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Published on: August 23, 2017
Long-term effect of different treadmill interventions on gait development in new walkers with Down syndrome
Rosa M Angulo-Barroso1, Jianhua Wu, Dale A Ulrich
1Motor Development Laboratory, Center for Motor Behavior and Pediatric Disabilities, Division of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA. rangulo@umich.edu
Insights
High-intensity individualized treadmill training significantly improved gait patterns in infants with Down syndrome (DS) long-term. This approach enhanced key gait parameters more effectively than generalized training.
Area of Science:
- Developmental Pediatrics
- Motor Control
- Genetics and Genetic Diseases
Background:
- Infants with Down syndrome (DS) often exhibit delayed motor development and atypical gait patterns.
- Early intervention is crucial for optimizing motor outcomes in children with DS.
- Treadmill training has shown promise in improving gait in various pediatric populations.
Purpose of the Study:
- To investigate the long-term effects of two distinct treadmill intervention protocols on gait development in infants with Down syndrome (DS).
- To compare the efficacy of a high-intensity individualized (HI) versus a low-intensity generalized (LG) treadmill training approach.
Main Methods:
- A longitudinal study involving 30 infants with DS, randomly assigned to either HI or LG treadmill intervention groups.
- Intervention occurred in-home until independent walking (3 steps), followed by a 1-year gait analysis follow-up for 25 participants.
- Six basic gait parameters (velocity, cadence, step length, step width, double support percentage, dynamic base) were analyzed using principal component analysis (PCA) and ANOVA.
Main Results:
- The first principal component (PC1), explaining 83.8% of gait variance, significantly increased over time in both groups.
- The high-intensity individualized (HI) group demonstrated significantly higher PC1 scores, normalized velocity, and cadence, with lower double support percentage compared to the low-intensity generalized (LG) group.
- Both groups showed significant reductions in foot rotation asymmetry over the study period, with no significant difference between the training protocols.
Conclusions:
- High-intensity individualized (HI) treadmill intervention offers superior long-term benefits for developing fundamental gait parameters in infants with Down syndrome (DS) compared to low-intensity generalized (LG) training.
- While both protocols improve gait over time, the individualized approach yields more significant enhancements in key gait metrics.
- The reduction of foot rotation asymmetry appears independent of the specific treadmill training intensity or individualization.
Abstract:
This longitudinal study investigated the long-term effect of different treadmill interventions on the development of gait patterns in infants with Down syndrome (DS). Thirty infants with DS (mean age 10.0 months, S.D. 1.9 months) were randomly assigned to either a "low intensity-generalized" (LG) training group, or a "high intensity-individualized" (HI) training group. Treadmill intervention was conducted in infants' homes until they walked three steps independently. Twenty-five participants completed a 1-year gait follow-up after the treadmill intervention. Six basic gait parameters were examined: normalized velocity, cadence, step length, step width, double support percentage, and dynamic base. Principal component analysis (PCA) conducted for the set of the six basic gait parameters demonstrated that the first principal component (PC1) accounted for 83.8% of the variance. A two-way ANOVA with repeated measures conducted with PC1 scores revealed a significant visit effect and group difference; both groups significantly increased PC1 scores over time, and the HI group produced significantly higher PC1 scores than the LG group. Specifically, the HI group produced significantly higher normalized velocity and cadence, and lower double support percentage than the LG group. In addition, both groups significantly reduced foot rotation asymmetry over time although no difference was found between the two groups. We concluded that the HI treadmill intervention provided a better long-term effect on the development of basic gait parameters than the LG training, and the reduction of foot rotation asymmetry over time was not differentially affected by the different training protocols.
