Investigation of Cardiopulmonary Parameters, Motor Development and Muscle Strength in DS With and Without CHD

Study Overview
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Brief Summary
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Congenital heart diseases (CHD) are detected in 40-60% of individuals with Down syndrome (DS) and increase the risk of developmental delay in the presence of syndromes. The aim of the study was to compare cardiopulmonary parameters, gross motor development and hand grip strength in DS children with and without CHD. Demographic variables, cardiopulmonary parameters and echocardiographic values were recorded. Gross motor development was evaluated with Gross Motor Function Measure (GMFM-88). Hand grip strength was measured with the Baseline Pneumatic Bulb Dynamometer.

Official Title
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Investigation of Cardiopulmonary Parameters, Motor Development and Muscle Strength in Children With Down Syndrome With and Without Congenital Heart Disease

Conditions
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Congenital Heart Defects, Down Syndrome, Gross Motor Development Delay

Intervention / Treatment
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* Diagnostic Test: evaluation of cardiopulmonary parameters, gross motor development and hand grip strength


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| with Congenital heart diseases<br> | Diagnostic Test: evaluation of cardiopulmonary parameters, gross motor development and hand grip strength<br>* Gross motor development was evaluated with Gross Motor Function Measure (GMFM-88). Hand grip strength was measured with the Baseline Pneumatic Bulb Dynamometer. Cardiopulmonary parameters values was evaluated with echocardiography.<br>|
| without Congenital heart diseases<br> | Diagnostic Test: evaluation of cardiopulmonary parameters, gross motor development and hand grip strength<br>* Gross motor development was evaluated with Gross Motor Function Measure (GMFM-88). Hand grip strength was measured with the Baseline Pneumatic Bulb Dynamometer. Cardiopulmonary parameters values was evaluated with echocardiography.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gross Motor Function Measure-88 | Gross motor development of the participants was evaluated with the Gross Motor Function Measure-88 questionnaire. The value as a percentage was obtained as a result of the survey. Gross Motor Function Measure-88 consists of 5 sections that include the evaluation of Lying & Rolling, Sitting, Crawling & Kneeling, Standing, Walking, Running & Jumping activities. Each item in the sections consists of a 4-point scale. Scores for each section are summed and divided by 5.The maximum score on the scale is 100. A high score indicates good gross motor development. 0 = does not initiate = initiates = partially completes = completes | october 2020- june 2021 | 
| Bulb Dynamometer | Hand grip strength was measured with a Baseline Pneumatic Bulb Dynamometer (Fabrication Enterprises INC, Elmsford, NY USA). With a bulb dynamometer, the spherical grip force is measured using a rubber balloon tip. The bulb dynamometer has 3 removable sizes. The values measured on the manometer are recorded in kPa. The measurement is repeated 3 times and the highest value is taken. | october 2020- june 2021 | 
| Left ventricular ejection fraction (EF) | Echocardiographic findings performed in the last 6 months were evaluated by a pediatric cardiologist. It is obtained by dividing the difference in left ventricular volume at end-diastolic and end-systolic by the end-diastolic left ventricular volume. Left ventricular ejection fraction (EF) indicate the systolic function of the left ventricle. Ejection fraction value show as a percentage (%). The ejection fraction normal value is between 50 percent and 70 percent. | october 2020- june 2021 | 
| Interventricular septum wall thickness (IVS) | Echocardiographic findings performed in the last 6 months were evaluated by a pediatric cardiologist. It is important in the risk classification potential of left ventricular systolic function. Its value is show as millimeters (mm). | october 2020- june 2021 | 
| Left ventricular end-diastolic diameter (LVDd) | Echocardiographic findings performed in the last 6 months were evaluated by a pediatric cardiologist. It is important in the risk classification potential of left ventricular systolic function. Its value is show as millimeters (mm). | october 2020- june 2021 | 
| Fractional shortening (FS) | Echocardiographic findings performed in the last 6 months were evaluated by a pediatric cardiologist. Fractional shortening evaluates left ventricular systolic function. Fractional shortening value show as a percentage (%). The value of normal fractional shortening in children is between 28-44%. | october 2020- june 2021 | 
| Wang Respiratory Score | The Wang respiratory score assesses respiratory frequency, wheezing, retraction, and general condition. parameters are scored between 0-3 and summed. A higher score indicates that the situation is getting severe. | october 2020- june 2021 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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congenital heart defects, Down syndrome, motor skills