Oscilação postural na condição de dupla tarefa durante atividade sentado para de pé em crianças e adolescentes com síndrome de down

Abstract

Activities of daily living commonly require that different tasks be done simultaneously, which is known as dual tasking. For an efficient integration of those tasks, integrity of the organic systems is necessary, especially for postural adjustments to occur. This may not happen in some health conditions that affect neuromuscular control. With this premise, the first study titled "Dual task activity in children with neuromotor dysfunctions - systematic review" was undertaken. This study aimed to systematically review the literature on the effects of dual tasks in children and adolescents with neuromotor dysfunctions. It also aimed to identify the methods used and to evaluate the methodological quality of the studies. We found that the addition of a secondary task impairs the performance of the primary task, independently of the neuromotor dysfunction; the same happens in control groups. Most of the studies assessed children during gait, and no other functional mobility activities, such as the sit-to-stand (ST-DP), were investigated. Considering the importance of this activity to functionality, as well as the high biomechanical demand it places, children with neuromotor dysfunctions may have difficulties to associate attentional and motor demands during the activity. One dysfunction of high incidence, but that has received little attention regarding these aspects is Down syndrome. This finding motivated the second study: "Influence of dual task on sitting to standing activity in children and adolescents with Down syndrome". The aim of this study was to verify the influence of dual motor tasks on postural oscillation of children and adolescents with DS while performing ST-DP activity, in comparison with typical children. The study showed that children and adolescents with DS have higher postural oscillation compared to their typical peers, and smaller oscillations during dual tasks when compared to each other. These results indicate that the greater attention and motor demands of dual tasks seems to cause freezing of degrees of freedom. This may be a strategy for suppressing neuromuscular deficits and maintaining body stability. Thus, more studies with this population and applying the dual task paradigm are necessary. Also, therapeutic practices should train both isolated and dual tasks, seeking to automate these activities, and to decrease the functional impairments caused by the syndrome.