatory movement patterns. While persistent physical therapy helps, the challenge is lifelong.
Back and Posture
One of the first challenges facing an infant with DS is sitting upright. Kyphosis -- or the abnormal forward rounding of the shoulders and upper back -- can ensue early on since ligamentous laxity, hypotonia and decreased muscle strength in the trunk make children sit slumped over, with a posterior pelvic tilt, trunk rounded and their head resting back on the shoulders. Physical therapy can teach them to sit upright and thereby avoid the breathing difficulties and decreased ability to rotate the trunk associated with this posture.
Gait
Physical therapy teaches children with DS to use the right muscles for walking and to increase their strength. Children with DS have an unstable gait due to their weak leg muscles and lax ligaments. They compensate by walking with their feet wide apart, their knees locked and their feet turned out. The problem is, however, that walking will become painful in the long run and endurance will peter out due to the strain on the joints and feet, if allowed to continue.
Neck Instability
Weakness in the ligaments and muscles supporting the base of the skull and cervical spine can lead to neck instability in patients with DS. Without the aid of physical therapy, the vertebrae within the cervical spine can slide and cause pressure on the spinal cord, leading to pain, poor coordination and weakness.
Learning Benefits
Physical therapy offers more than just the correctional steps to increase muscle strength; it literally teaches children how to learn. By incorporating physical therapy into their child's daily routine, parents have the opportunity to come to understand how their child learns, which method works best and how to make it fun. This can improve a child's success at overcoming the challenges of language, education and social skills that lay ahead, not to mention help fulfill his potential.
Repetition
Like all young learners, children with DS learn best through practice and repetition. Physical therapy helps teach and reinforce gross motor skills through daily reps. Perseverance, however, is important for the success of physical therapy. The results of physical therapy do not manifest from one day to the next but rather over the long term.
