Sport Preparticipation Screening for Asymptomatic Atlantoaxial Instability in Patients With Down Syndrome.
Autor: Tomlinson, Christopher; Campbell, Alastair; Hurley, Alison; Fenton, Eoin; Heron, Neil
Publication year: 2020
Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
issn:1536-3724 1050-642X
doi: 10.1097/JSM.0000000000000642
Abstract:
Down syndrome (DS) is a clinical syndrome comprising typical facial features and various physical and intellectual disabilities due to extra genetic material on chromosome 21, with one in every 1000 babies born in the United Kingdom affected. Patients with Down syndrome are at risk of atlantoaxial instability (AAI). Although AAI can occur in other conditions, such as rheumatoid arthritis, this position statement deals specifically with patients with DS and asymptomatic AAI. Atlantoaxial instability, also referred to as atlantoaxial subluxation, is defined as increased movement between the first (atlas) and second (axial) cervical vertebra joint articulation, the atlantoaxial joint. Atlantoaxial instability is reported to occur in 6.8% to 27% of the DS population, although this varies depending on the age of the patients whom you are screening. Less than 1% to 2% of these patients are then thought to later develop symptomatic AAI, although the natural history and progression of AAI is not well understood. The risks associated with AAI are neurological injury from excessive movement of the cervical vertebra impinging on and then damaging the spinal cord, although the risk of this during sporting activities is extremely rare. Clearly, physical activity and sports participation for patients with DS has many biological, psychological, and social benefits, and the Faculty of Sport and Exercise Medicine (FSEM), United Kingdom, wishes to promote safe physical activity and sport for all. The FSEM, United Kingdom, has therefore produced a statement regarding sport preparticipation screening for asymptomatic AAI in patients with DS.
Language: eng
Rights:
Pmid: 30119085
Tags: Humans; Risk Factors; Neurologic Examination; United Kingdom; Mass Screening/*methods; Physical Examination; Asymptomatic Diseases; Radiography; Medical History Taking; *Atlanto-Axial Joint/diagnostic imaging; *Sports for Persons with Disabilities; Down Syndrome/*complications; Joint Instability/*diagnosis/therapy
Link: https://pubmed.ncbi.nlm.nih.gov/30119085/
