The relationship between motor performance and femoral cartilage thickness in children with Down syndrome

  • Raikan BüyükavcıEmail author
  • Mehmet Akif Büyükavcı
  • Semra Aktürk
  • Feyzullah Necati Arslan
  • Derya Doğan
  • Sinem Kortay Canaloğlu
Original article


Down syndrome (DS) is a genetic disorder associated with mental and motor developmental delays in childhood. The aim of this study was to investigate the relationship of the femoral cartilage thickness with motor performance in children with Down syndrome (DS). A total of 39 children with DS in the age range of 12–42 months were included in the study (female/male: 21/18; mean age: 23.4 ± 8.2 months). Femoral cartilage thickness was measured with ultrasound in the medial and lateral condyles and intercondylar areas of both knees. Gross motor subtest scaled scores of the Bayley Scales of Infant and Toddler Development III were used for the motor performance assessment. There was a positive correlation between the gross motor scaled scores and the femoral cartilage thickness in both knee joints (p < .05; r = 0.415 for the right medial condyle; r = 0.323 for the right lateral condyle; r = 0.339 for the right intercondylar area; r = 0.369 for the left medial condyle; r = 0.364 for the left lateral condyle, and r = 0.590 for the left intercondylar area). The study demonstrated that the femoral cartilage thickness was positively correlated with gross motor functioning in children with DS.


Femoral cartilage thickness Gross motor function Down syndrome Bayley-III 


Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.


  1. 1.
    Down JLH (1866) Observations on an ethnic classification of idiots. Lond Hosp Rep 3:259–262Google Scholar
  2. 2.
  3. 3.
    Asim A, Kumar A, Muthuswamy S et al (2015) Down syndrome: an insight of the disease. J Bio med Sci 11:22–41Google Scholar
  4. 4.
    Glasson EJ, Sullivan SG, Hussain R et al (2002) The changing survival profile of people with Down’s syndrome: implications for genetic counselling. Clin Genet 62(5):390–393CrossRefPubMedGoogle Scholar
  5. 5.
    Ferry B, Gavris M, Tifrea C et al (2014) The bone tissue of children and adolescents with Down syndrome is sensitive to mechanical stress in certain skeletal locations: a 1-year physical training program study. Res Dev Disabil 35(9):2077–2084CrossRefPubMedGoogle Scholar
  6. 6.
    Kamalakar A, Harris JR, McKelvey DK et al (2014) Aneuploidy and skeletal health. Curr Osteoporos Rep 12:376–382CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Palisano RJ, Walter SD, Russell DJ et al (2001) Gross motor function of children with down syndrome: creation of motor growth curves. Arch Phys Med Rehabil 82(4):494–500CrossRefPubMedGoogle Scholar
  8. 8.
    Dupre C, Weidman-Evans E (2007) Musculoskeletal development in patients with Down syndrome. JAAPA 30(12):38–40CrossRefGoogle Scholar
  9. 9.
    Roizen NJ, Patterson D (2003) Down’s syndrome. Lancet 361(9365):1281–1289CrossRefPubMedGoogle Scholar
  10. 10.
    Bayley N (2005) Bayley scales of infant and toddler development, 3rd edn. Harcourt Assessments, San AntonioGoogle Scholar
  11. 11.
    Özçakar L, Tunç H, Öken Ö et al (2014) Femoral cartilage thickness measurements in healthy individuals: learning, practicing and publishing with TURK-MUSCULUS. J Back Musculoskelet Rehabil 27(2):117–124CrossRefPubMedGoogle Scholar
  12. 12.
    Ozturk GT, Malas FU, Yildizgoren MT et al (2015) Ultrasonographic assessment of the femoral cartilage thickness in patients with pes planus: a multicenter study by TURK-MUSCULUS. Am J Phys Med Rehabil 94:568–572CrossRefPubMedGoogle Scholar
  13. 13.
    Kilic G, Kilic E, Akgul O et al (2015) Ultrasonographic assessment of diurnal variation in the femoral condylar cartilage thickness in healthy young adults. Am J Phys Med Rehabil 94:297–303CrossRefPubMedGoogle Scholar
  14. 14.
    Carter DR, Beaupre´ GS (2001) Skeletal Function and form: mechanobiology of skeletal development, aging, and regeneration. Cambridge University Press, New YorkGoogle Scholar
  15. 15.
    Adiguzel E, Tok F, Ata E et al (2018) Ultrasonographic assessment of femoral cartilage thickness in patients with cerebral palsy. PMR 10:154–159CrossRefGoogle Scholar
  16. 16.
    Cathels BA, Reddihough DS (1993) The healthcare of young adults with cerebral palsy. Med J Aust 159:444–446PubMedGoogle Scholar
  17. 17.
    Kara M, Tiftik T, Öken Ö et al (2013) Ultrasonographic measurement of femoral cartilage thickness in patients with spinal cord injury. J Rehabil Med 45:145–148CrossRefPubMedGoogle Scholar
  18. 18.
    Patricia C. Winders PT (2003) The goal and opportunity of physical therapy for children with Down syndrome. In: Cohen WI (ed), Down syndrome: visions for the 21st Century. Wiley, New York, pp 203–214.
  19. 19.
    Windschall D, Trauzeddel R, Haller M et al (2016) Pediatric musculoskeletal ultrasound: age- and sex related normal B mode findings of the knee. Rheumatol Int 36:1569–1577CrossRefPubMedGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Department of Physical Medicine and Rehabilitation, Faculty of MedicineInonu UniversityMalatyaTurkey
  2. 2.Developmental and Behavioral Pediatrics UnitMalatya Education and Research HospitalMalatyaTurkey
  3. 3.Developmental and Behavioral Pediatrics Unit, Department of Pediatrics, Faculty of MedicineInonu UniversityMalatyaTurkey

Personalised recommendations