Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
Departament of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
Disabil Rehabil. 2022 Jun;44(11):2207-2222. doi: 10.1080/09638288.2020.1830439. Epub 2020 Oct 13.
Postural control assessment in children with Down syndrome (DS) may contribute to understanding the impact of impairments in Body Structures and Functions on Activities and Participation, providing a biopsychosocial approach to support clinical practice. The present study aimed to systematically review the literature addressing postural control in children and adolescents with Down syndrome, with a focus in the interactions among the components of the International Classification of Functioning (ICF).
We conducted a tailored search in databases.
We identified 20 full-texts that fulfilled the inclusion and exclusion criteria. Children and adolescents with DS showed lower postural stability across studies. The ICF components most commonly addressed were Body Structure and Function and Activity. Although the studies measured these components, they did not analyze the interrelationships of components when describing the determinants of postural control in this population.
Overall, the studies indicate that children and adolescents with DS show decreased postural stability and greater vulnerability to sensory changes than their typical peers. There is a lack of studies using the biopsychosocial approach. Only few studies have related the activity level of the participants with the variables of postural control. None of them addressed components of Participation and Environmental Factors. The poor methodological quality of the included studies limits the translation of results to clinical practice. Further studies addressing children with disabilities, such as DS, should utilize the ICF framework, thus providing a biopsychosocial approach of health in these individuals.IMPLICATIONS FOR REHABILITATIONChildren with Down syndrome show decreased postural stability and greater vulnerability to sensory changes than their typical peers.In clinical practice, when assessing postural control of individuals with DS, rehabilitation professionals should not only address components of Body Structures and Functions, but also investigate their impact on Activity and Participation.Training of postural control should address strategies that include natural environments and participation situations.The biopsychosocial approach provided by the ICF framework should be implemented in clinical practice.
对唐氏综合征（DS）患儿的姿势控制进行评估，有助于了解身体结构和功能损伤对活动和参与的影响，为支持临床实践提供一种生物-心理-社会方法。本研究旨在系统回顾有关唐氏综合征儿童和青少年姿势控制的文献，重点关注国际功能、残疾和健康分类（ICF）各组成部分之间的相互作用。
我们在特定数据库中进行了定制搜索。
我们确定了 20 篇符合纳入和排除标准的全文。研究表明，DS 患儿的姿势稳定性较低。最常涉及的 ICF 组成部分是身体结构和功能以及活动。尽管这些研究测量了这些组成部分，但在描述该人群姿势控制的决定因素时，它们并未分析组成部分之间的相互关系。
总的来说，这些研究表明，与典型同龄人相比，DS 患儿的姿势稳定性降低，对感觉变化更敏感。缺乏使用生物-心理-社会方法的研究。只有少数研究将参与者的活动水平与姿势控制的变量相关联。没有一个研究涉及参与和环境因素的组成部分。纳入研究的方法学质量较差，限制了将结果转化为临床实践。应进一步研究唐氏综合征等残疾儿童，利用 ICF 框架，为这些人提供健康的生物-心理-社会方法。
唐氏综合征患儿的姿势稳定性较典型同龄人差，对感觉变化更敏感。在临床实践中，当评估 DS 患者的姿势控制时，康复专业人员不仅应解决身体结构和功能的组成部分，还应调查其对活动和参与的影响。姿势控制训练应采用包括自然环境和参与情况的策略。ICF 框架提供的生物-心理-社会方法应在临床实践中实施。
