Inclusion Criteria:  Diagnosed with Down syndrome as a result of genetic analysis, For the congenital heart disease group; undergoing cardiac surgery at least 6 months before the evaluation, diagnosed as CHD by a pediatric cardiologist based on echocardiographic findings, For the group without congenital heart disease, patients who have not undergone cardiac surgery, are asymptomatic with a septal defect smaller than 4-5 mm, are expected to close, and are hemodynamically normal by a pediatric cardiologist, Children whose families were informed about the study and gave written consent to participate in the study were included in the study.  Exclusion Criteria:  Having another genetic abnormality other than Down syndrome, undergoing surgery other than cardiac surgery, Having an orthopedic or neurological problem, Respiratory support, With atlantoaxial instability, Children with hematological disease were not included in the study.