Assessment & Research

Postural strategies in Prader-Willi and Down syndrome patients.

Cimolin et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

Prader-Willi adults sway more forward-backward than Down syndrome adults, so both groups need balance checks and targeted training.

✓ Read this if BCBAs working with adults with Prader-Willi or Down syndrome in day or residential programs.
✗ Skip if Clinicians serving only typically developing clients or young children.

01Research in Context

01

What this study did

Cimolin et al. (2011) watched adults with Prader-Willi syndrome and Down syndrome stand still on a force plate. They measured tiny body wobbles in every direction.

The team compared the sway patterns to see which group had shakier balance.

02

What they found

Both groups wobbled more than adults without these syndromes. People with Prader-Willi swayed farther forward and backward than those with Down syndrome.

Side-to-side sway looked about the same for both groups.

03

How this fits with other research

Capodaglio et al. (2011) ran almost the same test and got the same result: Prader-Willi adults had the biggest forward-backward sway. This direct match boosts confidence in the finding.

Galli et al. (2011) compared Prader-Willi adults to adults with Ehlers-Danlos syndrome. Both groups swayed the same amount, but each swayed far more than healthy peers. This shows the balance risk is not unique to one syndrome.

Rigoldi et al. (2013) used a math tool called entropy on Ehlers-Danlos sway. Lower entropy meant less automatic balance. The same tool could flag Prader-Willi and Down syndrome clients who need help.

04

Why it matters

If you serve adults with Prader-Willi or Down syndrome, expect forward-backward balance trouble. Add short standing-on-foam drills or tandem walks to their day. Track anterior-posterior sway at intake and after training to show progress.

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Measure forward-backward sway on a foam pad for 30 seconds and log the biggest wobble as your baseline.

02At a glance

Intervention
not applicable
Design
other
Sample size
31
Population
down syndrome, other
Finding
not reported

03Original abstract

Patients affected by Down (DS) and Prader-Willi syndrome (PWS) are characterised by some common clinical and functional features including gait disorders and reduced postural control. The aim of our study was to quantitatively compare postural control in adult PWS and DS. We studied 12 PWS and 19 DS adult patients matched for age, height, weight and body mass index. They were instructed to maintain an upright standing position on a force platform for 30s with open eyes (OE) and we calculated the range of center of pressure (CoP) displacement in the A/P direction (RANGE(AP)) and in the M/L direction (RANGE(ML)) and the total CoP trajectory length during quiet stance (Sway Path, SP). The range of oscillations in PWS and DS in both AP and ML direction were higher than in controls. PWS and DS were statistically different for RANGE(AP), with PWS showing higher mean values. Our results confirm a reduced capacity of both PWS and DS in maintaining postural stability. This appears to be in some respect different in PWS and DS, with PWS showing poorer control in AP. DS and, particularly, PWS should be encouraged to undergo specific balance training and strengthening of the ankle muscles as part of a comprehensive rehabilitation program to enhance daily functioning and quality of life.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.11.017