Functional characteristics of children with Down syndrome and possibilities of their correction with the help of athletic activity in Russia

Open access: www.balimedicaljournal.org and ojs.unud.ac.id/index.php/b j Functional characteristics of children with Down syndrome and possibilities of their correction with the help of athletic activity in Russia Alexander Sergeevich Makhov1, Ilya Nikolayevich Medvedev1* Abstract: The presence of trisomy in chromosome 21 cause a The presence of trisomy in chromosome 21 cause a whole range of internals’ pathology. These internal’s pathology could cause abnormal motor development that can lead to inadequacy of physical activity. One way to rehabilitate children with Down syndrome is by giving them adequate physical activity in the form of physical training or sports. It is necessary to conduct some organizational arrangements in Russia intended for groups of persons with limited health possibilities into athletic activity. Aim: The aim of the research was to show the impact of athletic activity in Down syndrome children and to determine modern problems of its wide application to the given groups in Russia. Methods: Questioning and the method of mathematical statistics. Interviewing the parents of children with Down syndrome was conducted in some regions of Russia during November 2016. A total of 300 families having children with Down syndrome was included in this study. Results: It was found that lack of popular information and diversified scientific researchers in the field of athletic activity in children with Down syndrome is a great problem for trainers and parents. Many parents can’t find a qualified trainer. On the other hands, specialists who are ready to train children with Down syndrome, have no opportunity to get full information to conduct an effective training process with such children and often work

Down syndrome is one of the most known human genetic diseases. It is conditioned by trisomy in the chromosome 21 in all the cells of a body or in some of them. 1 This disease was first described by a British scientist John Langdon Down in his scientific work in 1866. Its etiology was determined only in 1959. 2 Children with this chromosomal pathology are met at the average of one in 700-800 newborn children. When antenatal diagnostics and conduction of timely abortion became possible, the incidence of children with Down syndrome decreased until 1 in 1200-1300 newborn children. The main factor influencing the chance of conception of a child with Down syndrome is the mother's age. If the mother's age range from 20 to 24 years old, the possibility is 1 in 1562; 25-30 years old is 1 in 1000; from 35 to 39 years old is 1 in 214; and after 45 years, the possibility is 1 in 19.
The presence of chromosome 21 could cause a whole range of internals' pathology. It may be rather difficult to compensate it, but it is quite possible with an accurate sequence of rehabilitation actions. One way to rehabilitate children with Down syndrome is by giving them adequate physical activity in the form of regular physical exercises or some available kind of sports. 3 Increased muscle's function through exercises was proved by clinical 4,5 and experimental 6,7 researchers. They can influence favorably even at late stages of ontogenesis. 8 That's why resource centers on professional training and job placement for persons with limited health possibilities and invalids are organized last years in Russia. 9 Professional skills' contests for invalids 10 began to be conducted in Russia with the same aim. So, two tasks are solved at once -rehabilitation of a man with irreversible disturbances in a body and receiving the possibility of his residual labor potential's usage for the industry.

ORIGINAL ARTICLE
The existence of a rather large number of persons with Down syndrome in Russia makes Russian society pay attention to the rehabilitation of muscular activity through physical exercises and sports. 11 At the same time, the given problem is still very far from its solving in Russia. Nowadays, the main trend of adaptive sport for people with Down syndrome is Special Olympics -socially adapted program of sports training all year round. At present, Russian sportsmen with Down syndrome are registered and take part in swimming and gymnastics competitions. Such category of sportsmen can take part in competitions within the framework of activity of All-Russian Sports Federation of persons with intellectual disturbances. However, such sportsmen aren't singled out as a separate sports classification of persons with intellectual disturbances and means aren't assigned to their participation in sporting events. 12 At the same time, at constant physical training, young people with Down syndrome can achieve good results. It makes the problem of sports' development for children with Down syndrome in Russia rather urgent and rises the necessity of its solving in parents. 13 We put the following aim in the research -to show the impact of athletic activity in children with Down syndrome and to determine modern problems of its wide application to the given groups in Russia.

Characteristics of children with Down syndrome
Children with Down syndrome are characterized by lowered growth rate at its maximally low indices in infancy and youth. The final stature of women is equal on average to 145 cm and men -157 cm. It is possible that following factors -congenital heart disease, malabsorption syndrome, celiac disease, and lowered level of somatotropic hormone and insulin-like growth factors in plasma -lie in the basis of it. 14 The musculoskeletal system at Down syndrome is characterized by muscle and connective tissue's weakness that leads to dysplasia of hip joints with luxation and subluxation in them, instability of patella, scoliosis, and platypodia. Development of bones in the middle part of the face slightly retards compare to the development of other cranial bones, making an applanation look. The upper jaw is often small, therefore the mouth opening is of small sizes and nasal sinuses are feebly marked. 15 The state of analyzers at this pathology is often disturbed. Hyperopia and myopia are often observed at Down syndrome. The hearing function is often lowered because of infectious diseases in the ear and congenital hearing loss. The skin is less elastic, drier, and rougher, hence it is subjected to fissures and decreased sensitivity. 2 Many children with Down syndrome have hypofunction of the thyroid gland and different pathology is often found in the gastrointestinal tract. 2 Such children often have impaired cardiac function because of various heart diseases. Myelinization of nerve trunks is also disturbed at Down syndrome and caused a slightly delays in the passage of signal along nerve fibers. Such children can sometimes have a deeply evident intellectual deficiency. It can show itself in several degrees: some children never speak, but most of them can learn to read and write. Practically all of them are loving, friendly, and behave well with their nearest people. Even the most evident form of mental retardation in optimal care and early rehabilitation doesn't block mastering the skills of communicability, self-service, and others. Bradygenesis is an important problem of children with Down syndrome. They begin to hold the head and move around very late. In comparison with other children, they require more time to start smiling and speaking. They also need more time to master the skills of self-service. 16 Children with mosaic form of Down syndrome show higher intellectual level, better speech development, and less quantity of somatic pathology. 2 As a result, the existence of Down syndrome disturbs many physical and psychic that demands more efforts from the side of rehabilitationspecialist to compensate.

Characteristics of motor development in children with Down syndrome
Motor functions in children with Down syndrome develop rather slowly, with a long formation of skills. Down syndrome is characterized by not only lagging in terms of motor development but also a special profile of motor skills' development. 17 There are four reasons for motor development disturbances 18  These motor disturbances Downcan be corrected with the help of competently planned athletic activity.

Estimation of problems of athletic state correction of children with Down syndrome in Russia
Earlier, one of the authors of the article conducted a wide questioning to the parents of children with Down syndrome. 12 (Table 1). To determinate the signification of these problems, the respondents were offered to specify the degree of importance according to 10-points' scale (1 point -minimum, 10 pointsmaximum). Depending on the urgency degree of the problem (expressed in points), the responses were subdivided into several groups: 9-10 points -"absolutely urgent", 7-8 points -"urgent", 5-6 points -"it's difficult to say", 3-4 points -"not urgent", 1-2 points -"not urgent at all".
From the questionnaire, we found that none of the problems from the given list was "not urgent" (3-4 points) and "not urgent at all" (1-2 points). All the problems got into the groups "absolutely urgent" (9-10 points) and "urgent" (7-8 points). Therefore, it speaks about the high degree of their signification and the state of being unsolved. The average point of estimation of the given questions' urgency range from 7.97 (absence of competitions on the levels of cities, regions, and Federation for children with Down syndrome) till 9.08 (absence or insufficient Legend: X -average, m -error of the mean, Ex -excess value, As -value of asymmetry.

ORIGINAL ARTICLE
quantity of specially prepared trainers for working with children with Down syndrome). Low values of the excess (Ex) and negative asymmetries (As) showed the fact that the parents Downare unanimous in their estimation of the problems' urgency. A similarity of respondents' opinions is also underlined by positive values of the excess (Ex) and negative asymmetry (As). The first problem -absence (insufficient quantity) of specially prepared trainers for working with children with Down syndrome -is recognized to be the most urgent one together with the third and fourth problem. Lack of information about abilities of children with Down syndrome and techniques of their training in different sports aggravate the shortage of staff in this field. That's why the work with people from the given category demands training intensification for competent specialists who have undergone some probations in special centers for children with Down syndrome. Their staff should include psychologists, medical workers, and correction pedagogues. Nowadays, modern Russia trainers and pedagogues were trying to go in for sports with children with Down syndrome and put this process into operation based on their own scarce experience. Sometimes it can repel the child from sports training.
The second problem -the absence of state support of the programs directed at the development of sports and physical training among people with Down syndrome -was the center of all the studied problem, therefore the other problems were directly depended on them. The presence of adequate sports sections, clubs' trainer's sportsmen, and competition's system in Russia would only be possible with support from the state.
The third problem -the absence of information about sports sections and clubs for people with Down syndrome in services of population social protection, city, and regional sports committees -existed in all the regions of Russia. Even in the largest cities in Russia, it's very difficult to find any information about sections and training for children with Down syndrome.
The fourth problem -the absence of structured and available information about the development of sports and physical training among children and young people with Down syndrome in mass media -was mostly a reflection of a stereotype that people with Down syndrome were unable to achieve serious results in sports.
The fifth and sixth problems -absence of state support for sportsmen with Down syndrome at competitions and absence of competitions at the levels of cities, regions, and Federation -were closely connected with each other and with the second problem. At this time, there is no official competition for children with Down syndrome in Russia, even though it is highly needed.
It became clear that insufficient information and diversified scientific researchers in the field of athletic training for children with Down syndrome was a great problem for trainers and parents. 19 Even if children were willing to train, their parents can't find a competent trainer. In turn, specialists who can train children with Down syndrome have no opportunity to get the necessary information to conduct an effective training with such children. 20

CONCLUSION
Planned application of complex muscular activity is necessary for children with Down syndrome to master the essential motor skills. Application of physical exercises and sports is the most rational way in this field. Children with Down syndrome need competent specialists, specialized clubs, and specialized sections as the provision of such help.. The development of training techniques, Downprograms for specialists' training, and competition system are far from being completed. The answer of these problems will promote the development of the psychic-physical potential of people with Down syndrome and their involvement into active social life. People with Down syndrome can compensate well enough and become sportsmen who are able not only to compete at different levels but also present Russia with dignity with the right approach and a competently worked out program.