SUNY Upstate Medical University, Syracuse, New York, USA.
School of Physical Therapy, University of Puget Sound, Puget Sound, Washington, USA.
Phys Ther. 2021 May 4;101(5). doi: 10.1093/ptj/pzab032.
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.
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.
唐氏综合征（DS）患儿的体力活动（PA）水平通常低于其具有典型发育的同龄人，并且在进行体力活动时面临挑战，例如合并症、获得机会的问题和社会污名。物理治疗师是运动处方和 PA 的专家，因此尽管存在固有挑战，但他们有能力成功促进 DS 患儿的参与。我们的观点是需要改变物理治疗服务的提供方式。我们建议物理治疗师将其对 DS 患儿的干预重点从低肌张力或关节松弛等潜在障碍，或从孤立地发展运动技能和“纠正”运动模式转移。相反，物理治疗师应该允许他们正在治疗的儿童和青少年的 PA 偏好和环境背景来指导治疗计划。通过这种方式，物理治疗师干预通过专注于发展儿童在其首选 PA 中取得成功所需的特定技能和策略，变得更加以儿童为中心。在本文中，我们考虑了美国以及低收入和中等收入国家的儿科物理治疗师在促进和监测从婴儿期到青春期 DS 患儿 PA 方面的作用。讨论了物理治疗师干预的例子，如俯趴时间、运动探索、跑步机训练、骑自行车和力量训练，跨越婴儿期、儿童期和青春期，重点是如何成功促进终身参与 PA。
物理治疗师是运动和体力活动方面的专家，因此有能力独特地促进唐氏综合征患儿的参与。物理治疗师不应将重点放在障碍或“正确”的运动模式上，而应鼓励他们让孩子和孩子的环境来指导治疗计划。
