Rectus tightness in Down syndrome is associated with which postural condition?

• A. Postural kyphosis
• B. Scoliosis
• C. Lordosis
• D. Neutral

Answer: (A)

When trunk muscle balance is off, the way the spine stacks in the sagittal plane changes. Tightness of the rectus abdominis tends to pull the upper trunk into flexion and can contribute to a forward-rounded posture. In kids with Down syndrome, there is often reduced strength in the back extensors and overall hypotonia, which means there’s less ability to resist that forward flexion. The result is a flexible, non-structural forward rounding of the thoracic spine—postural kyphosis. It’s a reversible posture that can improve with targeted stretching of the abdominal wall and strengthening of the trunk extensors and postural training.

Scoliosis involves a sideways (lateral) curvature of the spine, not primarily driven by abdominal tightness. Lordosis is an increased inward curve of the lower back, not the thoracic kyphosis described here. Neutral would mean no abnormal curvature, which isn’t the pattern produced by tight rectus abdominis in this context.