RT Journal
A1 Pastore E, Marino B, Calzolari A, Digilio M, Giannotti A, Turchetta A
T1 CLinical and cardiorespiratory assessment in children with down syndrome without congenital heart disease
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2000
FD April 1
VO 154
IS 4
SP 408
OP 410
DO 10.1001/archpedi.154.4.408
UL http://dx.doi.org/10.1001/archpedi.154.4.408
AB Objective 
    To assess the clinical and functional status of a young Down syndrome (DS) population without congenital heart disease.Design 
    Prospective study of children with DS and control subjects.Setting 
    Bambino Gesù Children's Hospital, Rome, Italy.Participants and Methods 
    Forty-two children with DS (mean ± SD age, 9.8 ± 3.6 years) underwent genetic, clinical, neuropsychological (IQ), and cardiorespiratory evaluation. Cardiorespiratory fitness was assessed with a treadmill test and a lung function test to determine forced vital capacity, first-second forced expiratory volume, and peak expiratory flow. Data were expressed as a percentage of the predicted values for control children. To assess cooperation during exercise testing, we devised a compliance scale assigning a score according to the subjects' ability to understand instructions, ability to walk and run as required, and need for vocal encouragement.Results 
    Eighteen (43%) of 42 children with DS were obese, 10 (24%) were short, and 17 (40%) had microcephaly. On the Leiter International Performance Scale, 2 of 35 subjects had a normal IQ score (80-120); all others had low IQ scores (79 to <40). Five subjects did not undergo cardiorespiratory assessment. Eighteen of 37 subjects completed lung function tests: the results for 10 were unremarkable, and results from 8 revealed reduced forced vital capacity because of poor compliance. The subjects tested had low exercise tolerance (mean ± SD tolerance percentage, 61% ± 12%), mild tachycardia (maximal heart rate, 91% ± 4%), and a mild hypertensive response (maximal blood pressure, 89% ± 8%). Compliance scores correlated significantly with exercise time and age but not with IQ.Conclusions 
    Clinical and cardiorespiratory assessment is feasible in subjects with DS without congenital heart disease and should be useful in gauging their fitness level for safe physical activity.