Homogeneity in Motor Competence Among Youths With Intellectual Disability With and Without Down Syndrome.

PURPOSE: To determine if there is a homogeneity of scores for youth with intellectual disability (ID) with and without Down syndrome (DS) in 19 test items of motor competence from the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2). Homogeneity was defined as the means for each of the 19 test items scores by sex and the presence or absence of DS sharing the same population mean. METHOD: Participants were 622 youth with ID aged 6 to 21 years. Items for bilateral coordination, balance, and upper limb coordination were examined using the BOT-2. RESULTS: For all 19 BOT-2 items, means between youth with and without DS did not differ from the population mean. CONCLUSION: These results potentiate the development of expected BOT-2 motor competence scores for youth with ID independent of the presence of DS for clinical practice.

Association between sleep quality and physical functioning in adults with Down syndrome: A brief report.

BACKGROUND: Sleep quality is associated with physical functioning in adults, but this has not been examined in those with Down syndrome (DS). High body mass index (BMI) and accelerated aging, both common in adults with DS, may alter the relationship between sleep quality and physical functioning in this population. OBJECTIVE: To examine sleep quality indicators and its association with physical functioning in adults with DS, and whether associations are altered by BMI and age. METHODS: Participants were 15 adults with DS (8 women; age 29 ± 14 years). We evaluated sleep quality over seven days with wrist-worn accelerometers and physical functioning with the timed-up-and-go (TUG) and 6-min walk (6 MW) tests. We examined the associations between sleep quality and physical functioning variables using Spearman's rho. RESULTS: Sleep quality indicators were: total sleep time 407 ± 54 min; latency 26.8 ± 21 min; efficiency 73.9 ± 12 %; wake after sleep onset 122.8 ± 65.2 min; number of awakenings 21.0 ± 6.2; and average length of awakenings 6.1 ± 3 min. Total sleep time and average length of awakenings were significantly associated with 6 MW distances (rho = 0.58 and -0.69; p < 0.05, respectively). After controlling for age and BMI, 6 MW distance was significantly associated with total sleep time, latency, efficiency, and average length of awakenings (rho = 0.56, -0.73, 0.60, and -0.87; p < 0.05, respectively). TUG was significantly associated with total time in bed (rho = 0.71); p < 0.05). CONCLUSIONS: Sleep quality indicators are associated with walking performance in adults with DS. Age and BMI strengthen the relationship between sleep quality and physical functioning.

Comparing Motor Competence of Sex- and Age-Matched Youth With Intellectual Disability From Brazil and the United States.

Youth with intellectual disabilities (IDs) demonstrate below-criteria motor competence (MC) compared with typically developing (TD) youth. Whether differences in MC exist for youth with ID from different countries is unknown. This study examined the MC of youth with ID from Brazil (BR) and the United States (US) and compared it with norms for TD youth as established by the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). The authors measured 19 BOT-2 test items for bilateral coordination, balance, and upper limb coordination of 502 youth (BR = 252, US = 250) with ID (6-21 years). Raw scores were converted to %ceiling (percentile of highest expected scores). For all test items, no significant differences were seen between BR and US participants in %ceiling scores. Participants from both countries demonstrated equivalent to slightly below BOT-2 norms in 14 of the 19 test items, with lowest scores seen in contralateral synchronizing bilateral coordination, balancing on one leg, and ball handling.

Measuring for nonsynostotic head deformities in preterm infants during NICU management: A pilot study.

BACKGROUND: Research has focused on the presence of nonsynostotic head deformities (NHD: plagiocephaly, dolichocephaly, brachycephaly) in preterm infants at discharge and within the first year after discharge. However, there is limited data on NHD in preterm neonates during neonatal intensive care unit (NICU) stay. AIM: To acquire quantitative data on head shapes among preterm neonates during NICU hospital stay. STUDY DESIGN: Investigators performed weekly head measurements on 68 premature infants starting within two weeks of birth or when medically stable until discharge. Infants recruited for the study were born at <34 weeks gestational age. OUTCOME MEASURES: Cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated from Ballert cranial caliper measurements during the infants stay (27 to 40 weeks postmenstrual age) in the NICU/Special Care Nursery (SCN) setting. Inter-rater retest reliability was determined for CI and CVAI. RESULTS: Throughout the measurement period, CI consistently demonstrated dolichocephaly (CI < 0.76), and CVAI fluctuated above and below the range indicating plagiocephaly (CVAI ≥ 3.5%). Good to acceptable levels of test-retest reliability was demonstrated; prevalence of dolichocephaly and plagiocephaly at discharge was 82% and 36%, respectively; and mean head dimension measurement time for different combinations of bed types and support systems ranged from 1.1 to 1.9 min. CONCLUSIONS: Following the progression of CI and CVAI during the NICU stay using the cranial caliper method is reliable, and a substantial presence of NHD was reported.

Balance and Coordination Proficiency of Age-Matched Male and Female Children and Adolescents With Intellectual Disabilities.

Male youth (8-18 years) with intellectual disability (ID) demonstrate motor proficiency below age-related competence capacities for typically developing youth. Whether below-criteria motor proficiency also exists for females with ID is not known. The purpose of this study was to determine if sex-specific differences exist in motor proficiency for youth with ID. The Bruininks-Oseretsky Test of Motor Proficiency was used to measure motor proficiency: six items for upper limb coordination, seven items for balance, and six items for bilateral coordination. One hundred and seventy-two (172) males and 85 females with ID but without Down syndrome were divided into five age groups for comparative purposes: 8-10, 11-12, 13-14, 15-16, and 17-21 years. Males scored sufficiently higher than females to suggest that sex data should not be combined to established Bruininks-Oseretsky Test of Motor Proficiency standards for upper limb coordination, balance, and bilateral coordination subtests.

Balance and Coordination Capacities of Male Children and Adolescents With Intellectual Disability.

Children and adolescents with intellectual disability (ID) exhibit a mixture of cognitive, motor, and psychosocial limitation. Identifying specific inadequacies in motor proficiency in youth with ID would improve therapeutic management to enhance functional capacity and health-related physical activity. The purpose of this study was to initiate descriptive data collection of gross motor skills of youth with ID and compare those skills with competency norms. The Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) was used to measure 6 items for balance (BAL), 5 items for upper limb coordination (ULC), and 6 items for bilateral coordination (BLC) of 123 males (ages 8-18) with ID but without Down syndrome. The authors performed 2,840 assessments (10-32 for each item); 944, 985, and 913 for BAL, ULC, and BLC, respectively. Mean scores for all age groups for BAL, ULC, and BLC were consistently below BOT-2 criteria. Overall motor skills of males with ID are below the competence expected for children and adolescents without disabilities.

Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review.

BACKGROUND: Children with Down syndrome (DS) are more likely to be overweight or obese than the general population of youth without DS. AIMS: To review the prevalence of overweight and obesity and their determinants in youth with DS. The health consequences and the effectiveness of interventions were also examined. METHODS AND PROCEDURES: A search using MEDLINE, Embase, Web of Science, Scopus, CINAHL, PsycINFO, SPORTDiscus, LILACS, and COCHRANE was conducted. From a total of 4280 studies, we included 45 original research articles published between 1988 and 2015. OUTCOMES AND RESULTS: The combined prevalence of overweight and obesity varied between studies from 23% to 70%. Youth with DS had higher rates of overweight and obesity than youths without DS. Likely determinants of obesity included increased leptin, decreased resting energy expenditure, comorbidities, unfavorable diet, and low physical activity levels. Obesity was positively associated with obstructive sleep apnea, dyslipidemia, hyperinsulinemia, and gait disorder. Interventions for obesity prevention and control were primarily based on exercise-based programs, and were insufficient to achieve weight or fat loss. CONCLUSIONS AND IMPLICATIONS: Population-based research is needed to identify risk factors and support multi-factorial strategies for reducing overweight and obesity in children and adolescents with DS.

Measuring joint hypermobility using the Beighton scale in children with intellectual disability.

PURPOSE: To determine the feasibility and reliability of using the 9-point Beighton Hypermobility Score (9-BHS) with youth with intellectual disabilities using a least to most prompting technique. METHOD: One hundred one youth (5-18 years old) enrolled in the study. Two separate evaluations, separated by 3 to 4 weeks, were performed on 25 participants. RESULTS: Ninety assented to the test, and 85 performed all 9-BHS maneuvers. Scores were not significantly different for age and gender, but participants with Down syndrome had significantly higher scores. Test-retest scores showed 80% to 90% agreement (n = 25). Cohen kappa ranged from moderate (0.41-0.60) to perfect (1.0) for the 9 maneuvers, and an ICC of 0.88 was found for total scores. CONCLUSION: The results demonstrate that the use of the 9-BHS in youth with intellectual disabilities in the manner described is feasible and reliable.

Effects of traditional treatment and partial body weight treadmill training on the motor skills of children with spastic cerebral palsy. A pilot study.

PURPOSE: This study was designed to examine the effects of intensive traditional physical therapy treatment methods combined with partial body weight treadmill training (PBWTT) on motor and ambulatory skills of children with cerebral palsy. METHODS: Five children (2.3 to 9.7 years) with cerebral palsy participated in a therapy program for four weeks, three to four sessions per week, for two hours per session. Outcomes were measured using the Gross Motor Function Measure, Pediatric Evaluation of Disability Inventory, pedographs, and the Timed 10-Meter Walk Test. RESULTS: Wilcoxon paired-sample tests and percent changes showed a significant (p < 0.05) decrease in mean step length differences. Results indicate improvements in motor and ambulatory skills of individual children indicating positive measurable outcomes of intensive physical therapy with partial body weight treadmill training. CONCLUSIONS: An intensive episode of physical therapy of reasonable frequency and duration that includes partial body weight treadmill training may be effective in improving motor skills of children with spastic CP.

Heart rate variability at rest and during exercise in persons with Down syndrome.

OBJECTIVES: To determine whether autonomic dysfunction explains chronotropic incompetence observed in persons with Down syndrome (DS) and to measure heart rate variability (HRV) at rest and during exercise in persons with mental retardation with and without DS. DESIGN: Comparative study. SETTING: University exercise science laboratory. PARTICIPANTS: Thirty-one subjects with mental retardation (age, 20.2 y) with DS (n=16; 10 men, 6 women) and without DS (n=15; 8 men, 7 women). INTERVENTIONS: Not applicable. Main outcome measures HRV was determined at rest and at 2 steady-state exercise intensities on the treadmill in both time (standard deviation of the R-R interval, percentage of R-R intervals deviating by more than 50 ms from the previous R-R interval [deviation >50], square root of the mean squared differences of successive differences) and frequency (low-frequency power [LF]), high-frequency power [HF], the LF/HF ratio) domains. RESULTS: The DS group demonstrated a statistically lower peak heart rate (161 beats/min vs 178 beats/min, P<.05), and peak oxygen consumption (27.4 mL.kg(-1).min(-1) vs 34.3 mL. kg(-1).min(-1), P<.05) than did the group with mental retardation without DS. At rest, all time domain measures of HRV and absolute HF power were significantly higher in the DS group (P<.05). Yet, LF power and LF/HF values did not differ between groups. All HRV variables decreased significantly at both exercise intensities, with no differences between groups during exercise (P<.05). CONCLUSIONS: People with DS have greater parasympathetic activity at rest, but group differences disappear with the onset of exercise, which suggests that other variables are responsible for chronotropic incompetence in persons with DS.