Psychomotor development and rehabilitation in Down syndrome : Investigations with complications

Abstract

  Objective: The present study aimed to investigate the association among psychomotor development, patient profiles, rehabilitation in our clinic, and complications in Down syndrome. Methods: We investigated the profiles, rehabilitation, complications, acquisition of motor developmental milestones, age at utterance of the first specific word, intelligence quotient (IQ) or developmental quotient (DQ) of patients with Down syndrome who first visited to our clinic from January 1997 to December 2016. We also examined the associations among the aforementioned factors. Results: Fifty eight patients with Down syndrome were included in this study but a patient whose first visit was in adulthood and a patient with mosaic trisomy were excluded. The average age of investigation and the first visit of them were 9.8 years and 22.3 months old, respectively. Fifty four patients (93%) had medical complications ; heart defects 37 patients, eye disorder 17, thyroid disease 11, hearing loss 9, hematologic diseases 5, gastrointestinal disease 3, and epilepsy 2. Hearing loss and epilepsy were related to motor developmental delay and the delayed utterance of the first specific word. Results of IQ or DQ in patients with hearing loss and epilepsy were lower than those in patients without these conditions. In contrast, patients' profiles and the other medical complications mostly were not related to the developmental levels. The patients who started physical therapy before 12 months old needed significantly shorter physical therapy periods to acquire independent walking than those who started physical therapy after 24 months old. Conclusion: Because epilepsy showed negative effects for patients' development, early intervention by treatment and rehabilitation would be important. Hearing loss also showed similar effect ; however, a final conclusion would require further considerations due to existence of other possible complications which might show some effects. In conclusion, early physical therapy would be important for early acquisition of independent walking for patients with Down syndrome.