Why is an atlantoaxial instability test required for participants with Down syndrome?

An atlantoaxial instability test is particularly important for individuals with Down syndrome because they are at an increased risk for instability at the junction between the first two cervical vertebrae (the atlas and the axis). This instability can pose a significant risk for spinal cord injury, especially during activities that involve movement, such as therapeutic riding.

The test assesses whether the vertebral spacing is safe for participation in activities that might put stress on the cervical spine. If instability is detected, appropriate precautions can be taken to ensure the individual's safety during therapeutic riding sessions, or they may be advised against such activities altogether.

The other options mention medical aspects that, while relevant in other contexts, do not specifically relate to the unique risk of atlantoaxial instability commonly associated with individuals who have Down syndrome.