By: Mujuthaba
I’m not aware of the percentage in the Maldives affected with Down’s syndrome. But I have seen ads regarding them on TV, and they were very touching. Please take some time to read this as this may help you to understand the syndrome more in a PT sense. On an average over one in eight hundred births are Down syndrome. Unlike normal individuals, Down syndrome is caused by an increase in an extra chromosome to the twenty first pair, from which gets its name ‘trisonomy-21’. This categorises this syndrome as a genetic disorder.
This common disorder is most prevalent in older women who get pregnant. One in thirty births by women over forty five bear a Down syndrome individual. With the age factor in bearing a Down syndrome child, the maternal parent is primarily responsible for the disorder, where only five to ten percent of the disorder occurs from the male parent. Therefore it may not be a good idea to delay the child bearing age. Since Maldivians have a tendency of getting a family at an early age, this syndrome may not be as common as in western nations. Anyhow this trend could be changing in the Maldives as more people wait to bear children in late life.
One of the main apparent defects of the Down syndrome individual is the mental and motor actions. Even though their action perceives them as being mentally retarded, not all of them are classified as severely retarded. There are many congenital (at birth) defects present in Down syndrome individuals. As a PT the main defects to be taken into consideration are the presence of bone deformations, shorter limbs, heart diseases, the presence of hypotonia, or the decreased strength/tone of muscles and also increased joint laxity (over flexibility).
Hypotonia decreases the function and movement of the limbs as to limit the amount of physical activity in Down syndrome individuals. Even though hypotonia is most prevalent in Down syndrome patients, it is also present in other diseases too. It has shown that this loss of motor functioning is due to the hypoplasia of the cerebellum of the brain, which occurs with age in normal populations.
With a very limited joint motor activity, the ‘active’ child looses his motivation to join in with their normal physically active peers. This trend continues throughout the childhood, unless an effort is made by their surrounding environment. A recent study states that the inactive lifestyle of Down syndrome individuals can be boosted by educating the care-takers of those individuals on the importance of physical activity. This states the importance of motivating the Down syndrome population by providing an active surrounding. Usually the Down syndrome individuals are kept at home by their families, without any involvement with the external active environments.
Unlike most of the normal population, Down syndrome individuals tend to gain weight with age, where the males tend to be overweight and the females obese. Increase in body fat is related to many of the chronic diseases. In inactive individuals the chronic diseases are more prevalent than physically active individuals. To decrease the risk of chronic diseases it is extremely important to take up a physical type of activity that would benefit in the long term. One of the best ways to stay away from chronic diseases is to adopt a cardiorespiratory exercise regimen. Cardiorespiratory fitness refers to the moderate to high prolonged activities which attributes to the efficient performance of the heart, blood vessels, blood, lungs and the contributing muscles during the activity.
It is crucial to investigate the benefits of a cardiorespiratory fitness regimen on Down syndrome patients. Various studies and papers have presented advantages of such a training program. One of these studies refers to the Down syndrome young individuals having a cardiorespiratory fitness level equal to normal individuals of thirty to forty years of age or individuals who have had a heart attack. This expresses the low functional capacity of the lungs, heart and the muscles.
In order to put the Down syndrome individuals on a cardiorespiratory fitness program it is extremely important to outweigh the medical complications that may affect the training. As Down syndrome patients have certain congenital heart disorders, muscle hypotonia, extreme joint laxity and valgus knee posture (inward knee posture), a cardiorespiratory program would be a challenge. Arguably benefits do occur with cardiorespiratory fitness prescription.
Different types of exercise regimens can be offered to Down syndrome patients, with reference from a specialised PT in the area. There are other physiological benefits that come out of endurance type of training for Down syndrome patients. One recent study published in 2006 showed that physical activity in Down syndrome patients increase the function of blood cells. This would conclude that physical activity would increase the oxygen carrying capacity of blood in this group. Another study conducted on Down syndrome individuals show that almost half of the cohort suffers from dementia with age. Dementia is usually the memory loss that occurs with old age or from diseases such as Alzheimer’s, which could affect Down syndrome patients. Six years later a study conducted in 2006 showed that physical activity can prevent the effect of dementia.
In order to see positive results for the individuals it is extremely important to construct a well structured exercise program. In walk/jog program studies, it showed cardiorespiratory fitness improvements and an increase in performing capabilities in Down syndrome individuals. As exercise requires specific movements, it is extremely important to instruct the individual on the exact technique of the exercise mode. It is necessary to make the individual understand the specific movements, or alternatively the exercise could be kept at a basic level to make the individual motivated in the beginning phase. Down syndrome patients should be referred to a medical practitioner for medical clearance prior to prescribing an exercise program. This is important in defining the medical complications of the Down syndrome patient, which may have occurred with birth or with age.
It is extremely important to engage these special populations into physical activity that they are so strange to. This will improve their quality of life, motivation in life and engagement in the society. Most of all be an inspiration for the rest of us. It is our responsibility to see that they live a normal life.
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