title: Developing a Physical Therapy Initial Evaluation Screening Tool for a Multidisciplinary Clinic for Adults with Down Syndrome
Creators: name: Russell, Isabella
Publisher: name: University of Nevada, Las Vegas
Year: 2023

description: Purpose: Down syndrome (Ds) is a chromosomal condition that can result in intellectual disability, as well as structural or functional disorders impacting the nervous, cardiovascular, and musculoskeletal systems. As individuals with Ds age, they can have an increased number of comorbidities that impact their health. Physical therapy can play an important role in managing many of the comorbidities adults with Ds have. Therefore, there is an increased need for physical therapists to efficiently screen, evaluate and treat adults with Ds. The purpose of this work is to create an Initial Evaluation Screening Tool and Patient Intake Form for physical therapists that would aid the initial evaluation process and ensure all comorbidities are being evaluated and addressed in a multidisciplinary clinic. Materials/Methods: A literature review was conducted to identify common comorbidities seen in adults with Ds. We then used the International Classification of Functioning, Disability and Health (ICF) model to organize the information gathered in the literature review and generate questions for the interviews. The questions aimed to confirm our findings in literature and gain an understanding of how an evaluation with an individual with Ds is conducted from a clinical perspective. We conducted interviews with two physical therapists and a physician who had experience working with adults with Ds. After conducting the interviews, we created a visual representation of the ICF model that uses information from literature and interviews. We then created a tool that guides the physical therapist in an initial evaluation. Results: Information from the literature review and the interviews were complementary. There were different presentations of the general impairments found in literature that were only uncovered by interviewing experts. For example, “hypermobility” was found in literature, but clinically this can be presented as hip dislocations. Based on this information, we created an Initial Evaluation Screening Tool. A Patient Intake Form was supplementally created to help screen the individuals with Ds. These aim to guide physical therapists in their assessment of adults with Ds in the multidisciplinary clinic. Conclusion: The study led to the creation of an Initial Evaluation Screening Tool for the initial physical therapy evaluation of individuals with Ds. These guidelines included a Patient Intake Form with topics to cover and tests or outcome measures to use that are suitable and relevant for individuals with Ds. Further research should focus on utilizing these tools in the clinic and test if they are viable. Clinical Relevance: Even though Ds is the most common chromosomal condition associated with intellectual disabilities, this population experiences a lack of healthcare as they age into adulthood. The combination of lack of healthcare and research makes it difficult for physical therapists to evaluate and treat adults with Ds. Our Initial Evaluation Screening Tool can give physical therapists a useful and practical instrument, as well as confidence to provide care to adults with Ds.