26 | Akwa | December 2022 / January 2023 / February 2023 Down Syndrome (DS) is a genetic disor- der that results from an abnormality in chromosome 21 and is the most preva- lent condition associated with intellec- tual and developmental disabilities. In addition to intellectual disability, most individuals with DS have physical disabil- ities such as hypotonic (overly relaxed) muscles, a greater prevalence of con- genital heart disease, ligamentous laxity, and obesity due to a sedentary lifestyle (Boer & Beer 2019). The already reduced muscular strength and cardiorespiratory fitness levels make exercise necessary. Promoting activity in a group setting can improve functional fitness in those with Down Syndrome so they may successfully complete activities of daily living (ADLs) and become more independent. While aquatic therapy may benefit this pop- ulation, aquatic group exercise classes can provide many of the same benefits in a more fun, relaxed environment that facilitates interpersonal communication. Some modifications may be necessary to certain exercise routines to promote aquatic safety and comfort among par- ticipants. Still, these are well worth it to improve the health and independence of those with Down Syndrome! Before we modify lesson plans, let’s take some time to review what Down Syndrome is by considering some com- mon signs and symptoms and target populations. Down Syndrome occurs in approximately 1 out of every 800 births worldwide (Bull 2020). While intellectual disability is a common fac- tor in those with DS, social functioning is often high compared to cognition. Physically, individuals with DS often have cardiac, respiratory, hearing, and growth abnormalities (Bull 2020). In addition, this population is at risk for hypertension, congenital heart disease (CHD), sleep apnea, hearing difficulties, and obesity. So, to prevent the profound impact of some of these conditions, integrate routine exercise into everyday life. The prevalence of Down Syndrome between males and females is roughly equal, with males slightly – but not sig- nificantly – higher. Now that we know the fundamentals of Down Syndrome, we can assess the ther- apies available today and make modifi- cations to accommodate this population. Since DS affects all areas of the body and life, multiple therapies and supple- mental treatments are usually needed to promote successful development and functioning. For example, social func- tioning is the least hindered in this pop- ulation. Still, due to facial abnormalities and macroglossia (an enlarged tongue), communication may be difficult and require the help of a speech therapist (ST). Often, multiple specialists, like physical therapists (PT), occupational therapists (OT), and exercise therapists, work with individuals to improve in a specific area (Hardee & Fetters 2017). For example, The PT targets physical movement, the OT focuses on activi- ties of daily living, and the ST concen- trates on speech/communication. These areas may intersect, but no one therapy encompasses all. These land-based alternatives are indi- vidually beneficial. The aquatic environ- ment provides a unique medium that can simultaneously target more than one, if not all, of these areas. Aquatic therapy can be used separately or in conjunction with land-based therapies. In addition to the water’s physical, emotional, cogni- tive, and social benefits, aquatic-based activities may offer an alternative to tra- ditional therapy realms. Costs of therapeutic treatment may vary greatly depending on the severity of one’s condition with DS. Still, the mean medical costs (outpatient, inpatient, and drug costs combined) for children with DS have been recorded at $36,363 for children ages 0-4 (Boulet et al. 2008). This value is variable; children with DS and heart abnormalities like a congenital heart disorder (CHD) often incur a much Let’s Get Physical! By Abigail Roop Making Group Exercise Available to Those with Down Syndrome
