RESUMO
OBJECTIVE: The study aimed to determine the efficacy of foot muscle exercises in children with DS having pes planus. METHODS: Forty-seven subjects randomly assigned to foot muscle exercises (study group) or an arch support insole with one-leg balance exercises (control group), thrice weekly intervention for 12-weeks followed by a home program with residual effect assessed after 24-weeks from baseline. RESULTS: The motor functions were significantly improved in both groups (p = 0.00). A positive residual effect was found in the study group for both parameters. Whilst in the control group it failed to give a positive residual effect for GMFM-88, while PBS yielded positive outcomes. The study group showed significantly better results than the control group in comparison. CONCLUSION: The novel finding suggests that the foot muscle exercise has the potential to improve motor functions in children with Down syndrome and it can be used as an alternative therapeutic approach to the conventional method.
Assuntos
Síndrome de Down , Terapia por Exercício , Pé Chato , Pé , Músculo Esquelético , Humanos , Síndrome de Down/reabilitação , Síndrome de Down/fisiopatologia , Masculino , Criança , Feminino , Pé Chato/reabilitação , Pé Chato/fisiopatologia , Pé Chato/terapia , Terapia por Exercício/métodos , Pé/fisiopatologia , Músculo Esquelético/fisiopatologia , Resultado do Tratamento , AdolescenteRESUMO
BACKGROUND: Altered gait patterns and reduced walking speed are commonly reported in adults with Down syndrome (DS). Research on the effects of DS-specific exercise programmes on adults with DS is lacking. The purpose of this quasi-experimental study was to evaluate the changes in gait deviations and walking speed in adults with DS after a DS-specific exercise programme. METHODS: Twenty participants underwent a 12-week, DS-specific exercise programme in a telehealth format. Before and after the intervention, gait deviations were assessed with the Ranchos Los Amigos Observational Gait Analysis form, and comfortable walking speed was evaluated with the 4-m walk test. RESULTS: We observed increased comfortable walking speed and reduced gait deviations in the whole gait cycle in adults with DS after the intervention. There were fewer gait deviations during single-leg stance and swing-limb advancement and at the hip, knee and ankle joints after the 12-week exercise programme. CONCLUSIONS: Gait speed and observable gait impairments in adults with DS significantly improved following a 12-week telehealth exercise programme.
Assuntos
Síndrome de Down , Terapia por Exercício , Velocidade de Caminhada , Humanos , Síndrome de Down/fisiopatologia , Síndrome de Down/reabilitação , Síndrome de Down/complicações , Masculino , Feminino , Adulto , Velocidade de Caminhada/fisiologia , Terapia por Exercício/métodos , Adulto Jovem , Telemedicina/métodos , Transtornos Neurológicos da Marcha/reabilitação , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/etiologia , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de SaúdeRESUMO
PURPOSE: The aim of this study was to evaluate gait characteristics, and the effectiveness of treadmill interventions on gait in infants and toddlers with Down syndrome (DS). MATERIALS AND METHODS: A comprehensive search was performed on six databases for evidence published up to November 2020 for articles related to infants and toddlers with DS. The Clinical Appraisal Skills Programme Checklist assessed the methodological quality. Strength of evidence were evaluated Sackett's level. RESULTS: Nine articles analyzing instrumental gait met the inclusion criteria. Of these, 4 compared DS and typically developing (TD), and 5 included treadmill training interventions for DS. Kinematic analysis was applied in 8 studies and all articles presented evaluations at different times according to the walking experience. Analysis with EMG was used in only one of the intervention articles and in 3 of the 4 comparative articles. CONCLUSIONS: Although similar improvements are seen in spatiotemporal parameters for toddlers with typical development and those with DS, the decrease in step width is not similar for DS. Early treadmill training can have a positively effect on the gait characteristics of DS infants. Further research should focus on the acquisition of gait characteristics, long-term evaluations, kinetics and EMG data, for these children.Implications For RehabilitationToddlers with DS walked significantly slower, shorter stride length and less stride frequency.Treadmill training before 1-year old had positive effects on gait characteristics in infants and toddlers with DS.High-intensity treadmill training may provide early walking (2 months earlier) than the low-intensity group, therefore clinicians can add treadmill training programs in rehabilitation protocols of infants and toddlers with DS.Limited evidence for the effects of treadmill training on the kinematic and kinetic parameters of walking in DS infants and toddlers.
Assuntos
Síndrome de Down , Humanos , Lactente , Pré-Escolar , Síndrome de Down/reabilitação , Marcha , Caminhada , Teste de Esforço , Fenômenos BiomecânicosRESUMO
BACKGROUND: The development of both gross and fine motor skills in a child with Down syndrome is generally delayed. The most seriously affected stage is the achievement of independent walking ability, which influences the onset of all following motor and cognitive skills. The study objectives were: 1) to assess the time taken to achieve independent walking ability in a cohort of children with Down syndrome; 2) to examine differences in walking onset by patient characteristics; and 3) to verify the effect of early physical therapy (neurodevelopmental treatment based on Bobath Concept practiced within the first months of life) in the achievement of that skill. METHODS: A retrospective study was carried out on a cohort of 86 children with Down Syndrome. The knowledge of the exact age of walking onset and information about comorbidities and rehabilitation practiced since birth were the eligibility criteria. RESULTS: The average age at which walking began in the sample was 26 months (standard deviation=9.66). Some patient characteristics proved to be related negatively to the walking onset: gender male, trisomy 21, improved joint ligamentous laxity. When practiced, early physical therapy was able to contrast the delay in walking. CONCLUSIONS: NDT-Bobath is a well-known and valid instrument for a child with Down syndrome to attain his highest possible psychomotor functioning level. This study pointed out for the first time ever its capability to contrast the delay on walking onset, which can influence positively the development of the following motor and cognitive skills.
Assuntos
Síndrome de Down , Estudos de Coortes , Síndrome de Down/reabilitação , Humanos , Lactente , Masculino , Modalidades de Fisioterapia , Estudos Retrospectivos , CaminhadaRESUMO
Down syndrome (DS) is a genetic neurodevelopmental disorder. In individuals with DS, a multidisciplinary approach to care is required to prevent multiple medical complications. The aim of this study was to describe the rehabilitation, medical care, and educational and social support provided to school-aged French DS patients with varying neuropsychological profiles. A mixed study was conducted. Quantitative data were obtained from a French multicentre study that included patients aged 4-20 years with diverse genetic syndromes. Qualitative data were collected by semi-structured face-to-face interviews and focus groups. Ninety-five DS subjects with a mean age of 10.9 years were included. Sixty-six per cent had a moderate intellectual disability (ID) and 18.9% had a severe ID. Medical supervision was generally multidisciplinary but access to medical specialists was often difficult. In terms of education, 94% of children under the age of six were in typical classes. After the age of 15, 75% were in medico-social institutions. Analysis of multidisciplinary rehabilitation conducted in the public and private sectors revealed failure to access physiotherapy, psychomotor therapy and occupational therapy, but not speech therapy. The main barrier encountered by patients was the difficulty accessing appropriate facilities due to a lack of space and long waiting lists. In conclusion, children and adolescents with DS generally received appropriate care. Though the management of children with DS has been improved considerably, access to health facilities remains inadequate.
Assuntos
Síndrome de Down/reabilitação , Reabilitação Neurológica/normas , Administração dos Cuidados ao Paciente/normas , Adolescente , Criança , Pré-Escolar , Educação de Pessoa com Deficiência Intelectual/organização & administração , Educação de Pessoa com Deficiência Intelectual/normas , Feminino , França , Acessibilidade aos Serviços de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/normas , Humanos , Comunicação Interdisciplinar , Masculino , Reabilitação Neurológica/organização & administração , Administração dos Cuidados ao Paciente/organização & administração , Apoio Social , Listas de Espera , Adulto JovemRESUMO
Children with Down syndrome (DS) often have lower physical activity (PA) levels compared with their peers with typical development, and face challenges to being physically active such as medical comorbidities, access issues, and societal stigma. Physical therapists are experts in exercise prescription and PA and are thus uniquely qualified to successfully promote participation in children with DS, in spite of inherent challenges. Our perspective is that a shift in physical therapy service delivery is needed. We suggest that physical therapists change the focus of their interventions for children with DS from underlying impairments such as low tone or joint laxity or from developing motor skills in isolation and "correct" movement patterns. Instead, physical therapists should allow the PA preferences and the environmental contexts of the children and adolescents they are working with to direct the treatment plan. In this way, physical therapist intervention becomes more child centered by concentrating on developing the specific skills and strategies required for success in the child's preferred PA. In this article, we consider the role of pediatric physical therapists in the United States, as well as in low- and middle-income countries, in promoting and monitoring PA in children with DS from infancy through adolescence. Examples of physical therapist interventions such as tummy time, movement exploration, treadmill training, bicycle riding, and strength training are discussed, across infancy, childhood, and adolescence, with a focus on how to successfully promote lifelong participation in PA. LAY SUMMARY: Physical therapists are experts in exercise and physical activity and are thus uniquely qualified to promote participation in children with Down syndrome. Instead of focusing on impairments or "correct" movement patterns, physical therapists are encouraged to allow the child and the child's environment to direct the treatment plan.
Assuntos
Síndrome de Down/reabilitação , Terapia por Exercício/métodos , Exercício Físico , Promoção da Saúde/métodos , Adolescente , Criança , Humanos , Estados UnidosRESUMO
AIMS: To evaluate the effects of side-alternating vibration therapy on physical function and body composition in adolescents with Down syndrome. METHODS: Fourteen adolescents (8 males) with Down syndrome (mean ± SD age: 15.5 ± 2.3 years) performed vibration treatment nine minutes daily, four times per week, for 20 weeks on a Galileo vibration platform. Data were collected at baseline and after 20 weeks of intervention. Assessments included six-minute walk test, muscle function (force plate), whole-body dual-energy X-ray absorptiometry and peripheral quantitative computed tomography of the non-dominant tibia. RESULTS: After 20 weeks, participants increased their distance walked in the six-minute walk test (p = 0.009), 2-leg single jump efficiency (p = 0.024) and jump velocity (p = 0.046). Participants also increased their power (p = 0.034) and reduced the time taken during the chair rise test (p < 0.001). At the total body level, increases were seen in bone mineral density (p = 0.004), bone mineral content (p = 0.043), fat free mass (p = 0.013) and lean mass (p = 0.021). CONCLUSION: Side-alternating vibration therapy was associated with increases in physical function and muscle mass with no effects on bone health in adolescents with Down syndrome. CLINICAL TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trial Registry (ACTRN12615000092594) - registered on 4th February 2015.
Assuntos
Densidade Óssea/fisiologia , Síndrome de Down/fisiopatologia , Síndrome de Down/reabilitação , Músculo Esquelético/fisiopatologia , Vibração/uso terapêutico , Absorciometria de Fóton , Adolescente , Feminino , Humanos , Masculino , Teste de CaminhadaRESUMO
BACKGROUND: While COVID-19 outbreak has had adverse psychological effects in children with special needs, the mental state and burden on their caregivers during this pandemic has yet to be reported. AIMS: The objectives of this study were to describe the mental health status and the change in perceived strain among caregivers during the COVID-19 outbreak. METHODS AND PROCEDURES: Two hundred sixty four caregivers completed an online survey that assessed demographics, use and perspective on tele-rehabilitation, homecare therapy, caregiver's strain and mental health. OUTCOMES AND RESULTS: The prevalence of depression, anxiety and stress symptoms were found to be 62.5 %, 20.5 % and 36.4 % respectively. A significant difference in caregiver strain (pâ¯<⯠0.001, effect size = 0.93) was observed during the outbreak compared to levels pre-outbreak (pre-outbreak strain was measured retrospectively). Caregivers not using tele-rehabilitation along with a perception of it being a poor medium for rehabilitation were at greater risks for poor mental health whereas a negative perception on homecare therapy were strongly associated with higher psychological symptoms and strain. CONCLUSIONS AND IMPLICATIONS: This study identified a high prevalence of depression and significant change in strain displayed by caregivers during the COVID-19 outbreak. We identified several factors associated with poor mental health and perceived strain that can be used to help safeguard caregivers.
Assuntos
Ansiedade/psicologia , COVID-19 , Sobrecarga do Cuidador/psicologia , Cuidadores/psicologia , Depressão/psicologia , Transtornos do Neurodesenvolvimento/reabilitação , Pais/psicologia , Estresse Psicológico/psicologia , Telerreabilitação , Fatores Etários , Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/reabilitação , Atitude Frente a Saúde , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/reabilitação , Sobrecarga do Cuidador/epidemiologia , Cuidadores/estatística & dados numéricos , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/reabilitação , Criança , Pré-Escolar , Depressão/epidemiologia , Deficiências do Desenvolvimento/fisiopatologia , Deficiências do Desenvolvimento/reabilitação , Síndrome de Down/fisiopatologia , Síndrome de Down/reabilitação , Feminino , Estresse Financeiro , Estado Funcional , Serviços de Assistência Domiciliar , Humanos , Renda , Índia/epidemiologia , Deficiências da Aprendizagem/fisiopatologia , Deficiências da Aprendizagem/reabilitação , Masculino , Saúde Mental , Transtornos do Neurodesenvolvimento/fisiopatologia , Prevalência , Disrafismo Espinal/fisiopatologia , Disrafismo Espinal/reabilitação , Estresse Psicológico/epidemiologia , Teletrabalho , Carga de TrabalhoRESUMO
PURPOSE: To report on the feasibility of an open-area, portable body weight support system (PBWSS) for in-home use and overground mobility training in an infant with Down syndrome. SUMMARY OF KEY POINTS: The family used the PBWSS on average 4 days/week and for a mean duration of 27.9 minutes/day. Within sessions, the infant's mobility in the open area was greater with PBWSS assistance. The infant's mobility increased whereas variable trends were noted in the infant's motor, language, and cognitive development. CONCLUSIONS: The long-term and frequent use of the PBWSS by this family provided opportunities to practice on emerging motor skills and exploratory actions that may have had a positive effect on her mobility and overall development. RECOMMENDATION FOR CLINICAL PRACTICE: High-dose, body weight-supported training on emerging motor skills is feasible in the infants' natural environments. Future studies using a large sample will quantify the effects.
Assuntos
Desenvolvimento Infantil/fisiologia , Síndrome de Down/reabilitação , Terapia por Exercício/métodos , Transtornos Motores/reabilitação , Destreza Motora/fisiologia , Reabilitação/métodos , Feminino , Humanos , LactenteRESUMO
BACKGROUND: Studies conducted on adults with Down syndrome have demonstrated the improvement of functional fitness (aerobic capacity, muscular strength, balance, flexibility, functional ability, body mass or body mass index) with varying exercise modalities but often with one or two components in isolation. Such modalities included walking, running, cycling, rowing or resistance training. Freestyle swim training has shown significant improvements of all parameters associated with functional fitness in the general population. Swimming is an aerobic activity where many of the large muscle groups are involved and may provide more functional fitness benefits. As a consequence, the purpose of our study was to investigate the effect of freestyle swim training on the functional fitness of adults with Down syndrome. METHODS: Twenty-six adults with Down syndrome (33 ± 6 years; 34 ± 9 kg/m2 ) were randomly allocated to an exercise (n = 13; 81.3 kg) or control group (n = 13; 81.5 kg). The exercise group performed 8 weeks of freestyle swim training, three times a week, 30 min per session (increased to 40 min after 4 weeks). To evaluate differences between groups, a one-way analysis of variance was used, controlling for differences at baseline. RESULTS: After 8 weeks of training, the results showed significant differences between the exercise and control group for body mass, body mass index, aerobic capacity, dynamic balance, muscular strength, 12-m swim time and functional ability (P < 0.05). Effect sizes ranged from small to large. CONCLUSIONS: Various components of functional fitness improved significantly after an intervention period of freestyle swim training. The collective improvement of many functional fitness parameters shown by this study may hold benefits for these often-neglected and in many cases functionally impaired individuals.
Assuntos
Síndrome de Down/reabilitação , Terapia por Exercício/métodos , Aptidão Física , Natação , Adulto , Feminino , Humanos , MasculinoRESUMO
PURPOSE: The aim of this study was to evaluate the feasibility and effectiveness of the Parent Empowerment Program (PEP) to help caretakers deliver a home program to promote developmental activities and gross motor function in their children with Down syndrome. METHODS: Parents attended a 14-month program with training sessions 1-4 times a month. Outcomes were measured using a change in the Gross Motor Function Measure (GMFM-88) at baseline and assessment one. RESULTS: Forty-eight families participated in the PEP. Children's mean age was 16.2 ± 10.8 months. There were significant changes in GMFM-88 scores between baseline and assessment one; t (30) =-9.158, p< 0.001; 95% CI -14.6 - -22.9. Previous hospitalization significantly affected GMFM scores. CONCLUSION: This study describes a clinically applied research that focuses on program design, development and evaluation. Findings indicate that the PEP is effective in improving gross motor function in children with Down's syndrome in Pakistan. Parents were satisfied with the program outcomes and were able to cope with the requirements at home. The PEP had favorable outcomes and may be an effective method to support PT services in resource poor countries.
Assuntos
Síndrome de Down/reabilitação , Intervenção Educacional Precoce/métodos , Pais/educação , Modalidades de Fisioterapia , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Lactente , Masculino , Destreza Motora , Paquistão , Projetos Piloto , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Resultado do TratamentoRESUMO
Volunteer activities can provide opportunities to learn new skills, build social networks, and contribute to enhanced self-esteem. Volunteering also provides a positive contribution to society, and an opportunity to participate in activities that may differ from those in paid employment. People with severe disabilities and complex communication needs, however, may face significant barriers in participating and communicating in volunteer activities. A multiple-probe-across-participants, single-case experimental design was used to evaluate the effectiveness of videos with integrated visual scene displays (video VSDs). The video VSDs were presented using a tablet-based augmentative and alternative communication (AAC) app, as an intervention to increase the percent of steps completed independently within a volunteer activity. Participants were four adolescents with autism spectrum disorder or Down syndrome, all of whom had complex communication needs. Each participant met the mastery criterion for the activity - completion of the volunteer work activities and communication exchanges with co-volunteers - with the use of the video VSDs. The results provide preliminary evidence that video VSDs may be an effective assistive technology for individuals with severe disabilities and complex communication needs to increase participation in volunteer activities, both as an instructional support in learning new skills, and as an AAC technique to support interaction with others.
Assuntos
Transtorno do Espectro Autista/reabilitação , Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação/reabilitação , Síndrome de Down/reabilitação , Voluntários , Adolescente , Computadores de Mão , Humanos , Masculino , Gravação em Vídeo , Adulto JovemRESUMO
This scoping review explores parents' experiences with implementing therapy home programs to determine the factors that influence compliance with incorporating therapy activities into their daily routines. Articles that described the experience of parents of children with Down syndrome with implementing an occupational therapy home program were included in this study. Peer-reviewed articles published within the past fifteen years (January 2003 - January 2018) were also included. Six articles met inclusion criteria. Three themes emerged: (1) emphasis on contextualization, (2) the parent-therapist relationship, and (3) emotional burden of parents. The findings suggest that practitioners develop interventions that are enfolded into the family's daily routine as well as considering the parents' emotional resources and learning style when designing therapy activities.
Assuntos
Cuidadores/psicologia , Síndrome de Down/reabilitação , Deficiência Intelectual/reabilitação , Terapia Ocupacional/métodos , Pais/psicologia , Cooperação do Paciente , HumanosRESUMO
A child with Down syndrome, like any other child, may benefit from interacting with memory stimuli, but needs additional support and help. The use of special teaching methods, which add playfulness and use of the computer, can enhance the memory processes of these children. In this work, we present the virtual environment "Nossa Vida (Our Life)", which was developed to assist children with Down syndrome to memorize action sequences of their daily routine. A daily routine memorization test (DRMT), consisting of a weekly reminder of typical daily routines completed by the children and parents, was performed before (pre-test) and after (post-test) the intervention. The work involved a multidisciplinary team and assessed the effectiveness of the test performed by 30 children with Down syndrome from APAE, a special education school for children with intellectual disabilities in São Paulo, Brazil. The children were separated into two groups (Experimental - GE and Control - GC) with homogeneity and normality of the data. Two hypotheses were tested in this study: H0 and H1, where: H0 = There is no statistical difference between memorizing daily tasks between individuals with Down syndrome who used our ludic virtual environment and those who used the conventional memory method.H1 = There is a difference between the group of subjects with Down Syndrome who used our virtual game environment and the group that did not use it in relation to memorizing the daily task. This produces t = -14.98 and p <0.0001, with H1 being accepted. The results showed that the EG presented significance in relation to the CG and the evolution mean of the children in the EG was 81.82% higher. According to experts (psychologist and pedagogue) from APAE and parents, the playful activities implemented in this virtual environment have been of great interest to children, who had fun, tested hypotheses and questioned them about the sequences of actions performed in their routine daily.
Assuntos
Síndrome de Down/fisiopatologia , Síndrome de Down/reabilitação , Deficiência Intelectual/fisiopatologia , Deficiência Intelectual/reabilitação , Memória , Jogos e Brinquedos , Atividades Cotidianas , Adolescente , Brasil , Criança , Computadores , Feminino , Humanos , Masculino , Pais , Instituições Acadêmicas , Software , Adulto JovemRESUMO
BACKGROUND: There is a lack of early (infant) mobility rehabilitation approaches that incorporate natural and complex environments and have the potential to concurrently advance motor, cognitive, and social development. The Grounded Early Adaptive Rehabilitation (GEAR) system is a pediatric learning environment designed to provide motor interventions that are grounded in social theory and can be applied in early life. Within a perceptively complex and behaviorally natural setting, GEAR utilizes novel body-weight support technology and socially-assistive robots to both ease and encourage mobility in young children through play-based, child-robot interaction. This methodology article reports on the development and integration of the different system components and presents preliminary evidence on the feasibility of the system. METHODS: GEAR consists of the physical and cyber components. The physical component includes the playground equipment to enrich the environment, an open-area body weight support (BWS) device to assist children by partially counter-acting gravity, two mobile robots to engage children into motor activity through social interaction, and a synchronized camera network to monitor the sessions. The cyber component consists of the interface to collect human movement and video data, the algorithms to identify the children's actions from the video stream, and the behavioral models for the child-robot interaction that suggest the most appropriate robot action in support of given motor training goals for the child. The feasibility of both components was assessed via preliminary testing. Three very young children (with and without Down syndrome) used the system in eight sessions within a 4-week period. RESULTS: All subjects completed the 8-session protocol, participated in all tasks involving the selected objects of the enriched environment, used the BWS device and interacted with the robots in all eight sessions. Action classification algorithms to identify early child behaviors in a complex naturalistic setting were tested and validated using the video data. Decision making algorithms specific to the type of interactions seen in the GEAR system were developed to be used for robot automation. CONCLUSIONS: Preliminary results from this study support the feasibility of both the physical and cyber components of the GEAR system and demonstrate its potential for use in future studies to assess the effects on the co-development of the motor, cognitive, and social systems of very young children with mobility challenges.
Assuntos
Relações Interpessoais , Limitação da Mobilidade , Atividade Motora , Aparelhos Ortopédicos , Robótica/métodos , Algoritmos , Pré-Escolar , Deficiências do Desenvolvimento/reabilitação , Síndrome de Down/reabilitação , Feminino , Humanos , Lactente , MasculinoRESUMO
BACKGROUND: Down syndrome (DS) is one of the most common birth defects in the USA associated with high levels of overweight and obesity. Unique characteristics of adults with DS that may contribute to the high levels of obesity are high rates of hypothyroidism, poor muscle tone, altered gait and lower resting metabolic rate. Due to these factors, it is unknown if the same weight management interventions that are effective in adults with intellectual or developmental disability (IDD) without DS are as effective in those with DS. Therefore, the purpose of this secondary analysis was to compare changes in weight, diet and physical activity between participants with DS-related and non-DS-related IDD participating in an 18-month weight management trial. METHODS: We used propensity score methods to adjust baseline variables of overweight/obese adults with and without DS participating in an 18-month effectiveness trial with 6 months weight loss and 12 months weight maintenance. Participants followed one of two reduced calorie diet plans, obtained 150 min of moderate-vigorous intensity physical activity (MVPA) per week, and logged dietary intake daily. A health educator held monthly at-home visits with participants and a caregiver to give feedback on intervention compliance. RESULTS: Out of the 124 participants that met the criteria for inclusion, 21 were diagnosed with DS and 103 with non-DS-related IDD. Twenty out of 21 participants with DS were successfully matched. Clinically significant weight loss was seen at 18 months in participants with DS (-5.2%) and non-DS-related IDD (-6.8%), with no difference between groups (P = 0.53). Significant reductions in energy intake were seen across the 18-month intervention in both DS and non-DS-related IDD groups with between-group differences at 12 months only (1119 vs. 1492 kcal/day, respectively; P = 0.003). Although MVPA did not increase in either group across the intervention, those with non-DS-related IDD had higher levels of MVPA compared with those with DS across 18 months. CONCLUSION: Participants with DS lost a clinically significant amount of weight across the 18-month intervention. Compared with those with non-DS-related IDD, those with DS lost similar amounts of weight, had similar decreases in energy intake and participated in less MVPA across the 18-month intervention. Although individuals with DS have physiological factors that may contribute to obesity, weight management interventions designed for individuals with IDD may be equally effective in this population.
Assuntos
Manutenção do Peso Corporal , Deficiências do Desenvolvimento/reabilitação , Síndrome de Down/reabilitação , Avaliação de Resultados em Cuidados de Saúde , Sobrepeso/terapia , Programas de Redução de Peso , Adulto , Comorbidade , Deficiências do Desenvolvimento/epidemiologia , Dietoterapia , Síndrome de Down/epidemiologia , Terapia por Exercício , Feminino , Humanos , Masculino , Obesidade/dietoterapia , Obesidade/epidemiologia , Obesidade/reabilitação , Sobrepeso/dietoterapia , Sobrepeso/epidemiologia , Sobrepeso/reabilitação , Educação de Pacientes como Assunto , Pontuação de PropensãoRESUMO
BACKGROUND: People with Down syndrome (PDS) have complex healthcare needs. Little is known about the quality of health care for PDS, let alone how it is appraised by PDS and their caregivers. This study explores the perspectives of PDS, their parents and support staff regarding quality in health care for PDS. METHOD: The present authors conducted semi-structured interviews with 18 PDS and 15 parents, and focus groups with 35 support staff members (of PDS residing in assisted living facilities) in the Netherlands. RESULTS: According to the participants, healthcare quality entails well-coordinated health care aligned with other support and care systems, a person-centred and holistic approach, including respect, trust and provider-patient communication adapted to the abilities of PDS. CONCLUSIONS: Our findings may be used to improve health care for PDS, and provide insight into how health care could match the specific needs of PDS.
Assuntos
Moradias Assistidas/normas , Síndrome de Down/reabilitação , Pessoal de Saúde/normas , Relações Profissional-Paciente , Qualidade da Assistência à Saúde/normas , Qualidade de Vida , Adolescente , Adulto , Idoso , Cuidadores , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Pais , Pesquisa Qualitativa , Adulto JovemRESUMO
BACKGROUND: Dog-assisted therapy (DAT) is hypothesized to help children with autism spectrum disorder (ASD) and Down syndrome (DS). METHODS: The present authors compared synchronous movement patterns of these children (n = 10) and their therapy dogs during the first and last session of a DAT programme, and their post-therapy changes in emotional and behavioural problems. RESULTS: The present authors found a significant increase in synchrony between child and therapy dog over time. Exploratory analyses suggest more synchrony between children with ASD and their therapy dogs, compared to the children with DS. CONCLUSIONS: This study is the first to test the synchrony hypothesis, shedding light upon a mechanism that may underlie the effect of DAT and how this may be different for children with ASD and DS.