Physical Therapy.

Down syndrome (Trisomy 21) is a commonly encountered condition by a pediatric physical therapists. It is a chromosomal disorder that leads to 47 chromosomes instead of the normal 46. The 21st chromosome is affected due to nondisjunction (95%), translocation (3-4%), or mosaic presentation (1%).

The condition can cause neuromotor, musculoskeletal, and cardiopulmonary disorders, visual/auditory/speech deficits, intellectual disabilities, and developmental delays. The brain weight is less as compared to normal and there is micro brachycephaly (abnormally round and short brain with less anteroposterior diameter) and reduced convoluted pattern. Children have linear growth deficits, reduced growth velocity, hypotonia, and ligamentous laxity (risk of subluxations/dislocations).

Typical features include the back of the head is slightly flattened, large fontanels, areas of hair loss, dry/rough skin, flat face contour, a small nose, depressed nasal bridge, narrow and slightly slanted eyelids, small mouth, narrow palate, furrowed shaped...

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