The Effects of Neuro-rehabilitation on the Quality of Motor Planning in Adolescents with Down’s Syndrome

The three intervention groups received neuro-rehabilitation therapy for 10 months, whilst the control group received standard therapy based on the curriculum of the Polish special education system. The standard therapy comprised physical education and adapted physical activity classes but did not include neuro-rehabilitation or physiotherapy. Group (G1) received one hour per week of neuro-rehabilitation therapy based on the Bobath Method and the SI Method. Group 2 (G2) received one hour per week of neuro-rehabilitation therapy based on the Bobath Method and the SI Method and additional, Children with Down’s syndrome played team sports and movement games wearing the dynamic orthosis during the hour after a neuro- rehabilitation session. Group 3 (G3) received one hour per week neuro-rehabilitation therapy based on the Bobath Method and the SI Method and additional, Children with Down’s syndrome played team sports and movement games wearing the dynamic orthosis during the hour after a neuro-rehabilitation session, and after it, therapy was supplemented and fixed by use of kinesiology tape. Application if kinesiology tape was held 4-6 days. The control group (G4) received one hour per week of general development and corrective gymnastics, conducted by physiotherapist or teacher of physical education, according to the curriculum in a special school. Each test group received the intervention of one on one (physiotherapist – person with DS). The aim of Bobath Method [Neurodevelopmental Treatment (NDT)] was normalisation of postural tension, which affects development of central stabilisation. Modification of alignment of various segments of the body, focused on crucial points (head, shoulder and pelvic girdle) and control points (upper and lower limbs) was used to promote changes in postural and motor habits. Techniques included provision of effective support as well as basic (suppression and priming) and special (pressure, traction, placing, alternative tapping, inhibitory tapping, pressure tapping, sweep tapping, push-pull) techniques. Physio balls, rollers, mattresses and mirrors were used as required. The intervention also included techniques based on the SI Method. The main objective of this type of neuro-rehabilitation is to provide controlled exposure to sensory stimuli, especially vestibular, proprioceptive and haptic stimuli, to facilitate an adaptive reaction. To promote effective organisation of the CNS at synaptic level and thus ensure that sensory information is processed appropriately children are encouraged to perform complex motor tasks; the tasks are designed to be appealing to children. Therapy based on this technique is thought to improve sensorimotor coordination. Supports are adjusted according to the participant’s developmental level. Two-piece suit (shorts and jacket with elastic bands tension (Dunag) – Adeli suit. Elastic bands, are minimal tensioned from shoes, through the knees, hips, torso until your shoulders. Increased pressure on the articular surfaces cause proprioceptive stimulation in normal postural and motor patterns. As a result, a muscle activity directed against the acting force of gravity, resulting in normalization of muscular tension. Children suits enable the children to better “feel” their body, allowing them to function better. Children wearing these suits feel the tension on their body and this then also allows them to perform better at physical tasks. In study kinesiology taping was used try to enhance central stabilisation and lower limb control. To achieve the desired effect kinesiology taping was used in conjunction with techniques targeting use of the rectus abdominis muscle and obliquus externus abdominis muscle, mechanical correction of the position of the genu valgum, correction of the position of the Achilles tendon, functional application of kinesiology taping for the dorsiflexion of the foot, mechanical correction consisting in static stabilisation of flat-foot.