تدوین برنامه توانبخشی ورزشی در افراد با سندرم داون با توجه به عملکرد و ساختار بدنی(مدل ICF)

بحیرایی, سعید; امیری, رحمان

doi:10.22059/jsmdl.2023.351565.1689

نوع مقاله : مقاله مروری Released under CC BY-NC 4.0 license I Open Access I

نویسندگان

¹ گروه آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکدۀ تربیت بدنی و علوم ورزشی، دانشگاه شهید باهنر کرمان، کرمان، ایران.

² گروه آسیب شناسی ورزشی و حرکات اصلاحی ، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه گیلان، گیلان، ایران.

https://doi.org/10.22059/jsmdl.2023.351565.1689

چکیده

مقدمه: افراد با سندروم داون، دارای سطح فعالیت بدنی و آمادگی جسمانی پایین و شیوع بالایی از اختلالات اسکلتی– عضلانی هستند. هدف از این تحقیق، تدوین برنامة توانبخشی با توجه به مرور سیستم‌ها در عملکرد و ساختار بدنی این افراد است.
روش پژوهش: جست‌وجوی مقالات با تأکید بر «مرور سیستم‌ها» به‌عنوان پایه و اساس و با مرور کلی از «اثرات» که بر فعالیت‌های جسمانی تأثیر می‌گذارند، انجام گرفت. جست‌وجوها در پایگاه‌های اطلاعاتی پابمد، وب آوساینس، مدلاین، گوگل اسکالر، اسکوپوس با ترکیبی از کلمات کلیدی سندروم داون، عملکرد و ساختار بدن، شیوع اختلالات و فاکتورهای آمادگی جسمانی انجام گرفت. مطالعات با استفاده از معیارهای از پیش تعریف‌شدة ورود و خروج انتخاب شدند. پس از بررسی و مطالعة مقالات توصیه‌هایی برای محتوا و ارائة یک برنامۀ تمرین بر اساس مرور متون استخراج شد.
یافته‌ها: بر اساس نتایج و مرور، برنامة تمرینی توانبخشی برای این افراد تدوین شد. برنامة توانبخشی ورزشی به حداقل تجهیزات نیاز دارد و می‌تواند به‌طور مستقل اجرا شود. همچنین به‌طور مؤثر به بهبود الگوهای راه رفتن، قدرت، ثبات، تعادل، هماهنگی، استقامت و مشارکت در فعالیت‌های هدفمند و با افزایش استقلال منجر شود. این برنامه تمرینی را می‌توان سه بار در هفته، حدود یک ساعت در هر جلسه اجرا کرد.
نتیجه‌گیری: با توجه به تحلیل محتوا در عملکرد و ساختار بدنی منحصربه‌فرد فیزیولوژیکی، عصبی - عضلانی و سبک یادگیری افراد با سندروم داون، برنامۀ جامع توانبخشی ورزشی ارائه‌شده می‌تواند اختلالات حرکتی، فعالیت‌های عملکردی و مشارکت را بهبود بخشد.

کلیدواژه‌ها

عنوان مقاله [English]

Development of a Sports Rehabilitation Program for Individuals With Down Syndrome Based on Body Function and Structure (ICF model)

نویسندگان [English]

Saeid Bahiraei ¹
Rahman Amiri ²

¹ Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran.

² Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran

چکیده [English]

Introduction: Individuals with Down syndrome often exhibit low levels of physical activity and physical fitness, as well as a high prevalence of musculoskeletal disorders. Therefore, this study aimed to develop a sports rehabilitation program based on the systems review of the body function and structure of individuals with Down syndrome.
Methods: Articles were searched with an emphasis on "systems review" as a basis and with an overview of "effects" that affect physical activities for people with Down syndrome. Searches were conducted in PubMed, Web of Science, Medline, Google Scholar, and Scopus databases with a combination of keywords related to Down syndrome, body function and structure, the prevalence of disorders, and physical fitness factors. Studies were selected using predefined inclusion and exclusion criteria. After reviewing and studying the articles, recommendations for the content and presentation of an exercise program were extracted based on the literature review.
Results: Based on the results and reviews, the rehabilitation exercise program was developed for these people. The sports rehabilitation program requires minimal equipment and can be implemented independently. It also effectively leads to the improvement of gait patterns, strength, stability, balance, coordination, endurance, and participation in purposeful activities with increased independence. This exercise program can be performed three times a week for about an hour per session.
Conclusion: According to the content analysis of the unique body function and structure of physiological, neuromuscular, and learning styles of individuals with Down syndrome, the presented comprehensive sports rehabilitation program can improve movement disorders, functional activities, and participation.

کلیدواژه‌ها [English]

Down syndrome
Sports Rehabilitation
Musculoskeletal
Systems review

مراجع

Agiovlasitis, S., McCubbin, J. A., Yun, J., Widrick, J. J., & Pavol, M. J. (2015). Gait characteristics of adults with Down syndrome explain their greater metabolic rate during walking. Gait & Posture, 41(1), 180-184. https:// doi.org/10.1016/j.gaitpost.2014.10.004

Aghdaei, M., namazizadeh, M., & nezam kheir abadi, S. M. (2019). Effect of muscular endurance, coordination and combination exercises on fine motor skills of Down syndrome subjects. Journal for Research in Sport Rehabilitation, 7(13), 41-53. https:// doi.org/ 10.22084/rsr.2019.20302.1466 (In Persian)

Ahmadi, Z., & Ghasemzadeh, S. (2022). The Effectiveness of Aerobic Group Exercise-based Interventions Based on The Sensory Integration Theory on the Gross and Fine Motor Skills of Children with Down Syndrome. Journal of Exceptional Children, 22(1), 81-96. (In Persian)

Alsakhawi, R. S., & Elshafey, M. A. (2019). Effect of core stability exercises and treadmill training on balance in children with Down syndrome: randomized controlled trial. Advances in therapy, 36(9), 2364-2373. https:// doi.org/10.1007/s12325-019-01024-2

Angelopoulou, N., Matziari, C., Tsimaras, V., Sakadamis, A., Souftas, V., & Mandroukas, K. (2000). Bone mineral density and muscle strength in young men with mental retardation (with and without Down syndrome). Calcified Tissue International, 66(3), 176-180. https:// doi.org/10.1007/s002230010035

Antonarakis, S. E., Skotko, B. G., Rafii, M. S., Strydom, A., Pape, S. E., Bianchi, D. W., . . . Reeves, R. H. (2020). Down syndrome. Nature Reviews Disease Primers, 6(1), 1-20. https:// doi.org/10.1038/s41572-019-0143-7

Asher, A. (2008). Mental Wellness in Adults with Down Syndrome: A Guide to Emotional and Behavioral Strengths and Challenges (2006) (Vol. 75).

Bahiraei, S., & Daneshmandi, H. (2014). The Study of relationship between structural profiles and postural control in individual with Down syndrome. Journal of Practical Studies of Biosciences in Sport, 2(4), 21-32. https:// doi.org/10.22077/JPSBS.2014.19 (In Persian)

Bahiraei, S., Daneshmandi, H., & Sedaghati, P. (2017). The effect of a selective combined training program on motor performance, balance and muscle strength in boys with Down Syndrome (DS). Journal of Paramedical Sciences & Rehabilitation, 6(4), 40-45. https:// doi.org/10.22038/JPSR.2017.18646.1473 (In Persian)

Barnard, M., Swanepoel, M., Ellapen, T. J., Paul, Y., & Hammill, H. V. (2019). The health benefits of exercise therapy for patients with Down syndrome: A systematic review. African journal of disability, 8(1), 1-9.

Barnhart, R. C., & Connolly, B. (2007). Aging and Down syndrome: implications for physical therapy. Physical Therapy, 87(10), 1399-1406. https:// doi.org/10.2522/ptj.20060334

Bennet, G. C., Rang, M., Roye, D. P., & Aprin, H. (1982). Dislocation of the hip in trisomy 21. The Journal of Bone and Joint Surgery. British volume, 64(3), 289-294. https:// doi.org/10.1302/0301-620X.64B3.6212586

Bertapelli, F., Pitetti, K., Agiovlasitis, S., & Guerra-Junior, G. (2016). Overweight and obesity in children and adolescents with Down syndrome—prevalence, determinants, consequences, and interventions: a literature review. Research in developmental disabilities, 57, 181-192. https:// doi.org/10.1016/j.ridd.2016.06.018

Biely, S., Smith, S., & Silfies, S. P. (2006). Clinical instability of the lumbar spine: diagnosis and intervention. Orthopaedic Practice, 18(3(

Capone, G., Chicoine, B., Bulova, P., Stephens, M., Hart, S., & Crissman, B. (2018). Down Syndrome Medical Interest Group DSMIG-USA Adult Health Care Workgroup. Co-occurring medical conditions in adults with Down syndrome: a systematic review toward the development of health care guidelines. Am J Med Genet A, 176(1), 116-133. https:// doi.org/10.1002/ajmg.a.38512

Capone, G., Stephens, M., Santoro, S., Chicoine, B., Bulova, P., Peterson, M., . . . Workgroup, D. S. M. I. G. A. H. (2020). Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II. American journal of medical genetics Part A, 182(7), 1832-1845. https:// doi.org/10.1002/ajmg.a.61604

Carmeli, E., Kessel, S., Coleman, R., & Ayalon, M. (2002). Effects of a treadmill walking program on muscle strength and balance in elderly people with Down syndrome. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(2), M106-M110. https:// doi.org/10.1093/gerona/57.2.M106

Carothers, A. D., Hecht, C. A., & Hook, E. B. (1999). International variation in reported livebirth prevalence rates of Down syndrome, adjusted for maternal age. Journal of medical genetics, 36(5), 386-393.http://dx.doi.org/10.1136/jmg.36.5.386

Clark, C., Patel, H., Kanekar, S., & Isildak, H. (2017). Enlarged vestibular aqueducts and other inner-ear abnormalities in patients with Down syndrome. The Journal of Laryngology & Otology, 131(4), 298-302. https:// doi.org/10.1017/S0022215116009786

Concolino, D., Pasquzzi, A., Capalbo, G., Sinopoli, S., & Strisciuglio, P. (2006). Early detection of podiatric anomalies in children with Down syndrome. Acta Paediatrica, 95(1), 17-20. https:// doi.org/10.1111/j.1651-2227.2006.tb02174.x

Doyle, L., Saunders, K. J., & Little, J.-A. (2016). Trying to see, failing to focus: near visual impairment in Down syndrome. Scientific reports, 6(1), 1-10. https:// doi.org/10.1038/srep20444

Dugdale, T. W., & Renshaw, T. (1986). Instability of the patellofemoral joint in Down syndrome. The Journal of Bone and Joint surgery. American Volume, 68(3), 405-413.

Dumont, G. D. (2016). Hip instability: current concepts and treatment options. Clinics in Sports Medicine, 35(3), 435-447. https://doi.org/10.1016/j.csm.2016.02.008

Farpoor, M., & Nazem, F. (2022). The role of the Aerobic Interval Exercise Training on the Lung Function Profile in Adolescent Girls With Different Body Composition Index. Jundishapur Scientific Medical Journal, 20(6), 566-575. (In Persian)

Fernhall, B., McCubbin, J. A., Pitetti, K. H., Rintala, P., Rimmer, J. H., Millar, A. L., & De Silva, A. (2001). Prediction of maximal heart rate in individuals with mental retardation. Medicine and science in sports and exercise, 33(10), 1655-1660. https:// doi.org/ 0195-9131/01/3310-1655/$3.00/0

Fernhall, B., Mendonca, G. V., & Baynard, T. (2013). Reduced work capacity in individuals with Down syndrome: a consequence of autonomic dysfunction? Exercise and sport sciences reviews, 41(3), 138-147. https:// doi.org/ 10.1097/JES.0b013e318292f408

Foley, C., & Killeen, O. G. (2019). Musculoskeletal anomalies in children with Down syndrome: an observational study. Archives of disease in childhood, 104(5), 482-487. https:// doi.org/10.1136/archdischild-2018-315751

Friedman, C., & Feldner, H. A. (2018). Physical therapy Services for People with intellectual and developmental disabilities: The role of Medicaid home-and community-based service waivers. Physical Therapy, 98(10), 844-854. https://doi.org/10.1093/ptj/pzy082

Fritz, J. M., Cleland, J. A., & Childs, J. D. (2007). Subgrouping patients with low back pain: evolution of a classification approach to physical therapy. journal of orthopaedic & sports physical therapy, 37(6), 290-302 https://www.jospt.org/doi/10.2519/jospt.2007.2498

Glasson, E. J., Sullivan, S. G., Hussain, R., Petterson, B., Montgomery, P. D., & Bittles, A. H. (2002). The changing survival profile of people with Down's syndrome: implications for genetic counselling. Clinical genetics, 62(5), 390-393. https:// doi.org/10.1034/j.1399-0004.2002.620506.x

Hauck, J. L., Felzer-Kim, I. T., & Gwizdala, K. L. (2020). Early movement matters: Interplay of physical activity and motor skill development in infants with Down syndrome. Adapted Physical Activity Quarterly, 37(2), 160-176. https://doi.org/10.1123/apaq.2019-0012

Hresko, M. T., McCarthy, J. C., & Goldberg, M. J. (1993). Hip disease in adults with Down syndrome. The Journal of Bone and Joint Surgery. British volume, 75(4), 604-607

Janicki, J. A., & Alman, B. (2007). Scoliosis: Review of diagnosis and treatment. Paediatrics & child health, 12(9), 771-776. https://doi.org/10.1093/pch/12.9.771

Jones, J. T., Smith, C., & Talib, N. (2021). Assessment of Down syndrome-associated arthritis: a survey of Down syndrome clinic providers. Global Pediatric Health, 8, 2333794X21999134. https:// doi.org/10.1177/2333794X21999134

Jones, J. T., Talib, N., Lovell, D., & Becker, M. L. (2019). Clinical features and treatment of Down syndrome arthropathy: experience from two US tertiary hospitals. Pediatric Drugs, 21(1), 33-39. https:// doi.org/10.1007/s40272-018-0322-0

Kageleiry, A., Samuelson, D., Duh, M. S., Lefebvre, P., Campbell, J., & Skotko, B. G. (2017). Out‐of‐pocket medical costs and third‐party healthcare costs for children with Down syndrome. American journal of medical genetics Part A, 173(3), 627-637. https:// doi.org/10.1002/ajmg.a.38050

Kashi, A., Sheikh, M., Dadkhah, A., Hemayattalab, R., & Arabameri, E. (2015). The effect of “Kashi Practices” on the improvement of psycho-motor skills in people with down syndrome. Iranian Rehabilitation Journal 2015; 13 (3) :14-22

Kashi, A., Sheikh, M., Dadkhah, A., Hemayattalab, R., & Arabameri, E. (2015). The effect of selected exercise training on reduce symptom of hypotonia and changing body composition in men with Down syndrome. Journal of Sports and Motor Development and Learning, 7(3), 269-294. https://doi.org/10.22059/jmlm.2015.55913 (In Persian)

Kawar, M. J., Frick, S. M., & Frick, R. (2005). Astronaut Training: A sound activated vestibular-visual protocol for moving, looking & listening: Vital Links.

King, P., & Tulloh, R. (2011). Management of pulmonary hypertension and Down syndrome. International Journal of Clinical Practice, 65, 8-13. https:// doi.org/10.1111/j.1742-1241.2011.02823.x

Krinsky-McHale, S. J., Jenkins, E. C., Zigman, W. B., & Silverman, W. (2012). Ophthalmic disorders in adults with Down syndrome. Current Gerontology and Geriatrics Research, 2012. https:// doi.org/10.1155/2012/974253

Krinsky‐McHale, S. J., Silverman, W., Gordon, J., Devenny, D. A., Oley, N., & Abramov, I. (2014). Vision deficits in adults with Down syndrome. Journal of Applied Research in Intellectual Disabilities, 27(3), 247-263. https:// doi.org/10.1111/jar.12062

Li, C., Chen, S., How, Y. M., & Zhang, A. L. (2013). Benefits of physical exercise intervention on fitness of individuals with Down syndrome: a systematic review of randomized-controlled trials. International Journal of Rehabilitation Research, 36(3), 187-195. https:// doi.org/10.1097/MRR.0b013e3283634e9c

Looper, J., & Ulrich, D. A. (2010). Effect of treadmill training and supramalleolar orthosis use on motor skill development in infants with Down syndrome: a randomized clinical trial. Physical Therapy, 90(3), 382-390. https:// doi.org/10.2522/ptj.20090021

Madhok, S. S., & Shabbir, N. (2020). Hypotonia.

Mahy, J., Shields, N., Taylor, N., & Dodd, K. (2010). Identifying facilitators and barriers to physical activity for adults with Down syndrome. Journal of Intellectual Disability Research, 54(9), 795-805. https:// doi.org/10.1111/j.1365-2788.2010.01308.x

Maïano, C., Hue, O., Lepage, G., Morin, A. J., Tracey, D., & Moullec, G. (2019). Do exercise interventions improve balance for children and adolescents with Down syndrome? A systematic review. Physical Therapy, 99(5), 507-518. https:// doi.org/10.1093/ptj/pzz012

Méndez, A. A., Keret, D., & MacEwen, G. D. (1988). Treatment of patellofemoral instability in Down's syndrome. Clinical orthopaedics and related research(234), 148-158

Mendonca, G. V., Pereira, F. D., & Fernhall, B. (2010). Reduced exercise capacity in persons with Down syndrome: cause, effect, and management. Therapeutics and clinical risk management, 6, 601–610 https:// doi.org/10.2147/TCRM.S10235

Meuwese-Jongejeugd, A. (2006). Hearing Impairment in Adults with an Intellectual Disability: epidemiology and rehabilitation.

Mohammadi, B. (2015). The effect of core stability training on static and dynamic balance in children Down’s syndrome. Journal for Research in Sport Rehabilitation, 3(5), 51-58. (In Persian)

Nordstrøm, M., Hansen, B. H., Paus, B., & Kolset, S. O. (2013). Accelerometer-determined physical activity and walking capacity in persons with Down syndrome, Williams syndrome and Prader–Willi syndrome. Research in developmental disabilities, 34(12), 4395-4403. https:// doi.org/10.1016/j.ridd.2013.09.021

Penrose, L. (1949). The incidence of mongolism in the general population. Journal of Mental Science, 95(400), 685-688. https:// doi.org/10.1192/bjp.95.400.685

Perotti, L., Abousamra, O., Del Pilar Duque Orozco, M., Rogers, K., Sees, J., & Miller, F. (2018). Foot and ankle deformities in children with Down syndrome. Journal of Children's Orthopaedics, 12(3), 218-226. https:// doi.org/10.1302/1863-2548.12.170197

Phillips, A. C., & Holland, A. J. (2011). Assessment of objectively measured physical activity levels in individuals with intellectual disabilities with and without Down's syndrome. PloS one, 6(12), e28618. https:// doi.org/10.1371/journal.pone.0028618

Pitetti, K. H., Climstein, M., Mays, M. J., & Barrett, P. J. (1992). Isokinetic arm and leg strength of adults with Down syndrome: a comparative study. Archives of physical medicine and rehabilitation, 73(9), 847-850. https:// doi.org/10.5555/uri:pii:000399939290157R

Proske, U., & Gandevia, S. C. (2012). The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiological reviews. https://doi.org/10.1152/physrev.00048.2011

Rahman, M., & Fatema, K. (2019). Seizures in Down Syndrome: An Update. Mymensingh Medical Journal: MMJ, 28(3), 712-715.

Rahmani, P., Shahrokhi, H., & Daneshmandi, H. (2012). The study of relationship spinal abnormalities with flexibility and body composition in down syndrome girls. Journal of Research in Rehabilitation Sciences, 8(4), 754-763. (In Persian)

Richards, B., & Enver, F. (1979). Blood pressure in Down's syndrome. Journal of mental deficiency research, 23(2), 123-135. https:// doi.org/10.1111/j.1365-2788.1979.tb00049.x

Rigoldi, C., Galli, M., & Albertini, G. (2011). Gait development during lifespan in subjects with Down syndrome. Research in developmental disabilities, 32(1), 158-163. https:// doi.org/10.1016/j.ridd.2010.09.009

Ruiz‐González, L., Lucena‐Antón, D., Salazar, A., Martín‐Valero, R., & Moral‐Munoz, J. (2019). Physical therapy in Down syndrome: systematic review and meta‐analysis. Journal of Intellectual Disability Research, 63(8), 1041-1067. https:// doi.org/10.1111/jir.12606

Saeid, B., Hassan, D., & Noureddin, K. (2014). The relationship between alignment of upper limb and postural control in adolescents with Down Syndrome. Sports Medicine Journal/Medicina Sportivâ, 10(2)

Sarlak, Z., & Kashi, A. (2013). Effect of selected exercise training program on cardiovascular function in adults with Down syndrome. Sport Physiology, 5(19), 15-32. (In Persian)

Sayadinezhad T, Abdolvahab M, Akbarfahimi M, Jalili M, Rafiee S, Baghestani A R.(2013) The study of the effect of progressive resistance training on functional balance of 8-12 years old children with Down syndrome. Mrj, 7 (1) :29-33. (In Persian)

Schenkman, M., Deutsch, J. E., & Gill-Body, K. M. (2006). An integrated framework for decision making in neurologic physical therapist practice. Physical Therapy, 86(12), 1681-1702. https:// doi.org/10.2522/ptj.20050260

Shokati, F., Norasteh, http://www.medrehab.sbmu.ac.ir/article_1100734.html?lang=enA. A., & Daneshmandi, H. (2019). Effect of vestibular stimulation exercises on motor proficiency in down syndrome Children. The Scientific Journal of Rehabilitation Medicine, 8(4), 257-268. https:// doi.org/10.22037/JRM.2019.111462.2010 (In Persian)

Seidel, M. (2005). The international classification of functioning, disability and health. Der Nervenarzt, 76(1), 79-90; quiz 91.

Stein, D. S. (2016). Supporting Positive Behavior in Children and Teens with Down Syndrome: The Respond But Don't React Method: Woodbine House.

Tartavoulle, T. M., Karpinski, A. C., Aubin, A., Kluger, B. M., Distler, O., & Saketkoo, L. A. (2018). Multidimensional fatigue in pulmonary hypertension: prevalence, severity and predictors. ERJ open research, 4(1).https:// doi.org/ 10.1183/23120541.00079-2017

Tomlinson, C., Campbell, A., Hurley, A., Fenton, E., & Heron, N. (2020). Sport preparticipation screening for asymptomatic atlantoaxial instability in patients with Down syndrome. Clinical Journal of Sport Medicine, 30(4), 293-295. https:// doi.org/ 10.1097/JSM.0000000000000642

Tsimaras, V. K., & Fotiadou, E. G. (2004). Effect of training on the muscle strength and dynamic balance ability of adults with down syndrome. Journal of strength and conditioning research, 18(2), 343-347.

Villarroya, M. A., González-Agüero, A., Moros-García, T., de la Flor Marín, M., Moreno, L. A., & Casajús, J. A. (2012). Static standing balance in adolescents with Down syndrome. Research in developmental disabilities, 33(4), 1294-1300. https://doi.org/10.1016/j.ridd.2012.02.017

Wlodek, D., & Gonzales, M. (2003). Decreased energy levels can cause and sustain obesity. Journal of theoretical biology, 225(1), 33-44. https:// doi.org/10.1016/S0022-5193(03)00218-2

رشد و یادگیری حرکتی ورزشی

تدوین برنامه توانبخشی ورزشی در افراد با سندرم داون با توجه به عملکرد و ساختار بدنی(مدل ICF)

مراجع

مراجع

دوره 15، شماره 2
تیر 1402
صفحه 69-93

تدوین برنامه توانبخشی ورزشی در افراد با سندرم داون با توجه به عملکرد و ساختار بدنی(مدل ICF)

مراجع

مراجع

دوره 15، شماره 2تیر 1402صفحه 69-93

دوره 15، شماره 2
تیر 1402
صفحه 69-93