MOTOR IMPROVEMENTS AFTER
3-8 MONTHS OF DRUG TREATMENT IN THE DOWN.
Renato COCCHI, a neurologist and a medical
psychologist, and Marco Favuto, a physician.
Summary
84 Down Ss (31 f + 53 m; age 7-15,
average 10 + 2.12 years) had their motor skills evaluated at 1st consultation
and at checks after 3-4 and 6-8 months drug therapy. Walking, balance, going
up/down the stairs, running had scores according to 5 points scale. Walking
improved after 3-4 months (.009), and all investigated motor skills improved
aafter 6-8 months (.009). At 1st checkup, improvements vary from 29.8% of
walking to 13.1% of balance. At 2nd checkup, made by 67 out of 84 Ss,
improvements vary from 61.2% of running to 47.9% of balance, with no
modifications in 13 Ss.
Motor skills improved at any age band
considered. The results confirm that drug therapy improves motility in Down Ss, as Cocchi, 1989, found for the
anticipation of walking.
Key words: Down's syndrome; walking;
balance; going up/down the stairs; running; drug therapy; results.
Drug modulation of stress answers
Home Page / / / Pagina iniziale
One first improvement that results evident,
and often reported by the parents of the Down children under drug therapy,
concerns the motor ability.
I observed and referred this fact long time
ago (Cocchi, 1984 ), and appraised in punctual way on the anticipation of
walking (Cocchi, 1989). In that research each case had reported the drugs used
and the respective daily dosing.
Always about the motility in Down children I
printed other papers, on the possible favourable effect of the
s-adenosil-l-methionine in the joint laxity (Cocchi, 1990), on the cerebral
palsies (Cocchi, 1990 ), on the balance control (Cocchi, 1991), and on the
presence of pure hypotonia (Favuto and Cocchi, 1992).
An evaluation of the drug therapy effects on
the motility, although scheduled, did not have been made for being sure to have
a good sample, too using restrictive criteria. This is the purpose of this
work.
Materials and methods.
From an unselected consecutive series of 504
subject clinical cards referring to Down Ss seen by one author between 1979 and
September 1993, we extracted a sample of cards of Downs with these features:
- not psychotic Down subjects under drug therapy,
who had the first checkup
after 3-4 months and a possible second
checkup after 6-8 months from the beginning of the therapy;
- 7-15 years of age, with half a year of cut
off (ex.: 7 years and 6 months = 7 years; 7 years and 7 months = 8 years ).
- drugs used in mg/daily:
- basic therapy: L-glutamine 250 or, when
with hyperactivity, l-glutamine + pemoline 90 + 10; pyridoxine 150; thiamine
150; (a variation: thiamine + pyridoxine + cyanocobalamin 125 + 125 + 0,5);
diazepam 1-2;
with possible addition of:
5-hydroxitriptophan 25 (when initial
insomnia was reported);
carbamazepine 100 (when peripheral
cholinergic hyperactivity and/or bruxism was found).
Scoring of the motility: It was detailed and
done on the judgment of the parents as answering to specific questions,
integrated with the consultant's observation. Four were the aspects token into
consideration:
Walking:
- insecure with some falls (1);
- rather clumsy, with the enlarged polygon
of sustaining (2);
- a little clumsy (3);
- normal, but little slowed down (4);
- normal (5).
Balancing:
- precarious, with support need (1);
- precarious, without any support, with some
falls (2);
- subjectively insecure, with the enlarged
polygon of sustaining (3);
- sure, with the enlarged polygon of sustaining
(4);
- normal (5).
Going up and downstairs:
- only with support (0);
- without support, without the alternation
of the feet (1);
- the alternation of the feet only when
going upstairs (2);
- the alternation of the feet also when
going downstairs (3);
- only a little slow (4);
- normal (5).
Running:
- slow, with the enlarged polygon of
sustaining, and without any pendular movement of the superior limbs (1);
- slow, with the enlarged polygon of sustaining,
and with pendular movement of the superior limbs (2);
- a little slow and clumsy (3);
- just clumsy (4);
- normal (5)
We did not consider, because irrelevant in
so short times, the frequency to sessions of psychomotor therapy, otherwise
common to nearly all the subjects with less of 10 years.
Statistic: Wilcoxon's ranks test.
Results.
We extracted the clinical cards of the Ss
who fitted the suitable characteristics.
N. of Ss = 84, 31 F (34.5%) and 53 M (65.5%)
of them;
M/F ratio = 170.97.
Age 7-15 years, with average 10 +/- 2.12
years;
Chromosomal diagnoses: standard trisomy 21:
70 Ss = 83.3%;
mosaicisms: 6 Ss = 7.2%;
translocations: 5 Ss = 5.9%;
only clinical diagnoses: 3 Ss = 3.6%.
Ss who had also the 2nd checkup: 67 Ss =
79.7%.
The case histories and the results are
reported in the Tab. 1.
Tab. 1: Case histories and results (17 Ss
did not come back for the 2nd checkup). Keys: 1 con = 1st consultation; 1 ch =
the 1st checkup; 2nd = the 2nd checkup; T21 = standard trisomy 21; mos = mosaicisms;
trans = translocations; nk = only clinical diagnosis.
|
no. of S. |
Age |
Gender |
Ano-maly |
Walking |
Balancing |
Going up- and downstairs |
Running |
|||||||||||||||||||
|
|
|
|
|
1 con |
1 ch |
2 ch |
1 con |
1 ch |
2 ch |
1 con |
1 ch |
2 ch |
1 con |
1 ch |
2 ch |
|||||||||||
|
1 |
9 |
m |
T21 |
2 |
3 |
|
2 |
2 |
|
1 |
2 |
|
1 |
2 |
|
|||||||||||
|
2 |
9 |
m |
T21 |
3 |
3 |
|
2 |
2 |
|
2 |
3 |
|
2 |
2 |
|
|||||||||||
|
3 |
15 |
m |
T21 |
3 |
3 |
|
2 |
2 |
|
2 |
3 |
|
3 |
3 |
|
|||||||||||
|
4 |
9 |
m |
T21 |
3 |
3 |
|
3 |
3 |
|
2 |
3 |
|
3 |
3 |
|
|||||||||||
|
5 |
11 |
m |
T21 |
3 |
4 |
4 |
2 |
3 |
3 |
3 |
3 |
4 |
3 |
3 |
4 |
|||||||||||
|
6 |
12 |
m |
T21 |
3 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
|||||||||||
|
7 |
12 |
m |
Mos |
3 |
3 |
|
3 |
3 |
|
2 |
2 |
|
2 |
2 |
|
|||||||||||
|
8 |
8 |
f |
t21 |
3 |
4 |
|
3 |
3 |
|
3 |
3 |
|
3 |
3 |
|
|||||||||||
|
9 |
12 |
m |
t21 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
1 |
1 |
2 |
|||||||||||
|
10 |
11 |
f |
t21 |
3 |
3 |
4 |
3 |
3 |
4 |
3 |
3 |
4 |
4 |
4 |
4 |
|||||||||||
|
11 |
12 |
m |
t21 |
3 |
3 |
4 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
2 |
|||||||||||
|
12 |
9 |
f |
t21 |
3 |
3 |
4 |
2 |
2 |
3 |
2 |
2 |
3 |
3 |
3 |
4 |
|||||||||||
|
13 |
13 |
f |
t21 |
3 |
4 |
|
3 |
3 |
|
3 |
3 |
|
3 |
3 |
|
|||||||||||
|
14 |
10 |
m |
t21 |
2 |
2 |
3 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
|||||||||||
|
15 |
9 |
m |
t21 |
3 |
3 |
4 |
3 |
3 |
3 |
2 |
2 |
3 |
3 |
3 |
4 |
|||||||||||
|
16 |
9 |
m |
t21 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
4 |
4 |
3 |
3 |
3 |
|||||||||||
|
17 |
9 |
f |
t21 |
2 |
2 |
3 |
2 |
2 |
3 |
1 |
2 |
2 |
2 |
2 |
3 |
|||||||||||
|
18 |
8 |
m |
t21 |
3 |
3 |
3 |
2 |
2 |
2 |
3 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
19 |
8 |
m |
t21 |
2 |
2 |
3 |
2 |
2 |
3 |
3 |
3 |
3 |
2 |
2 |
3 |
|||||||||||
|
20 |
8 |
m |
t21 |
4 |
4 |
4 |
3 |
3 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
|||||||||||
|
21 |
11 |
m |
Mos |
4 |
4 |
5 |
4 |
4 |
4 |
3 |
4 |
4 |
3 |
4 |
4 |
|||||||||||
|
22 |
8 |
m |
t21 |
3 |
3 |
4 |
3 |
3 |
3 |
4 |
4 |
4 |
3 |
3 |
4 |
|||||||||||
|
23 |
10 |
m |
t21 |
4 |
4 |
|
3 |
3 |
|
4 |
4 |
|
3 |
3 |
|
|||||||||||
|
24 |
12 |
m |
t21 |
4 |
4 |
|
4 |
4 |
|
4 |
4 |
|
4 |
4 |
|
|||||||||||
|
25 |
12 |
f |
Nk |
4 |
4 |
|
3 |
3 |
|
4 |
4 |
|
4 |
4 |
|
|||||||||||
|
26 |
11 |
f |
Mos |
3 |
4 |
|
2 |
3 |
|
3 |
4 |
|
2 |
3 |
|
|||||||||||
|
27 |
11 |
f |
t21 |
3 |
4 |
4 |
2 |
2 |
3 |
2 |
3 |
4 |
2 |
2 |
3 |
|||||||||||
|
28 |
15 |
m |
t21 |
4 |
4 |
4 |
3 |
3 |
4 |
4 |
4 |
5 |
4 |
4 |
4 |
|||||||||||
|
29 |
8 |
f |
t21 |
2 |
3 |
3 |
2 |
3 |
3 |
2 |
3 |
4 |
1 |
2 |
3 |
|||||||||||
|
30 |
13 |
m |
t21 |
3 |
3 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
|||||||||||
|
31 |
9 |
f |
Nk |
2 |
2 |
3 |
2 |
2 |
2 |
1 |
1 |
2 |
2 |
2 |
2 |
|||||||||||
|
32 |
7 |
f |
t21 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
|||||||||||
|
33 |
8 |
m |
t21 |
2 |
2 |
2 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
|||||||||||
|
34 |
7 |
f |
t21 |
2 |
3 |
3 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
|||||||||||
|
S no. |
Age |
Gen-der |
Ano-maly |
Walking |
Balancing |
Going up- and downstairs |
Running |
|||||||||||||||||||
|
|
|
|
|
1 con |
1 ch |
2 ch |
1 con |
1 ch |
2 ch |
1 con |
1 ch |
2 ch |
1 con |
1 ch |
2 ch |
|||||||||||
|
35 |
10 |
f |
t21 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
2 |
|||||||||||
|
36 |
8 |
m |
t21 |
3 |
3 |
4 |
3 |
3 |
4 |
3 |
4 |
4 |
3 |
4 |
4 |
|||||||||||
|
37 |
7 |
f |
t21 |
2 |
3 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
2 |
|||||||||||
|
38 |
9 |
m |
t21 |
2 |
2 |
3 |
2 |
3 |
3 |
2 |
3 |
3 |
2 |
3 |
3 |
|||||||||||
|
39 |
10 |
m |
Trans |
3 |
3 |
3 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
|||||||||||
|
40 |
9 |
m |
t21 |
2 |
2 |
3 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
2 |
3 |
|||||||||||
|
41 |
15 |
m |
t21 |
3 |
3 |
|
3 |
3 |
|
4 |
4 |
|
3 |
3 |
|
|||||||||||
|
42 |
10 |
m |
t21 |
4 |
4 |
|
3 |
3 |
|
4 |
4 |
|
3 |
4 |
|
|||||||||||
|
43 |
7 |
m |
t21 |
3 |
3 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
2 |
2 |
3 |
|||||||||||
|
44 |
12 |
f |
t21 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
|||||||||||
|
45 |
14 |
f |
t21 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
46 |
9 |
m |
Mos |
3 |
3 |
4 |
2 |
2 |
3 |
2 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
47 |
8 |
m |
t21 |
2 |
3 |
3 |
2 |
3 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
|||||||||||
|
48 |
11 |
m |
Mos |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
|||||||||||
|
49 |
7 |
f |
t21 |
3 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
|||||||||||
|
50 |
12 |
f |
t21 |
3 |
3 |
4 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
3 |
3 |
|||||||||||
|
51 |
7 |
f |
t21 |
2 |
3 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
2 |
2 |
3 |
|||||||||||
|
52 |
8 |
m |
t21 |
3 |
3 |
4 |
3 |
3 |
3 |
3 |
4 |
4 |
3 |
3 |
3 |
|||||||||||
|
53 |
12 |
f |
t21 |
3 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
3 |
3 |
4 |
|||||||||||
|
54 |
9 |
m |
t21 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
55 |
10 |
f |
t21 |
3 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
4 |
3 |
3 |
4 |
|||||||||||
|
56 |
11 |
m |
t21 |
3 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
4 |
2 |
4 |
4 |
|||||||||||
|
57 |
9 |
m |
t21 |
2 |
2 |
3 |
2 |
2 |
2 |
2 |
2 |
3 |
2 |
3 |
3 |
|||||||||||
|
58 |
8 |
f |
t21 |
4 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
4 |
3 |
3 |
4 |
|||||||||||
|
59 |
9 |
f |
T21 |
4 |
4 |
4 |
2 |
2 |
3 |
3 |
3 |
4 |
3 |
3 |
4 |
|||||||||||
|
60 |
11 |
f |
T21 |
3 |
4 |
|
2 |
3 |
|
2 |
3 |
|
3 |
4 |
|
|||||||||||
|
61 |
9 |
f |
T21 |
4 |
4 |
4 |
3 |
3 |
4 |
3 |
3 |
4 |
3 |
4 |
4 |
|||||||||||
|
62 |
10 |
m |
Trans |
3 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
4 |
|||||||||||
|
63 |
12 |
f |
t21 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
64 |
12 |
m |
Nk |
4 |
4 |
4 |
3 |
3 |
3 |
4 |
4 |
4 |
4 |
4 |
4 |
|||||||||||
|
65 |
9 |
m |
t21 |
3 |
4 |
4 |
3 |
3 |
3 |
4 |
4 |
4 |
3 |
3 |
4 |
|||||||||||
|
66 |
12 |
m |
t21 |
4 |
4 |
4 |
3 |
3 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
|||||||||||
|
67 |
15 |
m |
Trans |
4 |
4 |
4 |
3 |
3 |
4 |
3 |
3 |
4 |
4 |
4 |
4 |
|||||||||||
|
68 |
8 |
m |
t21 |
3 |
3 |
|
2 |
2 |
|
2 |
2 |
|
3 |
3 |
|
|||||||||||
|
69 |
10 |
f |
t21 |
4 |
4 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
4 |
4 |
|||||||||||
|
70 |
9 |
m |
T21 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
3 |
3 |
3 |
|||||||||||
|
71 |
10 |
f |
T21 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
72 |
8 |
m |
Trans |
4 |
4 |
4 |
3 |
3 |
3 |
4 |
4 |
4 |
3 |
3 |
4 |
|||||||||||
|
73 |
10 |
m |
t21 |
4 |
4 |
4 |
3 |
3 |
4 |
4 |
4 |
4 |
4 |
4 |
4 |
|||||||||||
|
74 |
9 |
f |
t21 |
3 |
4 |
4 |
2 |
3 |
3 |
3 |
3 |
4 |
3 |
4 |
4 |
|||||||||||
|
75 |
11 |
f |
t21 |
3 |
4 |
4 |
3 |
3 |
4 |
3 |
4 |
4 |
3 |
4 |
4 |
|||||||||||
|
76 |
11 |
f |
t21 |
3 |
3 |
4 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
3 |
4 |
|||||||||||
|
77 |
7 |
m |
t21 |
2 |
3 |
4 |
2 |
3 |
3 |
2 |
3 |
3 |
2 |
3 |
3 |
|||||||||||
|
78 |
9 |
m |
t21 |
3 |
3 |
3 |
2 |
2 |
3 |
2 |
3 |
3 |
3 |
3 |
3 |
|||||||||||
|
79 |
8 |
m |
t21 |
3 |
4 |
4 |
2 |
2 |
3 |
2 |
3 |
3 |
2 |
3 |
3 |
|||||||||||
|
80 |
14 |
m |
Mos |
4 |
4 |
4 |
3 |
3 |
3 |
4 |
4 |
4 |
4 |
4 |
4 |
|||||||||||
|
81 |
9 |
m |
t21 |
4 |
4 |
4 |
2 |
2 |
3 |
2 |
3 |
3 |
3 |
3 |
4 |
|||||||||||
|
82 |
14 |
m |
t21 |
4 |
4 |
|
3 |
2 |
|
3 |
3 |
|
4 |
3 |
|
|||||||||||
|
83 |
8 |
m |
t21 |
3 |
4 |
|
2 |
3 |
|
2 |
3 |
|
3 |
4 |
|
|||||||||||
|
84 |
7 |
m |
t21 |
3 |
3 |
3 |
2 |
3 |
3 |
2 |
2 |
3 |
2 |
3 |
3 |
|||||||||||
|
p (1 cons vs 1 checkup) |
0009 |
.06 |
.06 |
.06 |
||||||||||||||||||||||
|
p (1 cons vs 2 checkup) |
.0009 |
.0009 |
.0009 |
.0009 |
||||||||||||||||||||||
|
p (1 check. vs 2 check.) |
.0009 |
.0009 |
.0009 |
.0009 |
||||||||||||||||||||||
As we can see in the Tab.1, we always found
statistically significant improvements between the 1st consultation and 2nd
checkup and between 1st and 2nd checkups. On the other hand, between the 1st
consultation and 1st checkup, the improvement is only statistically significant
for walking, too showing a strong drive to the statistic significance even for
the other three investigated fields.
Tab. 2: Global analysis of the results at
1st (84 Ss) and 2nd checkups (67 Ss).
|
Investigated field |
At 3-4 months |
At 6-8 months |
||||||||||
|
worsen |
unchanged |
improved |
worsen |
unchanged |
improved |
|||||||
|
|
Ss |
% |
Ss |
% |
Ss |
% |
Ss |
% |
Ss |
% |
Ss |
% |
|
|
|
|
|
|
|
|||||||
|
Walking |
0 |
0.0 |
59 |
70.2 |
25 |
29.8 |
0 |
0.0 |
28 |
41.8 |
39 |
58.2 |
|
Balancing |
1 |
1.2 |
72 |
85.7 |
11 |
13.1 |
0 |
0.0 |
35 |
52.1 |
32 |
47.9 |
|
Going up- and downstairs |
0 |
0.0 |
66 |
78.5 |
18 |
21.5 |
0 |
0.0 |
30 |
44.8 |
37 |
55.2 |
|
Running |
1 |
1.2 |
65 |
77.5 |
18 |
22.5 |
0 |
0.0 |
26 |
38.8 |
41 |
61.2 |
As we can see in the Tab. 2, the
improvements at 1st checkup, vary between 29.8% of Ss, as for walking, and
13.1% as for balancing. At the 2nd check, improvements vary between 61.2% of
running to 47.9%, of balancing.
Tab 3: Analysis of the results for no. of
motor fields investigated.
|
Scoring |
At 3-4 months % |
At 6-8 months % |
|||
|
Worsen in two fields |
1 |
1.2 |
0 |
0.0 |
|
|
Worsen in 1 field |
0 |
0.0 |
0 |
0.0 |
|
|
Unchanged |
48 |
57.2 |
13 |
19.4 |
|
|
Improved in 1 field |
17 |
20.3 |
8 |
11.9 |
|
|
Improved in 2 fields |
7 |
8.3 |
14 |
20.9 |
|
|
Improved in 3 fileds |
6 |
7.1 |
17 |
25.4 |
|
|
Improved in all 4 fields |
5 |
5.9 |
15 |
22.4 |
|
|
Totals |
84 |
100.0 |
67 |
100.0 |
|
As we can observe in the Tab. 3, while at 3-4
months the improvement, from one to four motor fields, reached 35 Ss out of 84
(41.6%), at 6-8 months it reached 54 out of 67 Ss (80.6%). Therefore, the only
worsened subject at 3-4 months, then not more checked, was a particular case.
Tab. 4: Rates of positive results, at 3-8
months, according to the age.
|
Age (years) |
Total Ss No. |
Ss no. improved at 3-8 months |
% |
|
7 |
8 |
7 |
87.5 |
|
8 |
15 |
12 |
80.0 |
|
9 |
20 |
18 |
90.0 |
|
10 |
10 |
6 |
60.0 |
|
11 |
10 |
9 |
90.0 |
|
12 |
12 |
7 |
58.3 |
|
13 |
2 |
2 |
|
|
14 |
3 |
1 |
|
|
15 |
4 |
2 |
|
The Tab. 4, even if poorly meaningful for
what concerns the ages from 13 to 15 years, drives however the indication that motor
improvements were obtained in any age of the Ss who underwent drug therapy.
Discussion.
Even this survey, made 15 years later from
the beginning of a drug therapy with exact antistress features ( see: Cocchi,
1993 ) was not a simple task.
We did see progresses that, in a so short
times, could not be attributed to a sudden acceleration of the spontaneous
evolution. The same we say for the effect of the physiotherapy. Although having
the filmed documentation of it, we wanted to make more rigorously the
parameters of this investigation. The choice of the 7 years as the inferior age
limit for taking the subjects into consideration, corresponds to the age where,
in the CP evaluation, it is considered the spontaneous neuromotor development
as concluded.
The 15 years age choice, as the superior
limit, corresponds to what, normally, it is considered the limit of the
developmental age, and that corresponds even to the limit of the dendritic
development (Iida and coll., 1993).
As for the possible action of current
rehabilitation therapies, at the age of seven years usually Down children, at
least in the observed Ss, are going on, but not always, a psychomotor therapy.
This fact doesn't seem particularly remarkable, for this study, and within the
investigated times. Among the motor symptoms biking has not a report, although
regularly investigated.
That because it seems that learning, to this
intention, is too much influenced by extraneous factors. Often there is
parents' fear, or poor insistence that the child learns biking, but there are
not rare "unreasonable" refusals, which the child same shows mainly
when support wheels are to remove from the bicycle. As for it, it appears an
excessive fear of losing the control of the balance. It is not well clear if it
corresponds to a true difficulty. The sometimes concomitant fear of the
oscillating surfaces, even of the scale to weigh, does think that we are not
dealing with a mere psychological problem.
As for the results, while at 3-4 months,
walking reaches already a statistically significant improvement, at 6-8 months
the positive results become very statistically significant even for balancing,
for going upstairs and downstairs and for running. So it occurred in comparison
with the first consultation or the first checkup. The first° checkup
improvements vary from the 29.8% in walking to 13.1% in balancing. At the
second checkup, done only by 67 Ss, the positive results vary from 61.2% in
running to 47.9% in balancing, with 13 unchanged subjects.
This is further confirmation of individual
differences in answeringto to the prescribed drug therapy, and such an answer
is even a function of the therapy lasting.
If we evaluate the fact of being some
improvement happened, independently from the investigated motor behaviour, then
we observe that the 41.6% already improved at the first checkup, a rate growing
to 81.6 % of whom had even a second checkup.
The motor improvements occurred to all
considered ages, even if, from the ten years in then, it may be a decrease of
them.
It is possible that we are dealing with a
more apparent result than a real one, having the Down children, from that age
in then, an average motility that is more developed.
The used drugs act primarily on the GABA. In
particular, they improve the type A GABAergic inhibition, reduce the type B
GABAergic inhibition, and favour the synthesis of the GABA.
Why the proposed therapy is acting on
motility, is a problem that can drive to many speculations. Undoubtedly an
improvement of the balance has its role, but it is possible that there are
other variables, by now not sufficiently known.
Conclusions.
The investigation on Down children of motor
development aged 7-15 years, at 3-4 months and at 6-8 months since the drug
beginning, did find that, at least in both examined samples, the prescribed
drugs act in a statistically significant way.
The results accord with the drug taking
length, and are mostly evident among 7-10 years Ss. Of the investigated motor
skills, walking improved as the first one, but at 6-8 months therapy, running
improved in mostly Ss. The balance showed instead a smaller rate of
improvement, less than 50% at the 6-8 months checkup.
References.
Cocchi R.: La farmacoterapia come ulteriore
strumento per lo sviluppo motorio nel bambino Down. Il Cinesiologo (Naples)
1984, no.37: 35-37.
Cocchi R.: The anticipation of walking in
drug treated Down infants: A controlled study. Ital. J. Intellect. Impair.
1989, 1: 15-19. (<www.stress-cocchi.net/Down9.htm>)
Cocchi R.: La S-adenesil-l-metionina (SAMe)
riduce la lassità articolare nel bambino Down Riv. Ital. Disturbo Intellet.
1990, 3: 141-143. (English translation:
<www.stress-cocchi.net/Down18.htm>)
Cocchi R.: Paralisi cerebrali infatili in
bambini Down: 3 casi. Riv. Ital. Disturbo Intellet. 1990, 3: 327-330. (English
translation: <www.stress-cocchi.net/Down21.htm>)
Cocchi R.: Difficoltà di controllo
dell'equilibrio nel bambino Down. Riv. Ital. Disturbo Intellet. 1991, 4:
267-270. (English translation: <www.stress-cocchi.net/Down18.htm>)
Cocchi R.: Drug therapy in Down's Syndrome:
A theoretical context. Ital. J. Intellect. Impair. 1993: 6: 143-1954.
(<www.stress-cocchi,net/Down14.htm>)
Iida K., Takashima S., Mito T., Yao R.,
Onodera K.: Immuno-istochemical and Golgi studies on brain development and
aging in patients with Down syndrome. Ital. J. Intellect. Impair. 1993, 6:
3-11.
Favuto M., Cocchi R.: L'ipotonia nel bambino
Down: Indagine epidemiologica. Riv. Ital. Disturbo Intellet. 1992, 5: 113-117.
<www.stress-cocchi.net/Down48-it.htm>
Printed in Italian on Riv. It. Disturbo Intellet. 1993, 6: 251-258.
Text in English posted on Internet on 18 February 2005. Copyright by
Renato Cocchi, 2005.
Author's address: dr Renato COCCHI, via
Rabbeno, 3
41100 Reggio Emilia
renatococchi@libero.it
Drug modulation of stress answers
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