Effect of Neuro Developmental Therapy in Infants With Down Syndrome

Study Overview
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Brief Summary
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Neurodevelopmental treatments are a progressive therapeutic method experienced thru qualified therapists for the improvement in affected ones. The most important trial in Down syndrome children is motor milestones and postural reactions to develop on time. Neurodevelopmental therapy is applied to accurate atypical postural tone and to enable further regular motion for execution of presentation of abilities. Objective: To determine the effects of Neuro Developmental therapy in improving postural reaction and motor milestones in infants with Down syndrome.

Detailed Description
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This study was a randomized trial design. This study was conducted in Rehab Care Physiotherapy Department. 20 Children with Down syndrome meeting the predetermined inclusive and exclusive criteria were arbitrarily allocated into dual batches through convenient sampling technique. The first batch which was the experimental group was given Neurodevelopmental therapy and the duration of the treatment comprised of 1.5 hour, three days a week for 6 weeks. The second group which was the control group received conventional therapy and the period of the ministrations comprised of 1 hour, with 10 repetition 3 sets for each muscle three days a week for 1.5 months, Pre-assessment and post-assessment was evaluated through Gross motor function-88. Recorded values were analyzed through SPSS.

Official Title
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Effect of Neuro Developmental Therapy to Improve Postural Reactions and Motor Milestones in Infants With Down Syndrome

Conditions
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Down Syndrome

Intervention / Treatment
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* Other: conventional therapy
* Other: Neurodevelopmental therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Trisomy 21 by genetic karyotype. Down syndrome children with delayed milestone. Definite identification of Down syndrome by neurologist. Children having the average birth weight above 2.500 grams and average birth length above 49.52 cm. Laxity, low muscle tone and psychomotor development deficits Exclusion Criteria: Infants with Heart Defect. Seizure. Critical orthopedic difficulties or deformities (hip instability, patellar instability, foot deformity). Unrestrained thyroid conflicts. Perilabour asphyxia (Apgar of minutes 1 and 5 equal to or less than 7). Critical optical or acoustic disorders. Mass below the 3rd percentage of Down syndrome

Ages Eligible for Study
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Minimum Age: 5 Months
Maximum Age: 3 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: (Neurodevelopmental therapy)<br>Starting Posture Start and evaluate the supreme effective posture to move from(usually straight) Reassemble to mid plane (head/trunk) •Neutral position of body Identify the Missing Components Detect starting posture and compare to normal. Neurodevelopmental therapy application : Tonic postural extensor muscle strengthening: Push-pull scooter board games contrary to resistive tubing strips. Developmental movement patterns training: Obstacle crawl, hold swing's ropes in kneeling anhalf kneeling position, throw balls to aim kneeling and standing position. Manual Cues .Use hands on key points of control to assist normal posture, movement and prevent abnormal posture and movement. Balance and corrective reactions was established by means of ball and tilt board after the development of the skill of sustaining exercise positions in children.4. Ambulation training, suitable to the motor | Other: Neurodevelopmental therapy<br>* Starting Posture Start and evaluate the supreme effective posture to move from(usually straight) Reassemble to mid plane (head/trunk) Neutral position of body (47) Identify the Missing Components Detect starting posture and compare to normal.(47) Neurodevelopmental therapy application : Tonic postural extensor muscle strengthening: Push-pull scooter board games contrary to resistive tubing strips.(48) 2. Developmental movement patterns training: Obstacle crawl, hold swing's ropes in kneeling and half kneeling position, throw balls to aim kneeling and standing position. Manual Cues .Use hands on key points of control to assist normal posture, movement and prevent abnormal posture and movement. Balance and corrective reactions was established by means of ball and tilt board after the development of the skill of li<br>|
| Active Comparator: Conventional treatment<br>Range of motion and Resistance training Linear actions are used to regularize extensor muscle tone (Neck extensors, back extensors hip extensors, knee extensors).(49) Postural control exercises Bouncing on gym ball in sitting, kneeling, or standing Linear swinging using a platform and swing, glider, hammock, and barrel; swinging in the kneeling, standing, sitting, | Other: conventional therapy<br>* Range of motion and Resistance training Linear actions are used to regularize extensor muscle tone (Neck extensors, back extensors hip extensors, knee extensors).(49) Postural control exercises Bouncing on gym ball in sitting, kneeling, or standing - Linear swinging using a platform and swing, glider, hammock, and barrel; swinging in the kneeling, standing, sitting,<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gross Motor Function Measure-88(GMFM-88) | The GMFM-88 is the original 88-item measure. Items span the spectrum of gross motor activities in five dimensions. ... The GMFM-66 is a 66 item subset of the original 88 items identified through Rasch analysis to best describe the gross motor function of children with cerebral palsy of varying abilities. | 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Down syndrome, Children, Gross motor function, Neurodevelopmental treatment, Rehabilitation, Milestones, Postural reactions