Physical Challenges

Having Down syndrome (Trisomy 21) alters development, making movement programs challenging and often out of reach for many families to find suitable programs. Some of these developmental complexities are........

A quick list:

• Hyper-Mobilty of Joints

• Hypotonia (Low Muscle Tone)

• Laxity (Looseness) of Ligaments

• Decreased Proprioception

• Possible Atlantoaxial Instability

• Postural Instability

• Flat Feet (often turned out)

• Delayed fine & gross Motor

• Sensory Processing Challenges

• Digestive Issues

• Heart Disease / Respiratory Disfunction

• Thyroid Disfunction

• Compromised Immune Systems

• Vision Impaired

• Scoliosis

• Cerebral Palsy

• Shorter Limbs and Digits

• Obesity

• Hearing Loss

  
  

Does every person with Down Syndrome have all of these challenges?

No, generally we may see variations , often I find that many Physical Challenges can also relate to the severity of Intellectual Disability and a Dual Diagnosis of Autism & ADHD.

Each individual with Down Syndrome will present with a varied list of challenges and often as a Movement Professional you will discover more to add to the list as you work closely with them.

An example of Physical Challenges presenting due to another diagnosis would be Obesity.

Many Folk with Down Syndrome come to us with Movement Challenges because of their struggles with Obesity.

Along with Obesity there maybe Heart Disease present along with Respiratory Disfunction & Thyroid Disease.

Hyper-Mobility of The Joints.

Hyper- Mobility of the joints affects Connective Tissue - connective Tissue holding the joints together (Ligaments & Joint Capsule) are all too loose.

Muscles are weak around the joints and the joints can move way beyond normal range of motion.

Constant movement beyond the natural Range Of Motion leads to joint dislocation - ligament strain and tearing.

Over time can also lead to severe Arthritic conditions and joint pain.

Hip Dysplasia is reasonably common in Down Syndrome, it is very different to that seen in Cerebral Palsy as it isn't a muscle issue, but an Anatomical Issue. The pelvis is a lot wider, if you think of a cup and a socket the cup faces backwards a little more and the surface area is smaller. So it's often a boney anatomy problem.

Down Syndrome folk have a very high tolerance to deep pain, so often we can be unaware of physical issues, if unexpected events happen in a session and client doesn't respond to noticing any pain levels, be vigilant and watch them closely and monitor movement, expressions & emotions, document carefully. I have had personal experience with this one, my son broke a bone in his foot and continued the whole day at school, it was noticed on the school bus when his foot was bulging our of his sandal.... his temperature was through the roof, however he was still smiling and content, its very easy to not notice and carry on.

What do we need to provide to support Joints ?

• Strengthening and stabilising exercises to increase strength in Muscles that surround the joints.

• Exercise/Postures that provide proprioceptive feedback (deep pressure)

• Weight baring exercises to increase core strength

• Provide props and supports to avoid Hyperextension or Locking of the joints

• Always encourage softness in joints, particularly Knees, Elbows in weight baring Exercises/Postures

• Avoid over stretching, always modify

• Provide rest time throughout sessions

Again using picture communication options and creating a task board, possibly 3 options and then rest

Down Syndrome & ASD clients often present with poor balance and coordination skills. This can also be due

to Low Muscle Tone and Hyper- flexibility, its good to include balancing exercises in to regular routines.