Physiotherapy management of Down syndrome

Over the past century, the life expectancy of people born with Down syndrome has increased from 9 to 60 years, with data indicating that it could match the general population within a generation. This rapid increase in survival is largely due to earlier surgical correction of heart defects, better treatment of infections and improved general healthcare. This success, however, is tempered by the substantially higher risk and early onset of several chronic health conditions in adults with Down syndrome, particularly cognitive decline commencing in their early 40s.

Evidence-based clinical guidelines for the medical care of adults with Down syndrome were recently published, with one strong recommendation that screening for Alzheimer-type dementia start after the age of 40 years. By comparison, there are no known clinical practice guidelines to support physiotherapy management. The physiotherapy profession has much to offer people with Down syndrome: a wide breadth of practice spanning early infancy through to old age, unique contributions as part of a multidisciplinary team in managing chronic health conditions and, specifically, expertise in exercise and physical activity. Therefore, it is timely to review the available evidence to guide physiotherapists in their management of Down syndrome. This review focuses on the most recent evidence (published since 2000) from randomised controlled trials involving people with Down syndrome across their lifespan. It provides an evaluation of interventions that are either currently within the scope of, or could become part of, physiotherapy practice.