Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review
Open accessAbstract
Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions.Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome.Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO.Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities.Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.
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The DS neurodevelopmental phenotype encompasses deficits in executive function, working memory, motor coordination, and linguistic processing that emerge within the first postnatal months and influence academic, occupational, and adaptive functioning trajectories throughout the lifespan.
“This neurodevelopmental phenotype encompasses deficits in executive function, working memory, motor coordination, and linguistic processing - impairments that emerge within the first postnatal months and profoundly influence academic, occupational, and adaptive functioning trajectories throughout the lifespan (2-5).”
From Molecular and cellular processes disrupted in the early postnatal Down syndrome prefrontal cortex (2026) · cites this paper as [3]
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- Authors
- Jain, P. D., Nayak, A., Karnad, S. D., & Doctor, K. N.
- Affiliations
- Manipal Academy of Higher Education (IN)
- Corresponding author
- Nayak, Akshatha
- Venue
- Clinical and Experimental Pediatrics
- Publisher
- Korean Pediatric Society
- Published
- 2022-03-15
- Volume
- 65
- Issue
- 3
- Pages
- 142-149
- ISSN
- 1738-1061 (ISSN-L)
- 2713-4148
- PMC
- PMC8898616
- OpenAlex
- W3166272673
- Cited by
- 66
- References
- 23
- Citations by year
- 2026: 21 · 2025: 23 · 2024: 9 · 2023: 9 · 2022: 3 · 2021: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Korean Journal of Pediatrics (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Keywords
- Down syndrome, balance disorders, motor delay, hypotonia, ligamentous laxity, postural control, compensatory strategies, children and adolescents, center of pressure displacement, trunk stiffness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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