Down’s Syndrome

Down’s syndrome is a chromosomal disorder resulting in 47 chromosomes instead of 46. commonly called trisomy 21.

Down’s syndrome result from faulty cell division affecting the 21st pair of chromosomes.



  • Delay in motor transition like turning, sitting, standing or walking,
  • difficulty in fine motor activity,
  • difficulty in balancing activity,
  • delay in speech,
  • hyper mobility of all joint,
  • flat feet,
  • lack of face muscle belies,
  • flexible spine,
  • hearing or visual problem,
  • some patient suffering mental retardation.
  • cognition problem is also their.

Down’s syndrome affect 

  • Neuropathology
  • Musculoskeletal
  • Cardiopulmonary
  • Sensory deficits
  • Learning differences

1. Neuropathology

  •  CNS disorder
  • Microbrachycephely
  • Motor incoordination
  • Lack of myelination
  • ( that cause developmental delay)


  • Anticipate gross and fine motor delay and provide intervention to minimise it.
  • positioning and handling activities to promote antigravity control and weight bearing
  • facilitate antigravity extension in prone
  • weightshiffing
  • transition from prone
  • In supine and supported sitting, encourage midline orientation,
  • Bimanual activity including eye-hand coordination.
  • Activity to promote anterior neck and trunk antigravity strength.
  • Increase axial tone
  • allow dynamic movement rather than static movement
  • Supported sitting and standing when trunk control.

2. Musculoskelatal difference 

  • Liner growth deficits are observed, including a decrease in normal velocity of growth in structure.
  • Reduce the length of leg and 10% to 30% reduce in metacarpal and phalangeal length.
  • Muscle variation is present including an absent plamaris longus & supernumerary forearm flexors.
  • lack of muscle belies for the zygomaticus major and minor and levator labii superia in face.
  • other problem is hypotonic and ligamentus laxity result pes planus, patellar instability, scoliosis, atlantoaxial instability.
  • Hip subluxation is also comman
  • Hypotonia found in all muscle group of extremities, neck, trunk, hall mark feature in children.
  • It is a major contributing factor to development motor delay.
  • problem in grip strength, isometric strength and ankle strength.


  • Avoid exaggerated movement
  • Joint approximation
  • compression of cervical spine

3. cardiopulmonary pathologies

  • Most comman down syndrome with congenital heart defects
  • Atrioventricular canal defects
  • Ventriculoseptal defects
  • Its risk for restrictive pulmonary disease
  • Decease lung volume and weak cough
  • high risk of respiratory infection


  • Increase cardiopulmonary endurance and muscular strength.

4. sensory deficits

  • Visual and hearing problem are comman in children with down syndrome
  • In vision ( cataracts, myopia, farsightness, strabismus, nystagmus )
  • 60% to 80% are found to have mild to moderate hearing loss


  • sensory integration therapy for vision and hearing.

5. Learning differences

specially in mental retardation

  • capable of learning a fewer number of thing
  • need a greater number of repetition to learn
  • greater difficulty generalising skill
  • greater difficulty maintaining skill
  • slower response time


  • Develop area of cognition, language, socialization
  • special education
  • behaviour therapy