Vestibular Stimulation Versus Foot Intrinsic Muscle Exercises in Children With Down Syndrome

Down syndrome (DS) is a genetic disorder commonly associated with hypotonia, ligamentouslaxity, impaired postural control, motor incoordination, and balance difficulties. Theseimpairments can negatively affect functional mobility and participation in activities ofdaily living. Balance is one of the major functional domains affected in children andadolescents with Down syndrome. Postural instability may result in increased displacementof the center of mass during gait and center of pressure during standing, which canfurther affect gait performance, transfers, and other functional activities.Pes planus (flat foot) is also frequently observed in individuals with Down syndrome andmay contribute to impaired balance, physical activity, and quality of life. Vestibularstimulation exercises (VSE) provide repetitive sensory information regarding bodyposition, movement, and orientation in space and may improve postural control andbalance. Similarly, foot intrinsic muscle exercises (FIMEs) aim to strengthen the musclesresponsible for foot stability and may improve foot function, postural control, gait, andfunctional mobility.Previous studies have reported beneficial effects of vestibular stimulation and footintrinsic muscle exercises when used independently in individuals with Down syndrome orbalance‐related impairments. However, there is limited research directly comparing thesetwo approaches in children with Down syndrome. Therefore, this study will compare theeffects of vestibular stimulation exercises and foot intrinsic muscle exercises onbalance and functional mobility in children aged 4‐15 years with Down syndrome.Balance will be assessed using the Pediatric Balance Scale (PBS), while functionalmobility will be evaluated using the Timed Up and Go (TUG) test. The study aims todetermine which intervention provides greater improvement in balance and functionalmobility. The findings may help physiotherapists and rehabilitation professionals selectan appropriate exercise approach for children with Down syndrome and contribute to thedevelopment of more effective pediatric rehabilitation strategies.