Unique medical study on children with Down Syndrome’s participation in sports

6 Sep 2021

A recent collaboration between a University College Cork Medicine student and Down Syndrome Cork explored the prevalence and impact of X-ray screening for Atlanto-Axial Instability (AAI) in children with Down syndrome across Ireland. Down syndrome athletes are often required to undergo pre-participation X-ray screening for AAI to help identify those at risk. However, the evidence for plain cervical spine X-ray as a form of screening is poor. 

Daniel Shenoda, a Graduate Entry Medicine student, carried out the research project over two years supervised by Paediatric Consultant Dr Louise Gibbons at Cork University Hospital.  The nation-wide cross-sectional online survey was rolled out via email by Down Syndrome Ireland to 1511 registered families. The survey asked parents if their child has had to undergo x-ray screening, the result of the x-ray, the impact of the result and if they developed symptoms. The survey also assessed parental knowledge of symptoms of AAI.

Out of 240 responders, 7 responders had symptomatic AAI and 5 of these had normal X-rays (29% sensitivity). Chi-Squared testing showed no variables significantly correlated with having an abnormal X-ray. Of the total group of 146 who underwent X-ray pre-participation screening, 20 had abnormal results and were excluded from playing their desired sports (specificity 86.7 %).

Liam Ahern, Integration lead Down Syndrome Cork, comments on the importance of the findings from this research:

“On behalf of Down Syndrome Cork, we were delighted to be part of Daniel Shenoda’s project into the Prevalence and Impact of X ray screening for Atlantoaxial Instability in Children with Down Syndrome. It was a research project that was long overdue and will be of great value to our members. It will be of value because as Daniel pointed out there was a dearth of information on the subject. Many of our members were unnecessarily deprived of the opportunity to participate because of the lack of information identified in the research. We very much welcome the conclusions and as an organisation we will be more informed going forward in supporting our members around this area.

I would like to take this opportunity to thank Daniel and the Carl project team who supported him. We will ensure that Down Syndrome Ireland circulates the research findings to all of their branches.”

Daniel Shenoda says:

"Working on a CARL project meant a lot to me. It gave me the opportunity to conduct a research project that would not only fulfil the requirement for my Medical degree but also benefit the community. CARL connected me with Down syndrome Cork, who had many research questions to choose from. Each question was based on actual concerns from parents of children with Down syndrome. It was amazing to know that I would be helping address one of these concerns. I hope that many more students do CARL projects, as it truly benefits the community." 

For more on this story contact:

Find out more about CARL (Community Academic Research Links) here

Civic & Community Engagement

Comhpháirteachas Cathartha agus Pobail

University College Cork, Cork, Ireland,