Organization of a simple two-joint synergy in individuals with Down syndrome.

Subjects with Down syndrome and age- and gender-matched control subjects performed discrete elbow or wrist, flexion or extension movements in a sagittal plane, moving one of the joints as fast as possible. The hand was either pronated or supinated. In control subjects, alternating bursts of activity were seen in the agonist-antagonist muscle pair controlling the nonfocal joint. Subjects with Down syndrome, in most series, demonstrated simultaneous bursts of activity in the flexor and extensor muscles controlling both joints. This group difference was particularly pronounced for the muscles controlling the nonfocal joint. We assume that the central nervous system may use two strategies to avoid flapping of a postural joint. The more universal co-contraction strategy in Down syndrome may be viewed as an adaptive feature reflecting a general tendency of these persons to trade efficacy for safety.