title: Atlanto-Axial Instability in People with Down's Syndrome and its Impact on the Ability to Perform Sports Activities - A Review.
abstract: Atlanto-axial instability (AAI) is a developmental anomaly often occurring in persons with Down's syndrome (DS). According to various reports, AAI affects from 6.8 to 27% of the population with DS. The aim of this review was to illustrate the issue of AAI with regard to the progressively changing state of scientific knowledge. The extended distance between the rear surface of the frontal arcus of the C1 cervical vertebra and the anterior surface of C2 cervical vertebra dens (anterior atlanto-odontoid distance, AAOD) indicates the occurrence of AAI and is detectable through X-ray examination. Hypoplasia of the C2 dens, also detectable through X-ray examination, is another suggested risk factor for AAI. According to current data, the methodology of taking measurements is inconsistent, which leads to errors in interpretation. As research focusing on AAI was progressing, new data emerged from other studies on persons with DS, suggesting that neurological symptoms in persons with DS that indicated the occurrence of spinal cord compression were an important factor in medical imaging detection of AAI. One of the main arguments supporting this thesis is that in isolated cases spinal cord (SC) damage was noted during screening examinations conducted on a large population of subjects. Moreover, cases in which the neurological symptoms indicate spinal cord compression existed long before the occurrence of the actual damage also remain of significant importance. Therefore, it is necessary to promote neurological studies on persons with DS to enable early diagnosis of spinal cord compression and, at the same time, reduce the use of medical imaging in cases of neurological symptoms.
authors.affiliation: Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Myśliwiec
authors.affiliation: The Joseph Tischner Special Schools Complex no.10 in Jastrzębie-Zdrój, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Posłuszny
authors.affiliation: Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; The Academy of Business in Dąbrowa Górnicza, Poland.
authors.forename: Edward
authors.initials: E
authors.lastname: Saulicz
authors.affiliation: Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; School of Health Sciences in Katowice, Medical University of Silesia, Department of Rehabilitation.
authors.forename: Iwona
authors.initials: I
authors.lastname: Doroniewicz
authors.affiliation: Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Linek
authors.affiliation: Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; The Academy of Business in Dąbrowa Górnicza, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wolny
authors.affiliation: Department of Health Care, Medical University of Silesia in Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Knapik
authors.affiliation: Department of Physiotherapy, Higher School of Administration in Bielsko Biała, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Rottermund
authors.affiliation: Department of Physiology, Institute of Sport, Warsaw Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Żmijewski
authors.affiliation: Faculty of Physical Education and Health Promotion, University of Szczecin, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Cieszczyk
keywords: Down’s syndrome; atlanto-axial instability; medical imaging; spinal cord compression
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