Efficacy of Proprioceptive Neuromuscular Facilitation on Dynamic Balance in Children with Down Syndrome: A Pilot Study

Introduction: Down syndrome is a non hereditary genetic condition characterised by an extra copy of chromosome 21. This is why it is also called trisomy 21. Normally developing children improve their balance with age and growth, but individuals with Down syndrome often do not achieve independent gait and proper balance even after years of therapy. There has been very limited research investigating the use of the Proprioceptive Neuromuscular Facilitation (PNF) technique for treating children with Down syndrome, and there is an essential need for research to establish the role of PNF in this population with neuromotor issues. The effect of PNF on Down syndrome is unclear in the literature. Aim: To determine the effect of the PNF technique on dynamic balance in Down syndrome. Materials and Methods: The present pilot pre- and postinterventional study was conducted at Jawaharlal Nehru Medical College and Hospital, Aligarh, Uttar Pradesh, North India, from January 2024 to December 2024. Participants were allocated to an intervention group and a control group by convenience sampling. Balance was assessed before and after the intervention using (a) the Timed Up and Go (TUG) test and (b) the Timed Up and Down Stairs (TUDS) test, following anthropometric measurements for each child. Eight weeks of PNF intervention were delivered three days per week (on alternate days), for a total of 24 sessions. Each session lasted 40 minutes, including 10 minutes of warm-up and cool-down, with 30 minutes of pelvic PNF and lower-limb PNF techniques for each participant in the intervention group. The control group received homebased physiotherapy, including strengthening exercises for the lower limbs and pelvis, three days per week for eight weeks. The Mann-Whitney U test was used to compare baseline values and change scores (pre- to post-intervention) between groups. The Wilcoxon’s signed-rank test was applied to assess within-group differences between pre- and post-intervention values in both the experimental and control groups. Results: The TUDS time (p=0.17) was not statistically significant, while TUG time (p=0.02) demonstrated a significant difference. Furthermore, the experimental group exhibited a statistically significant improvement over the control group in both TUG (p=0.05) and TUDS (p=0.007), accompanied by a larger effect size. Conclusion: Proprioceptive Neuromuscular Facilitation (PNF) training enhances dynamic balance in children aged 4-10 years with Down syndrome. Improvements are evident in the performance of the TUG and TUDS tests.