Do Body Mass Index, Q Angle, and Pes Planus Affect Walking Age in Children with Down Syndrome and Their Typically Developing Peers?

Yıl 2022, , 571 - 576, 29.10.2022

Guliz Ertekin , İsmihan İlknur Uysal , Mehmet Sinan İyisoy

https://doi.org/10.54005/geneltip.1155681

Öz

Objective: To investigate the effects of body mass index (BMI), quadriceps angle (Q0) and pes planus on walking age in children with Down syndrome (DS) and typically developing peers.
Methods: Bodyweight, height and Q0 were measured and footprints were obtained in 50 children with DS and 50 typically developing children (control), ages between 2-6 years. BMI and Staheli index (SI) were calculated.
Results: The mean walking age was 26±8 months in the DS group and 12±2 months in the control group (p<0.0001). While BMI was 85 percent in all age groups in girls in the DS group, it increased with age in boys this group. SI was 1.17±0.28 in the DS group and 0.93±0.04 in the control group (p<0.001). Although there was no significant relationship between walking age and BMI, Q0, pes planus, the difference in walking age between the two groups decreased statistically as Q0 increased (p<0.001).
Conclusion: In the DS group, regular monitoring of BMI, keeping it within healthy limits, and adding exercises related to Q0 and pes planus to physical therapy programs will reduce the delay in walking age.

Anahtar Kelimeler

Body mass index, Down syndrome, Q angle, Walking age, Pes planus

Down Sendromlu Çocuklarda Ve Tipik Gelişim Gösteren Akranlarında Vücut Kitle İndeksi, Q Açısı Ve Pes Planus Yürüme Yaşını Etkiler Mi?

Öz

Amaç: Down sendromlu (DS) olan çocuklar ve tipik gelişime sahip yaşıtlarında vücut kitle indeksi (VKİ), kuadriseps açısı (Q0) ve pes planusun yürüme yaşı üzerine etkilerini araştırmak.
Yöntem: Yaşları 2-6 arasında 50 DS’lu çocuk (DS grubu) ve 50 tipik gelişim gösteren çocukda (kontrol grubu) vücut ağırlığı, boy uzunluğu ve Q açısı ölçüldü ve ayak izleri elde edildi. VKİ ve Staheli indeksi (SI) hesaplandı.
Bulgular: DS grubunda ortalama yürüme yaşı 26±8 ay, kontrol grubunda 12±2 ay idi (p<0.0001). VKİ, DS grubundaki kız çocuklarında tüm yaş gruplarında %85 iken, bu gruptaki erkek çocuklarda yaşla birlikte artış gösterdi. SI, DS grubunda 1.17±0.28 ve kontrol grubunda 0.93±0.04 idi (p<0.001). Yürüme yaşı ile VKİ, Q0, pes planus arasında anlamlı bir ilişki olmamasına rağmen, Q0 arttıkça iki grup arasındaki yürüme yaşı farkı istatistiksel olarak anlamlı azaldı (p<0.001).
Sonuç: DS grubunda VKİ'nin düzenli izlenmesi, sağlıklı sınırlarda tutulması ve fizik tedavi programlarına Q0 ve pes planus ile ilgili egzersizlerin eklenmesi yürüme yaşındaki gecikmeyi azaltacaktır.

Anahtar Kelimeler

Down sendromu, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Pes planus, Q açısı, Vücut kitle indeksi, Yürüme Yaşı

Kaynakça

• 1. Wang HY, Long IM, Liu MF. Relationships between task-oriented postural control and motor ability in children and adolescents with Down syndrome. Research in Developmental Disabilities. 2012;33(6):1792-8.
• 2. Galli M, Rigoldi C, Brunner R, Virji-Babul N, Giorgio A. Joint stiffness and gait pattern evaluation in children with Down syndrome. Gait Posture. 2008;28(3):502-6.
• 3. Boontan N, Rojnueangnit K. Growth patterns of Thai children with Down Syndrome from birth to 5 years. J Pediatr Genet. 2021;10(1):16-22.
• 4. Bull MJ. Down Syndrome. N Engl J Med. 2020;382(24):2344-52.
• 5. Rigoldi C, Galli M, Albertini G. Gait development during lifespan in subjects with Down syndrome. Res Dev Disabil. 2011;32(1):158-63.
• 6. Carmeli E, Ariav C, Bar-Yossef T, Levy R, Imam B. Movement skills of younger versus older adults with and without Down syndrome. Res Dev Disabil. 2012;33(1):165-71.
• 7. Tüysüz B, Topal Göknar N, Oztürk B. Growth charts of Turkish children with Down syndrome. Am J Med Genet A. 2012;158A(11):2656-64.
• 8. Bertapelli F, Pitetti K, Agiovlasitis S, Guerra-Junior G. Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: a literature review. Res Dev Disabil. 2016;57:181-92.
• 9. Bindayel IA. Relationship between Down syndrome (DS) and obesity in children and adolescents and its relation to dietary and lifestyle factors. Progress in Nutrition. 2021;23(4): e2021180.
• 10. Tudella E, Pereira K, Basso RP, Savelsbergh GJP. Description of the motor development of 3–12 month old infants with Down syndrome: the influence of the postural body position. Res Dev Disabil 2011;32:1514–20.
• 11. Foley C, Killeen OG. Musculoskeletal anomalies in children with Down syndrome: an observational study. Arch Dis Child. 2019;104(5):482-7.
• 12. Kanai Y, Mutsuzaki H, Watanabe M, et al. Use of malleoli as an indicator for flatfoot in patients with Down syndrome: development of a simple and non-invasive evaluation method through medial longitudinal arch. J Phys Ther Sci. 2020;32(5):315-8.
• 13. Smith TO, Hunt NJ, Donell ST. The reliability and validity of the Q-angle: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2008;16(12):1068-79.
• 14. Jaiyesimi AO, Jegede OO. Influence of gender and leg dominance on Q-angle among Adult Nigerians. Afr J Phys and Reh Sci. 2009;1:18−23.
• 15. Park SK, Stefanyshyn DJ. Greater Q angle may not be a risk factor of patellofemoral pain syndrome. Clin Biomech. 2011;26(4):392-6.
• 16. Cankaya T, Dursun Ö, Davazlı B, et al. Assessment of quadriceps angle in children aged between 2 and 8 years. Turk Pediatri Ars. 2020;55(2):124-30.
• 17. Havaslı F, Demir M, Ciçek M, Yoldas A. Association between Q angle and predisposition to gonarthrosis*. Anatomy 2017;11(1):21–25.
• 18. Rauh MJ, Koepsell TD, Rivara FP, Rıce SG, Margherita AJ. Quadriceps angle and risk of injury among high school cross-country runners. J Orthop Sports Phys Ther. 2007;37(12):725-33.
• 19. Antinolfi P, Bartoli M, Placella G, et al. Acute patellofemoral instability in children and adolescents. Joints. 2016;4(1):47–51.
• 20. Jimshad TU, Mainali S, Swethankh KS, John AT. Does Q angle change in spastic diplegia children? Indian J Pediatr 2016; 2: 85−9.
• 21. Hernandez AJ, Kimura LK, Laraya MHF, Favaro E. Calculation of staheli's plantar arch index and prevalence of flat feet: a study with 100 children aged 5-9 years. Acta Ortopédica Bras. 2007;2:68-71.
• 22. Neyzi O, Bundak R, Gokcay G, et al. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015;7(4):280-93.
• 23. Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults. J Bone Joint Surg Am. 1987;69(3):426-8.
• 24. Vicari S. Motor development and neuropsychological patterns in persons with Down syndrome. Behavior Genetics. 2006;36(3):355-64.
• 25. Yamauchi Y, Aoki S, Koike J, Hanzawa N, Hashimoto K. Motor and cognitive development of children with Down syndrome: The effect of acquisition of walking skills on their cognitive and language abilities. Brain Dev. 2019;41(4):320-6.
• 26. Corrado B, Sommella N, Ciardi G, et al. Can early physical therapy positively affect the onset of independent walking in infants with Down syndrome? A retrospective cohort study. Minerva Pediatr. 2022;74(1):31-9.
• 27. Cronk C, Crocker AC, Pueschel SM, et al. Growth charts for children with Down syndrome: 1 month to 18 years. Pediatrics. 1988;81:102-10.
• 28. Myrelid A, Gustafsson J, Ollars B, Anneren G. Growth charts for Down’s syndrome from birth to 18 years of age. Arch Dis Child. 2002;87:97-103.
• 29. Meguid NA, El-Kotoury AI, Abdel-Salam GM, El-Ruby MO, Afif HH. Growth charts of Egyptian children with Down syndrome (0–36 months). East Mediterr Health J. 2004;10:106–15.
• 30. Brattström H. Shape of the intercondylar groove normally and in recurrent dislocation of the patella. Acta Orthop Scand 1964;68:1-44.
• 31. Woodland LH, Francis RS. Parameters and comparisons of the quadriceps angle of collage-aged men and women in the supine and standing positions. Am J Sports Med. 1992; 20(2):208-211.
• 32. Mandigo JL, Livingston LA. Bilateral Q angle symetry and anterior knee pain syndrome. Clinical Biomechanics. 1999;14(1):7-13.
• 33. Ford SE, Scannell BP. Pediatric flatfoot: pearls and pitfalls. Foot Ankle Clin. 2017; 22(3):643–56.
• 34. Michaudet C, Edenfield KM, Nicolette GW, Carek PJ. Foot and ankle conditions: pes planus. FP Essent. 2018;465:18-23.
• 35. Carr 2nd CB, Yang S, Lather LA. Pediatric pes planus: A state of the art review. Pediatrics. 2016;137(3):e20151230.
• 36. Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics. 2006;118:634-9.
• 37. Bordin D, De Giorgi G, Rigon F. Flat and cavus foot, indexes of obesity and overweight in a population of primary-school children. Minerva Pediatr. 2001;53(1):7-13.
• 38. Pereira K, Basso RP, Lindquist AR, da Silva LGP, Tudella E. Infants with Down syndrome: percentage and age for acquisition of gross motor skills. Res Dev Disabil. 2013;34(3):894-901.
• 39. Concolino D, Pasquzzi A, Capalbo G, Sinopoli S, Strisciuglio P. Early detection of podiatric anomalies in children with Down syndrome. Acta Paediatr. 2006;95(1):17-20.