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Rita Herawany *1 
, Nilla Mayasari1 , Wa Ode Sri Nikmatiah2 , Andi Alfian Zainuddin3 , Anshory Sahlan1 , Husnul Mubarak1
, Nilla Mayasari1 , Wa Ode Sri Nikmatiah2 , Andi Alfian Zainuddin3 , Anshory Sahlan1 , Husnul Mubarak1
1- Department of Physical Medicine and Rehabilitation. Faculty of Medicine. Hasanuddin University. Makassar, Indonesia.
2- Department of Physical Medicine and Rehabilitation, Faculty of Medicine. Hasanuddin University, Makassar, Indonesia.
3- Department of Public Health. Faculty of Medicine. Hasanuddin University. Makassar, Indonesia.
2- Department of Physical Medicine and Rehabilitation, Faculty of Medicine. Hasanuddin University, Makassar, Indonesia.
3- Department of Public Health. Faculty of Medicine. Hasanuddin University. Makassar, Indonesia.
Abstract: (19 Views)
Purpose: Children with Down syndrome (DS) often present with hypotonia, ligamentous laxity, and poor postural stability, leading to deficits in fine motor coordination and dexterity. This study aimed to compare the effects of hand-strengthening exercises and combined proximal–distal training on manual dexterity in children with DS.
Methods: A quasi-experimental study was conducted with 40 children aged 6–12 years diagnosed with DS. Participants were randomly assigned to either a hand-strengthening group or a combined proximal–distal training group incorporating shoulder stabilization and hand exercises. Both interventions were delivered three times per week for eight weeks. Manual dexterity was evaluated using the Functional Dexterity Test (FDT) for both dominant and non-dominant hands. Data were analyzed using Wilcoxon signed-rank and Mann–Whitney U tests with a significance level of p ≤ 0.05.
Results: Both groups showed significant improvements in FDT scores (p<0.001). The combined proximal–distal group demonstrated greater improvement in the non-dominant hand (Δ –34s vs. –20.5s; p=0.005) and a higher proportion of participants transitioned from non-functional to minimally functional levels.
Conclusions: Combined proximal–distal training produced superior gains in manual dexterity compared with isolated hand strengthening, particularly in the non-dominant hand. Integrating proximal stabilization into rehabilitation programs may enhance functional independence and neuromuscular efficiency in children with Down syndrome.
Methods: A quasi-experimental study was conducted with 40 children aged 6–12 years diagnosed with DS. Participants were randomly assigned to either a hand-strengthening group or a combined proximal–distal training group incorporating shoulder stabilization and hand exercises. Both interventions were delivered three times per week for eight weeks. Manual dexterity was evaluated using the Functional Dexterity Test (FDT) for both dominant and non-dominant hands. Data were analyzed using Wilcoxon signed-rank and Mann–Whitney U tests with a significance level of p ≤ 0.05.
Results: Both groups showed significant improvements in FDT scores (p<0.001). The combined proximal–distal group demonstrated greater improvement in the non-dominant hand (Δ –34s vs. –20.5s; p=0.005) and a higher proportion of participants transitioned from non-functional to minimally functional levels.
Conclusions: Combined proximal–distal training produced superior gains in manual dexterity compared with isolated hand strengthening, particularly in the non-dominant hand. Integrating proximal stabilization into rehabilitation programs may enhance functional independence and neuromuscular efficiency in children with Down syndrome.
Keywords: Down Syndrome, Manual Dexterity, Proximal–Distal Training, Exercise Therapy, Shoulder Joint
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