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Determinants of hand function in children and adolescent with Down Syndrome-A scoping review
Neha Padia1, Meruna Bose2, Shrutika Parab1
1MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India.
Insights
Children with Down syndrome (DS) exhibit physical traits affecting hand function, leading to reduced grip and pinch strength. Further research is needed to correlate upper extremity measurements with overall hand function in this population.
Area of Science:
- Genetics
- Human Physiology
- Developmental Pediatrics
Background:
- Down syndrome (DS) is a genetic condition characterized by specific physical traits.
- These traits, including short stature and hypotonia, impact upper extremity development.
- This can lead to diminished grip strength and impaired fine motor skills in individuals with DS.
Purpose of the Study:
- To review existing literature on the physical characteristics of the upper extremities in individuals with Down syndrome.
- To examine the influence of these physical characteristics on hand function.
- To identify gaps in current research regarding upper extremity anthropometry and hand function in DS.
Main Methods:
- A comprehensive scoping review of the literature was performed.
- Searches were conducted in PubMed, CINAHL, and Cochrane Library for English articles published between 2010 and 2021.
- The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) guided the protocol.
Main Results:
- Review of 28 articles indicated shortened humerus in fetuses with DS (9% below 5th percentile).
- Individuals with DS demonstrated significantly reduced grip strength (60%), palmar pinch strength (33%), and key pinch strength (20%).
- Increased trunk rotation during reaching and poorer manual dexterity were also reported in the DS population.
Conclusions:
- Physical characteristics of the upper extremity significantly influence hand function in children and adolescents with Down syndrome.
- Current research has quantified arm length and hand span in relation to grip strength.
- Future studies should investigate the correlation between broader upper extremity anthropometry and overall hand function in the DS population.
Background:
Down Syndrome (DS) is a genetic condition. Physical characteristics like short stature, hypotonia, small, and thick hands result in decreased grip and pinch strength and quality of fine motor tasks.
Purpose:
The purpose of this review is to summarize the evidence of upper extremity physical characteristics and its influence on hand function in DS population.
Study Design:
A scoping review.
Methodology:
A comprehensive electronic literature search was conducted through PubMed, CINAHL, Cochrane Library. The search was limited to articles written in English and published between 2010 to 2021. Additionally, books were referred for a better understanding of the hand function in DS. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) was adopted to develop the protocol.
Results:
Following a detailed review of 28 articles meeting the inclusion criteria, fetuses with a diagnosis of DS are reported to have shortening of humerus on sonographic markers wherein 9% of fetuses had below 5th percentile shortening. Additionally, literature reports that during reaching there was increased trunk rotation (effect size = 0.88). DS population had 60% less grip strength, 33% less palmar pinch strength ,20% less key pinch strength and poor manual dexterity (CI = 4.5-5.5).
Conclusion:
Findings of this review concludes that physical characteristics of the upper extremity have an influence on hand function performance in children and adolescents with DS.However, only arm length and hand span have been quantified and correlated with grip strength. Further work must focus on correlation of upper extremity anthropometry and overall hand function in children and adolscents with DS.
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