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Published on: August 23, 2017
Treadmill training of infants with Down syndrome: evidence-based developmental outcomes
D A Ulrich1, B D Ulrich, R M Angulo-Kinzler
1Division of Kinesiology, University of Michigan, Ann Arbor, Michigan 48109-2214, USA. ulrichd@umich.edu
Insights
Practice stepping on a motorized treadmill significantly reduced the delay in walking onset for infants with Down syndrome (DS). Home-based treadmill training, with parental support, helped infants with DS achieve walking milestones earlier than the control group.
Area of Science:
- Pediatrics
- Developmental Neuroscience
- Rehabilitation Medicine
Background:
- Infants with Down syndrome (DS) typically experience a significant delay in achieving developmental milestones, particularly walking, often starting around one year later than their non-disabled peers.
- Early intervention is crucial for optimizing motor development in infants with DS.
- Motor delays in DS are associated with various factors, including hypotonia and differences in motor planning.
Purpose of the Study:
- To investigate the efficacy of a home-based motorized treadmill intervention in reducing the delayed walking onset observed in infants with Down syndrome.
- To determine if structured practice stepping on a treadmill can accelerate the acquisition of key motor skills related to independent walking.
Main Methods:
- Thirty infants with Down syndrome (DS) were randomized into either an intervention or a control group.
- The intervention group received traditional physical therapy plus daily 8-minute practice stepping on a motorized treadmill at home for 5 days a week.
- Motor progress was assessed bi-weekly using the Bayley Scales of Infant Development, Second Edition, with primary outcome measures including time to stand, walk with assistance, and independent walking.
Main Results:
- Infants in the intervention group achieved walking with help and independent walking significantly faster than the control group, with large effect sizes noted.
- While not statistically significant, a moderate effect size suggested a meaningful difference in the rate of learning to raise self to stand, favoring the intervention group.
Conclusions:
- Home-based motorized treadmill training, supported by parents, can effectively accelerate the onset of walking in infants with Down syndrome.
- Further research is warranted to optimize the intervention protocol, examine gait patterns, and explore its applicability to other populations with motor delays.
Objective:
On average, infants with Down syndrome (DS) learn to walk about 1 year later than nondisabled (ND) infants. The purpose of this study was to determine if practice stepping on a motorized treadmill could help reduce the delay in walking onset normally experienced by these infants.
Methods:
Thirty families of infants with DS were randomly assigned to the intervention or control group. All infants were karyotyped trisomy 21 and began participation in the study when they could sit alone for 30 seconds (Bayley Scales of Infant Development, Second Edition 1993, item 34). Infants received traditional physical therapy at least every other week. In addition, intervention infants received practice stepping on a small, motorized treadmill, 5 days per week, for 8 minutes a day, in their own homes. Parents were trained to support their infants on these specially engineered miniature treadmills. Every 2 weeks research staff went into the homes and tested infants' overall motor progress by administering the Bayley Scales of Infant Development, Second Edition, monitored growth status via a battery of 11 anthropometric measures, and checked parents' compliance with physical therapy and treadmill intervention. The primary measures of the intervention's effectiveness were comparisons between the groups on the length of time elapsed between sitting for 30 seconds (entry into the study) and 1) raising self to stand; 2) walking with help; and 3) walking independently.
Results:
The experimental group learned to walk with help and to walk independently significantly faster (73.8 days and 101 days, respectively) than the control group, both of which also produced large effect size statistics for the group differences. The groups were not statistically different for rate of learning to raise self to stand but there was a moderate effect size statistic suggesting that the groups were meaningfully different in favor of the experimental group.
Conclusions:
These results provide evidence that, with training and support, parents can use these treadmills in their homes to help their infants with DS learn to walk earlier than they normally would. Current research is aimed at 1) improving the protocol to maximize outcome; 2) determining the impact of treadmill practice on walking gait patterns; 3) testing the application to other populations with a history of delays in walking; and 4) determining the long-term benefits that may accrue from this form of activity. motor development, Down syndrome, early intervention, walking.
