Research Article|Articles in Press

Determinants of hand function in children and adolescent with Down Syndrome-A scoping review

Published:September 17, 2022DOI:


      • A scoping review of hand function in children and adolescents with Down Syndrome.
      • Physical characteristics of the upper extremity in Down Syndrome are detailed.
      • The correlation between upper extremity physical characteristics and determinants of hand function is explored.



      Down Syndrome (DS) is a genetic condition. Physical characteristics like short stature, hypotonia, small, and thick hands result in decreased grip and pinch strength and quality of fine motor tasks.


      The purpose of this review is to summarize the evidence of upper extremity physical characteristics and its influence on hand function in DS population.

      Study Design

      A scoping review.


      A comprehensive electronic literature search was conducted through PubMed, CINAHL, Cochrane Library. The search was limited to articles written in English and published between 2010 to 2021. Additionally, books were referred for a better understanding of the hand function in DS. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) was adopted to develop the protocol.


      Following a detailed review of 28 articles meeting the inclusion criteria, fetuses with a diagnosis of DS are reported to have shortening of humerus on sonographic markers wherein 9% of fetuses had below 5th percentile shortening. Additionally, literature reports that during reaching there was increased trunk rotation (effect size = 0.88). DS population had 60% less grip strength, 33% less palmar pinch strength ,20% less key pinch strength and poor manual dexterity (CI = 4.5-5.5).


      Findings of this review concludes that physical characteristics of the upper extremity have an influence on hand function performance in children and adolescents with DS.However, only arm length and hand span have been quantified and correlated with grip strength. Further work must focus on correlation of upper extremity anthropometry and overall hand function in children and adolscents with DS.



      DS (Down Syndrome), TD (Typically Developing), ID (Intellectual disability), M-ABC (Movement assessment battery for children), CoP (Centre of pressure), RTG (Reach to grasp), BOT2 (Bruininks- Oseretsky Test of Motor Proficicency -2), GMFM (Gross motor function measure), NMT (Neuromuscular tapping), T21 (Trisomy 21)
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