Exploring effects of different treadmill interventions on walking onset and gait patterns in infants with Down syndrome

Abstract

Two cohorts of participants were included to investigate the effects of different treadmill interventions on walking onset and gait patterns in infants with Down syndrome (DS). The first cohort included 30 infants with DS (17 males, 13 females; mean age 10mo [SD 1.9mo]) who were randomly assigned to either a lower‐intensity‐generalized (LG) training group, or a higher‐intensity‐individualized (HI) training group. A control (C) group from another study, who did not receive treadmill training, served as the control (eight males, seven females; mean age 10.4mo [SD 2.2mo]). Mean age at walking onset was 19.2, 21.4, and 23.9 months for the HI, LG, and C groups respectively. At walking onset the HI group was significantly younger than the C group (p=0.011). At the gait follow‐up that was conducted between 1 and 3 months after walking onset, three groups significantly different in overall gait patterns (p=0.037) were examined by six basic gait parameters including average velocity, stride length, step width, stride time, stance time, and dynamic base. Post‐hoc analyses demonstrated that stride length was the gait parameter largely contributing to this overall group difference (p=0.033), and the HI group produced a significantly longer stride length than the C group (p=0.030). In conclusion, the HI treadmill intervention significantly promoted earlier walking onset and elicited more advanced gait patterns (particularly in stride length) in infants with DS.

Effect of Treadmill Training and Supramalleolar Orthosis Use on Motor Skill Development in Infants With Down Syndrome: A Randomized Clinical Trial

“…In studies by Ulrich and colleagues, 13,16 traditional treadmill training led to a large decrease in time to independent walking onset and to improved gait at walking onset compared with no treadmill training. In the current study, infants with DS who received traditional treadmill training were compared with a group of children with DS who received traditional treadmill training as well as early orthotic use.…”

“…There were improvements in gait parameters and a decrease in gait variability when compared with the original treadmill paradigm and with toddlers with DS who did not receive treadmill training. 8,16 The higherintensity, individualized training also has been reported to have a positive impact on adaptive gait and physical activity. 17,18 This study is an extension of the previous treadmill training research involving infants with DS.…”

Gait and Balance

“…The available randomized clinical trials include people with Down syndrome, treated to improve gait and balance with treadmill training protocols (Angulo- Carmeli et al 2002c;Ulrich et al 2001;Wu et al 2007;Wu et al 2008). Carmeli et al (2002c) have shown that TUG test performance, as well as knee flexion and extension strength, improved significantly for the experimental group of adults (57-65 years old) with ID after 6 months of training.…”

“…Other randomized clinical trials have been applied in infants with Down syndrome and revealed an earlier onset of independent sitting (Ulrich et al 2001) and walking (Ulrich et al 2001;Wu et al 2007;Wu et al 2008), and longer stride length . Furthermore, infants with ID responded better to a high compared to a low-intensity treadmill program, by increasing walking speed, cadence, by decreasing double support duration and by being able to walk over an obstacle at higher rates within a 6-month training period .…”

Terapia neuromotora intensiva nas habilidades motoras de criança com Síndrome de Down

“…Os resultados do presente estudo corroboram com outros que defendem eu na SD intervenções de maior intensidade, favorecem e até mesmo antecipam ganho de habilidades motoras quando comparadas às crianças com intervenções convencionais 20,21 . Provavelmente, os ganhos funcionais observados no presente estudo tenham relação com ganho de força muscular pelo treinamento da TNMI, que, embora não tenha sido aferido de forma direta, é observado pelo incremento de habilidades funcionais em atividades contra a gravidade.…”