Case 10: Down Syndrome Flashcards
Ranitidine
Inhibits stomach acid production
Commonly used to treat gastroesophageal reflux
Thyroxine
Synthetic thyroid hormone replacement used to treat hypothyroidism
Ventricular Septal Defect
Hole in the wall (septum) that separates the lower chambers of the heart (ventricles)
Precautions During PT (Patients with Down Syndrome)
Protect joints from extreme ROM - hypotonia + ligamentous laxity
Observe for S&S of AA instability
Observe for signs of inadequate management of thyroid and cardiopulmonary comorbidities
Complications During PT (Patients with Down Syndrome)
Behavioral challenges secondary to young age and intellectual disability
OA instability (rare)
Initial radiographs in children with Down Syndrome should be taken between ___ and ___ years of age.
3, 5
What is the most common cause of intellectual disability (cognitive delay) in the U.S.?
Down Syndrome
The incidence of DS ___ with increasing maternal age.
increases
What characteristics of a child at birth lead medical professionals to suspect Down Syndrome?
Small ears
Wide space between first and second toes
Small internipple distance
Brushfield’s Spots (colored speckles in iris)
Increased neck skinfold thickness
What are children with Down Syndrome most delayed in?
Achieving gross motor milestones that require postural control and coordination (walking / running / jumping)
Key MSK Impairments in Children w/ Down Syndrome
Hypotonia (reduced resting muscle tone and decreased resistance to passive stretch)
Ligamentous laxity (results in joint hypermobility)
Key Neurologic Impairments in Children w/ Down Syndrome
Reduced brain volume
Smaller frontal and temporal areas
Smaller cerebellum (critical for postural control and balance)
Smaller hippocampus (critical for long-term memory)
___ disorders (particularly ___) are much more frequent in individuals with DS than the general population.
thyroid, hypothyroidism
What defects related to the heart are often present in patients with DS?
Congenital heart defects (such as septal defects)
What measures are often used to assess postural control and balance in patients with DS?
Berg Balance Scale
Pediatric Balance Scale
In children with DS, what test has the strongest research supporting its use?
Gross Motor Function Measure (GMFM)
Gross Motor Function Measure (GMFM)
Subscales (5) - Lying and rolling / sitting / crawling and kneeling / standing / walking, running, jumping
4-point scoring system
What other standardized tests are appropriate to utilize on children with DS?
Peabody 2nd edition (birth - 72 months)
Bayley Scales of Infant Development (1 - 42 months / global development)
What are key goals for an infant or toddler with DS?
Postural control
Righting
Balance reactions
Motor milestones (especially independent ambulation)
The delayed development of postural control in children with DS is most affected by ___.
smaller than normal cerebellum
What intervention has been shown to help a young child with DS learn to walk independently earlier?
Treadmill training
Common Symptoms of Hypothyroidism
Poor endurance / fatigue
Decreased motivation
Muscle and joint aches
Children with Down Syndrome often demonstrate which impairment at the ankle?
M/L instability
