A Study to Compare the Effectiveness of Vestibular Stimulation Vs Neurodevelopment Therapy in Improving Balance for Children with Down Syndrome

INTRODUCTION: Down syndrome was named after JOHN LANGDON DOWN the first physician to identify the syndrome. Down syndrome is the most common Chromosomal abnormality among live birth. Down syndrome is the most frequent genetic cause of mild to moderate mental retardation and associated medical problem and occurs in 1 out of 800 live births in all races and economic groups. Down syndrome is characterized by a variety of dimorphic features, congenital malformation and other health problems and medical condition. Not all of them are present in each affected individual. In children with Down syndrome there have been a number of observed and measured motor characteristics such as hypotoncity, joint hypo mobility, decrease in deep tendon reflex, maintenance of primitive reflex and a delay in appearance of reaction timing and equilibrium reaction that may have contributed to delay development. AIM OF THE STUDY: Aim of the study is to compare the effectiveness of Vestibular stimulation Vs Neurodevelopmental therapy in improving balance for children with Down syndrome. MATERIALS AND METHODOLOGY: Study design: Pretest & posttest experimental study design. Sample Size: 20 Children who fit into the inclusive criteria were taken. 10 patients were allotted for each group. Duration of Study: 4 months. Sampling Technique: Purposive sampling technique. Study setting: Retna Global hospital, Trichy, Spastic Society, Trichy and Thanthai Roever College of Physiotherapy OP Department, Perambalur. Inclusive Criteria: • Age : 5 to 10 Yrs. • Sex : Both Male & Female. • Children diagnosed with Down syndrome through chromosome Karyo type. Exclusive Criteria: • Congenital heart disease. • Hearing problem. • Dementia similar to Alzheimer’s. • Eye problem such as Cataract. • Celiac disease. RESULT: Paired ‘t’ test, Pediatric balance scale, Experimental Group I (Vestibular Stimulation). For 9 degree of freedom at 5% level of significance the calculated ’t’ value is 41.489 which is greater than the table ‘t’ value 2.262. Hence alternate hypothesis is accepted. Experimental Group II (Neurodevelopmental therapy). For 9 degree of freedom at 5% level of significance the calculated ‘t’ value is 15.932 which is greater than the table ‘t’ value 2.262. It shows there is significant difference between data. Hence alternate hypothesis is accepted. Unpaired ‘t’ test, Pediatric balance scale, Post test value (Experimental Group I & II). When the post test value of experimental Group I and experimental Group II were analyzed by unpaired ‘t’ test. The calculated ‘t’ value is 5.125. The table ‘t’ value at 5% level of 18 degree of freedom is 2.101 which is less than the calculated ‘t’ value. So there is significant difference between two groups and hence alternate hypothesis is accepted. SUMMARY AND CONCLUSION: A balance disorder is a disturbance that causes an individual to feel unsteady or have a sensation of movement. An organ in our inner ear is an important part of our vestibular system. The Vestibular system in the brain does more than just allow us to stand upright, maintain balance and move through space. It co-ordinates information from the vestibular organ in the inner ear eyes, muscle, joints finger tips, palm of the hand, gravity receptors on the skin and adjust to heart rate, Blood pressure, muscle tone, limb position, arousal and balance. Dysfunction in the vestibular system can cause abnormalities in muscle tone, difficulty defecating, need for self-stimulation etc. Exercises that activate wide range of inputs to the vestibular system have been found to be effective in reducing vestibular problem. Physical therapy intervention like vestibular stimulation and neurodevelopmental therapy were given to selected patient 10 patient in each group. Pretest, posttest scores are noted and analysis was done using paired ‘t’ test and independent ‘t’ test statistical analysis shows that there is significant improvement in balance with both technique and vestibular stimulation is found to be more effective than neurodevelopmental therapy. From this it can be concluded that vestibular stimulation can be incorporated to treat children with Down syndrome to improve balance. Further undergoing earlier management leads to better prognosis

Synchronisation schemes for two dimensional discrete systems

In this work we consider two models of two dimensional discrete systems subjected to three different types of coupling and analyse systematically the performance of each in realising synchronised states.We find that linear coupling effectively introduce control of chaos along with synchronisation,while synchronised chaotic states are possible with an additive parametric coupling scheme both being equally relevant for specific applications.The basin leading to synchronisationin the initial value plane and the choice of parameter values for synchronisation in the parameter plane are isolatedin each case.Comment: 17 pages 8 figures. submitted to physica script

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