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The Young Athlete with Down Syndrome

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Book cover Spinal Injuries and Conditions in Young Athletes

Part of the book series: Contemporary Pediatric and Adolescent Sports Medicine ((PASM))

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Abstract

Participation in sports is important for the physical and emotional health of physically and mentally challenged children. Before participation in sports, several questions need to be answered: (1) Is the child ready to participate? (2) What types of sports are appropriate? (3) What are the advantages/disadvantages of specific sports? Each child with Down syndrome (DS) must undergo a careful pre-participation evaluation by an individual trained and experienced with the medical and orthopedic comorbidities associated with DS. Important medical factors relevant to sports participation by children with DS include hearing loss, cardiovascular disorders, pulmonary hypoplasia, obesity, and musculoskeletal problems. Approximately 20 % of children with DS suffer from musculoskeletal pathology, secondary to abnormal collagen leading to ligamentous laxity and decreased muscle tone. Children with DS commonly suffer from abnormalities of the cervical spine, hip, patellofemoral joint, and feet. Most athletes with DS can participate safely in several sports if appropriately screened, supervised, and matched. Children with DS should be encouraged to participate in sport at all levels because of the well-recognized psychological and medical benefits.

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References

  1. Down J. Observation on the ethnic classification of idiots. London: London Hospital; 1866.

    Google Scholar 

  2. Roizen NJ, Patterson D. Down’s syndrome. Lancet. 2003 Apr 12;361(9365):1281–9.

    Article  PubMed  Google Scholar 

  3. Sanyer ON. Down syndrome and sport participation. Curr Sports Med Rep. 2006 Dec;5(6):315–8.

    Article  PubMed  Google Scholar 

  4. Weijerman ME, de Winter JP. Clinical practice. The care of children with Down syndrome. Eur J Pediatr. 2010 Dec;169(12):1445–52.

    Article  PubMed  Google Scholar 

  5. Caird MS, Wills BP, Dormans JP. Down syndrome in children: the role of the orthopaedic surgeon. J Am Acad Orthop Surg. 2006 Oct;14(11):610–9.

    PubMed  Google Scholar 

  6. Mik G, Gholve PA, Scher DM, Widmann RF, Green DW. Down syndrome: orthopedic issues. Curr Opin Pediatr. 2008 Feb;20(1):30–6.

    Article  PubMed  Google Scholar 

  7. Ferrara MS, Buckley WE, McCann BC, Limbird TJ, Powell JW, Robl R. The injury experience of the competitive athlete with a disability: prevention implications. Med Sci Sports Exerc. 1992 Feb;24(2):184–8.

    Article  PubMed  CAS  Google Scholar 

  8. Patel DR, Greydanus DE. Sport participation by physically and cognitively challenged young athletes. Pediatr Clin North Am. 2010 Jun;57(3):795–817.

    Article  PubMed  Google Scholar 

  9. Birrer RB. The Special Olympics athlete: evaluation and clearance for participation. Clin Pediatr (Phila). 2004 Nov-Dec;43(9):777–82.

    Article  Google Scholar 

  10. Tassone JC, Duey-Holtz A. Spine concerns in the Special Olympian with Down syndrome. Sports Med Arthrosc. 2008 Mar;16(1):55–60.

    Article  PubMed  Google Scholar 

  11. Bergeron JW. Athletes with disabilities. Phys Med Rehabil Clin N Am. 1999 Feb;10(1):213–28, viii.

    Google Scholar 

  12. American Association on Intellectual and Developmental Disabilities. Intellectual disability: definition, classification, and systems of support. Washington: American Association on Intellectual and Developmental Disabilities; 2010.

    Google Scholar 

  13. Wind WM, Schwend RM, Larson J. Sports for the physically challenged child. J Am Acad Orthop Surg. 2004 Mar-Apr;12(2):126–37.

    PubMed  Google Scholar 

  14. Woodhouse JM, Adler P, Duignan A. Vision in athletes with intellectual disabilities: the need for improved eyecare. J Intellect Disabil Res. 2004 Nov;48(Pt 8):736–45.

    Google Scholar 

  15. John FM, Bromham NR, Woodhouse JM, Candy TR. Spatial vision deficits in infants and children with Down syndrome. Invest Ophthalmol Vis Sci. 2004 May;45(5):1566–72.

    Article  PubMed  Google Scholar 

  16. Hild U, Hey C, Baumann U, Montgomery J, Euler HA, Neumann K. High prevalence of hearing disorders at the Special Olympics indicate need to screen persons with intellectual disability. J Intellect Disabil Res. 2008 Jun;52(Pt 6):520–8.

    Google Scholar 

  17. Fernhall B, Pitetti KH, Rimmer JH, McCubbin JA, Rintala P, Millar AL, et al. Cardiorespiratory capacity of individuals with mental retardation including Down syndrome. Med Sci Sports Exerc. 1996 Mar;28(3):366–71.

    PubMed  CAS  Google Scholar 

  18. Krebs P. Mental retardation. In: Winnick J, editor. Human Kinetics. Champaign; 2000.

    Google Scholar 

  19. Jacob T, Hutzler Y. Sports-medical assessment for athletes with a disability. Disabil Rehabil. 1998 Mar;20(3):116–9.

    Article  PubMed  CAS  Google Scholar 

  20. Lai AM, Stanish WD, Stanish HI. The young athlete with physical challenges. Clinics in sports medicine. 2000 Oct;19(4):793–819.

    Article  PubMed  CAS  Google Scholar 

  21. American Academy of Pediatrics: health supervision for children with Down syndrome. Pediatrics. 2001 Feb;107(2):442–9.

    Article  Google Scholar 

  22. Davidson MA. Primary care for children and adolescents with Down syndrome. Pediatr Clin North Am. 2008 Oct;55(5):1099–111, xi.

    Google Scholar 

  23. Bull MJ. Health supervision for children with Down syndrome. Pediatrics. 2011 Aug;128(2):393–406.

    Article  PubMed  Google Scholar 

  24. Pitetti KH, Climstein M, Campbell KD, Barrett PJ, Jackson JA. The cardiovascular capacities of adults with Down syndrome: a comparative study. Med Sci Sports Exerc. 1992 Jan;24(1):13–9.

    Article  PubMed  CAS  Google Scholar 

  25. Dodd KJ, Shields N. A systematic review of the outcomes of cardiovascular exercise programs for people with Down syndrome. Arch Phys Med Rehabil. 2005 Oct;86(10):2051–8.

    Article  PubMed  Google Scholar 

  26. Ng DK, Chan CH, Cheung JM. Children with Down syndrome and OSA do not necessarily snore. Arch Dis Child. 2007 Nov;92(11):1047–8.

    PubMed  Google Scholar 

  27. Shott SR, Amin R, Chini B, Heubi C, Hotze S, Akers R. Obstructive sleep apnea: should all children with Down syndrome be tested? Arch Otolaryngol Head Neck Surg. 2006 Apr;132(4):432–6.

    Article  PubMed  Google Scholar 

  28. Brockmeyer D. Down syndrome and craniovertebral instability. Topic review and treatment recommendations. Pediatr Neurosurg. 1999 Aug;31(2):71–7.

    Article  Google Scholar 

  29. Atlantoaxial instability in Down syndrome: subject review. American Academy of Pediatrics Committee on Sports Medicine and Fitness. Pediatrics. 1995 Jul;96(1 Pt 1):151–4.

    Google Scholar 

  30. Pueschel SM. Clinical aspects of Down syndrome from infancy to adulthood. Am J Med Genet Suppl. 1990;7:52–6.

    PubMed  CAS  Google Scholar 

  31. Cremers MJ, Beijer HJ. No relation between general laxity and atlantoaxial instability in children with Down syndrome. J Pediatr Orthoped. 1993 May-Jun;13(3):318–21.

    Google Scholar 

  32. Burke SW, French HG, Roberts JM, Johnston CE, 2nd, Whitecloud TS, 3rd, Edmunds JO, Jr. Chronic atlanto-axial instability in Down syndrome. Bone Joint Surg Am. 1985 Dec;67(9):1356–60.

    Google Scholar 

  33. Davidson RG. Atlantoaxial instability in individuals with Down syndrome: a fresh look at the evidence. Pediatrics. 1988 Jun;81(6):857–65.

    PubMed  CAS  Google Scholar 

  34. Shikata J, Yamamuro T, Mikawa Y, Iida H, Kobori M. Atlanto-axial subluxation in Down’s syndrome. Int Orthop. 1989;13(3):187–92.

    Article  PubMed  CAS  Google Scholar 

  35. Cremers MJ, Ramos L, Bol E, van Gijn J. Radiological assessment of the atlantoaxial distance in Down’s syndrome. Arch Dis Child. 1993 Sep;69(3):347–50.

    Article  PubMed  CAS  Google Scholar 

  36. Diamond LS, Lynne D, Sigman B. Orthopedic disorders in patients with Down’s syndrome. Orthop Clin North Am. 1981 Jan;12(1):57–71.

    PubMed  CAS  Google Scholar 

  37. Platt LS. Medical and orthopaedic conditions in special olympics athletes. J Athl Train. 2001 Jan-Mar;36(1):74–80.

    PubMed  CAS  Google Scholar 

  38. Martel W, Tishler JM. Observations on the spine in mongoloidism. Am J Roentgenol Radium Ther Nucl Med. 1966 Jul;97(3):630–8.

    Article  PubMed  CAS  Google Scholar 

  39. Pizzutillo PD, Herman MJ. Cervical spine issues in Down syndrome. J Pediatr Orthop. 2005 Mar-Apr;25(2):253–9.

    Article  PubMed  Google Scholar 

  40. Roy M, Baxter M, Roy A. Atlantoaxial instability in Down syndrome–guidelines for screening and detection. J R Soc Med. 1990 Jul;83(7):433–5.

    PubMed  CAS  Google Scholar 

  41. Olympics S. Coaching guides: participation by individuals with Down syndrome who have Atlantoaxial instability. 2009. http://sports.specialolympics.org/specialo.org/Special_/English/Coach/Coaching/Basics_o/Down_Syn.htm.

  42. Cope R, Olson S. Abnormalities of the cervical spine in Down’s syndrome: diagnosis, risks, and review of the literature, with particular reference to the Special Olympics. South Med J. 1987 Jan;80(1):33–6.

    Article  PubMed  CAS  Google Scholar 

  43. Pueschel SM, Scola FH, Tupper TB, Pezzullo JC. Skeletal anomalies of the upper cervical spine in children with Down syndrome. J Pediatr Orthop. 1990 Sep-Oct;10(5):607–11.

    Article  PubMed  CAS  Google Scholar 

  44. Cremers MJ, Bol E, de Roos F, van Gijn J. Risk of sports activities in children with Down’s syndrome and atlantoaxial instability. Lancet. 1993 Aug 28;342(8870):511–4.

    Article  PubMed  CAS  Google Scholar 

  45. Pueschel SM, Findley TW, Furia J, Gallagher PL, Scola FH, Pezzullo JC. Atlantoaxial instability in Down syndrome: roentgenographic, neurologic, and somatosensory evoked potential studies. J Pediatr. 1987 Apr;110(4):515–21.

    Article  PubMed  CAS  Google Scholar 

  46. Pueschel SM, Scola FH, Pezzullo JC. A longitudinal study of atlanto-dens relationships in asymptomatic individuals with Down syndrome. Pediatrics. 1992 Jun;89(6 Pt 2):1194–8.

    Google Scholar 

  47. Morton RE, Khan MA, Murray-Leslie C, Elliott S. Atlantoaxial instability in Down’s syndrome: a five year follow up study. Arch Dis Child. 1995 Feb;72(2):115–8; discussion 8–9.

    Google Scholar 

  48. Wills BP, Dormans JP. Nontraumatic upper cervical spine instability in children. J Am Acad Orth Surgeons. 2006 Apr;14(4):233–45.

    Google Scholar 

  49. Uno K, Kataoka O, Shiba R. Occipitoatlantal and occipitoaxial hypermobility in Down syndrome. Spine (Phila Pa 1976). 1996 Jun 15;21(12):1430–4.

    Google Scholar 

  50. Karol LA, Sheffield EG, Crawford K, Moody MK, Browne RH. Reproducibility in the measurement of atlanto-occipital instability in children with Down syndrome. Spine (Phila Pa 1976). 1996 Nov 1;21(21):2463–7; discussion 8.

    Google Scholar 

  51. Pueschel SM. Should children with Down syndrome be screened for atlantoaxial instability? Arch Pediatr Adolesc Med. 1998 Feb;152(2):123–5.

    Article  PubMed  CAS  Google Scholar 

  52. Mitchell V, Howard R, Facer E. Down’s syndrome and anaesthesia. Paediatr Anaesth. 1995;5(6):379–84.

    Article  PubMed  CAS  Google Scholar 

  53. Harley EH, Collins MD. Neurologic sequelae secondary to atlantoaxial instability in Down syndrome. Implications in otolaryngologic surgery. Arch Otolaryngol Head Neck Surg. 1994 Feb;120(2):159–65.

    Article  PubMed  CAS  Google Scholar 

  54. Litman RS, Zerngast BA, Perkins FM. Preoperative evaluation of the cervical spine in children with trisomy-21: results of a questionnaire study. Paediatr Anaesth. 1995;5(6):355–61.

    Article  PubMed  CAS  Google Scholar 

  55. Hata T, Todd MM. Cervical spine considerations when anesthetizing patients with Down syndrome. Anesthesiology. 2005 Mar;102(3):680–5.

    Article  PubMed  Google Scholar 

  56. Bennet GC, Rang M, Roye DP, Aprin H. Dislocation of the hip in trisomy 21. J Bone Joint Surg Br. 1982;64(3):289–94.

    PubMed  CAS  Google Scholar 

  57. Shaw ED, Beals RK. The hip joint in Down’s syndrome. A study of its structure and associated disease. Clin Orthop Relat Res. 1992 May;(278):101–7.

    Google Scholar 

  58. Hresko MT, McCarthy JC, Goldberg MJ. Hip disease in adults with Down syndrome. J Bone Joint Surg Br. 1993 Jul;75(4):604–7.

    PubMed  CAS  Google Scholar 

  59. Aprin H, Zink WP, Hall JE. Management of dislocation of the hip in Down syndrome. Journal of pediatric orthopedics. 1985 Jul-Aug;5(4):428–31.

    Google Scholar 

  60. Beguiristain JL, Barriga A, Gent RA. Femoral anteversion osteotomy for the treatment of hip dislocation in Down syndrome: long-term evolution. J Pediatr Orthop B. 2001 Apr;10(2):85–8.

    PubMed  CAS  Google Scholar 

  61. Woolf SK, Gross RH. Posterior acetabular wall deficiency in Down syndrome. J Pediatric Orthop. 2003 Nov-Dec;23(6):708–13.

    Google Scholar 

  62. Katz DA, Kim YJ, Millis MB. Periacetabular osteotomy in patients with Down’s syndrome. J Bone Joint Surg Br. 2005 Apr;87(4):544–7.

    PubMed  CAS  Google Scholar 

  63. Sankar WN, Millis MB, Kim YJ. Instability of the hip in patients with Down Syndrome: improved results with complete redirectional acetabular osteotomy. J Bone Joint Surg Am. 2011 Oct 19;93(20):1924–33.

    Article  PubMed  Google Scholar 

  64. Merrick J, Ezra E, Josef B, Hendel D, Steinberg DM, Wientroub S. Musculoskeletal problems in Down Syndrome European Paediatric Orthopaedic Society Survey: the Israeli sample. J Pediatr Orthop B. 2000 Jun;9(3):185–92.

    Article  PubMed  CAS  Google Scholar 

  65. Mendez AA, Keret D, MacEwen GD. Treatment of patellofemoral instability in Down’s syndrome. Clin Orthop Relat Res. 1988 Sep;(234):148–58.

    Google Scholar 

  66. Hennequin M, Morin C, Feine JS. Pain expression and stimulus localisation in individuals with Down’s syndrome. Lancet. 2000 Dec 2;356(9245):1882–7.

    Article  PubMed  CAS  Google Scholar 

  67. Dugdale TW, Renshaw TS. Instability of the patellofemoral joint in Down syndrome. J Bone Joint Surg Am. 1986 Mar;68(3):405–13.

    PubMed  CAS  Google Scholar 

  68. Bettuzzi C, Lampasi M, Magnani M, Donzelli O. Surgical treatment of patellar dislocation in children with Down syndrome: a 3- to 11-year follow-up study. Knee Surg Sports Traumatol Arthrosc. 2009 Apr;17(4):334–40.

    Article  PubMed  Google Scholar 

  69. Diamond LS, Lynne D, Sigman B. Orthopedic disorders in patients with Down’s syndrome. Orthop Clin North Am. 1981 Jan;12(1):57–71.

    PubMed  CAS  Google Scholar 

  70. Stanisavljevic S, Zemenick G, Miller D. Congenital, irreducible, permanent lateral dislocation of the patella. Clin Orthop Relat Res. 1976 May;(116):190–9.

    Google Scholar 

  71. Livingstone B, Hirst P. Orthopedic disorders in school children with Down’s syndrome with special reference to the incidence of joint laxity. Clin Orthop Relat Res. 1986 Jun;(207):74–6.

    Google Scholar 

  72. Storen H. Congenital complete dislocation of patella causing serious disability in childhood: the operative treatment. Acta Orthop Scand. 1965;36(3):301–13.

    Article  PubMed  CAS  Google Scholar 

  73. Kocon H, Kabacyj M, Zgoda M. The results of the operative treatment of patellar instability in children with Down’s syndrome. J Pediatr Orthop B. 2012 Sep;21(5):407–10.

    Article  PubMed  Google Scholar 

  74. Crenshaw AH. Campbell’s Operative Orthopaedics. 4th ed. Saint Louis: The C-V Mosby Company; 1963.

    Google Scholar 

  75. Chrisman OD, Snook GA, Wilson TC. A long-term prospective study of the Hauser and Roux-Goldthwait procedures for recurrent patellar dislocation. Clin Orthop Relat Res. 1979 Oct;(144):27–30.

    Google Scholar 

  76. Fondren FB, Goldner JL, Bassett FH, 3rd. Recurrent dislocation of the patella treated by the modified Roux-Goldthwait procedure. A prospective study of forty-seven knees. J Bone Joint Surg Am. 1985 Sep;67(7):993–1005.

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, Massachusetts, USA

    Benjamin J. Shore MD, FRCSC

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  1. Benjamin J. Shore MD, FRCSC
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Correspondence to Benjamin J. Shore MD, FRCSC .

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Editors and Affiliations

  1. Division of Sports Medicine, Childrens Hospital Boston, Boston, Massachusetts, USA

    Lyle Micheli

  2. Division of Sports Medicine, Childrens Hospital Boston, Boston, Massachusetts, USA

    Cynthia Stein

  3. Division of Sports Medicine, Childrens Hospital Boston, Boston, Massachusetts, USA

    Michael O'Brien

  4. Division of Sports Medicine, Childrens Hospital Boston, Boston, Massachusetts, USA

    Pierre d’Hemecourt

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Shore, B. (2014). The Young Athlete with Down Syndrome. In: Micheli, L., Stein, C., O'Brien, M., d’Hemecourt, P. (eds) Spinal Injuries and Conditions in Young Athletes. Contemporary Pediatric and Adolescent Sports Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4753-5_14

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  • DOI: https://doi.org/10.1007/978-1-4614-4753-5_14

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