Aim Children with Down syndrome have delayed motor development relative to their peers. Estimates of this effect vary in the literature, from 40% of children walking independently by 24 months, to 50% of children walking by 1 year, and many possible causes have been suggested. In terms of management, early physiotherapy is popular with parents; moreover it is recommended, in part for future benefit, within Down syndrome guidelines in the UK, Europe and the USA. However, there is increasing opinion that children with Down syndrome do not benefit from routine physiotherapy and, as such, it is not routinely offered to all children in the UK.
The aim of this retrospective study was to identify whether children with Down syndrome who received physiotherapy had an earlier age of independent walking than those who did not.
Methods The database of children attending the Down syndrome clinic at St George’s Hospital (United Kingdom) was reviewed. Motor outcome was measured by the age at which healthy children achieved independent walking. Comparative testing was performed between the group that received physiotherapy versus those who did not.
Results Results did not demonstrate any significant difference in walking age between the physiotherapy group (n = 11) who walked at a mean of 27.7 months, compared with the non-physiotherapy group (n = 18) who walked at a mean of 22.6 months (p = 0.09). When measuring the number of patients who were mobile at the age of 2 years, 55% of patients who received physiotherapy were walking independently, versus 66% of patients who did not receive physiotherapy.
Conclusion Early physiotherapy was not associated with earlier age of walking in children with Down syndrome. This supports our current local practice that physiotherapy should not be offered routinely, and is in contrast with the major guidelines on management of Down syndrome. The observations from this study demonstrate a pressing need for further research, which should be prospective and multi-centre in nature.
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