Background: Down syndrome is a genetic disorder attributed to chromosomal abnormality. Children with Down syndrome have low score on balance and agility tasks as well as on running speed, strength and visual-motor control. Pediatric clinical test of sensory interaction in balance (P-CTSIB) was used to assess which component amongst visual, vestibular and somatosensory was more involved in causing this imbalance in children. The aim of this study was to determine the effects of individual sensory component on stationary standing posture control and balance using P-CTSIB.Results: Min and max time required to perform the balance test was noted down with mean SD of max 21.03±1.28 and min 7.32±1.18. ANOVA and Students t test were used for analysing data. It was found that the measure of balance on all 6 conditions of P-CTSIB was better for boys compared to girls and is also better with increase in age. Children with Down syndrome have weak performance when only the vestibular system was available for maintaining balance and the visual and somatosensory systems were compromised. Conclusion:The findings of the present study concluded that children with Down syndrome performed better in condition1 were all the systems were available to maintain balance and the poor balance was noted in condition 6 were vestibular system was the only available sensory system for maintaining balance. Poor performance was noted at the early stage of life and was slight better as the age advanced with boys performing better than girls. Balance in children with Down syndrome is an important aspect to be considered during rehabilitation. Including the visual, vestibular and somatosensory system individually and in combination during rehabilitation will help improve the balancing skills of patients.

Background: Spinal arteriovenous metameric syndrome (SAMS), also known as Cobb syndrome is a rare metameric developmental disorder presenting as an extradural-intradural vascular malformation that involves bone, muscle, skin, spinal cord, and nerve roots.Case Report: An 11-year-old girl presented with history of progressive paraparesis, lower extremity sensory loss, along with bowel and bladder incontinence who was diagnosed with Cobb syndrome. She underwent endovascular embolization of one arterial feeder and two metameric components. Post embolization patient experienced further decline in muscle strength. Physiotherapy regimen was implemented for 4-5 days per week for period of two months. The patient was discharged with a home exercise programme.Result: At the time of discharge, muscle power was improved. Patient was able to walk with the help of walker. Conclusion:Spinal metameric arteriovenous syndrome is a complex nonhereditary genetic vascular disorder associated with variety of neurologic deficits. Physiotherapy management will play a major role in minimizing disability hence improve clinical outcome.

Telemedicine in pediatric physiotherapy simply refers to physical therapy services that are provided over a technology platform, rather than by in-person means. Telemedicine can in particular aid underprivileged communities dwelling in remote or underdeveloped areas with scarcely any health services and medical resources. With “social distancing” becoming the norm, we are facing difficulty following up with patients. Therapists are on a lookout for more innovative ways to reach out to their patients and make sure the child's progress is not hampered. Telemedicine is one such opportunity to stay connected with the patients and monitor patient progress. The purpose of this article is to compile and summarize all the scarce and scattered information on telemedicine and its application in pediatric physiotherapy so that researchers can conduct studies on the same and take the work forward from here. Search engines such as Cochrane Library, PubMed, and Google Scholar were explored with specific keywords like telemedicine, pediatric physiotherapy, India. Articles were then skimmed for relevance in the Indian scenario and used for reference. There is a big void in data available for telemedicine in pediatric physiotherapy. Providing telemedicine facilities and services to the huge population can be a daunting task as it involves technical, ethical, and legal issues. It can save the time of the patient and the therapist, provide instant care and assistance to the pediatric population as well as stay available to the increasing number of patients.

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