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Stepping responses of infants with myelomeningocele when supported on a motorized treadmill
Caroline Teulier1, Beth A Smith, Masayoshi Kubo
1Developmental Neuromotor Control Laboratory, Division of Kinesiology, University of Michigan, 401 Washtenaw Ave, Ann Arbor, MI 48109-2214, USA. cteulier@umich.edu
Insights
Infants with myelomeningocele (MMC) showed stepping responses and increased motor activity on a treadmill. Their stepping patterns developed differently compared to typically developing infants.
Area of Science:
- Developmental pediatrics
- Neurorehabilitation
- Motor control in infants
Background:
- Infants with myelomeningocele (MMC) experience delays in acquiring functional skills like walking.
- Early motor development and stepping patterns in infants with MMC require further investigation.
Purpose of the Study:
- To determine if infants with MMC respond to treadmill practice with stepping or motor activity within their first year.
- To compare the stepping trajectories of infants with MMC to those of typically developing (TD) infants.
Main Methods:
- Twelve infants with MMC and 12 TD infants participated.
- Infants were tested on a treadmill at 1, 3, 6, 9, and 12 months of age.
- Step rate, interlimb patterns, step parameters, and motor activity were analyzed using video and behavioral coding.
Main Results:
- Treadmill practice elicited stepping in infants with MMC, though at a lower rate than in TD infants.
- Interlimb stepping was less alternating in infants with MMC, but step parameters were similar to TD infants.
- Motor activity increased when infants with MMC were on a moving treadmill compared to a nonmoving one.
Conclusions:
- Infants with MMC demonstrate responsiveness to treadmill practice with stepping and increased motor activity.
- The developmental trajectory of stepping patterns in infants with MMC differs from that of TD infants.
- Further research on sensory input during treadmill practice is recommended to optimize responses in infants with MMC.
Background And Purpose:
Infants with myelomeningocele (MMC) have difficulty with, and show delays in, acquiring functional skills, such as walking. This study examined whether infants with MMC will respond to treadmill practice by producing stepping patterns or at least motor activity during the first year after birth. This study also compared the stepping trajectories of infants with MMC across age with those of infants with typical development (TD) to analyze the characteristics of the development of stepping patterns in infants with MMC early in life.
Participants:
Twelve infants with MMC (lumbar and sacral lesions) and 12 infants with TD were the participants in this study.
Methods:
The infants were tested on a treadmill at ages 1, 3, 6, 9, and 12 months, with no treadmill practice between test sessions. Infants were supported on the treadmill for twelve 20-second trials. A digital camera and behavior coding were used to determine step rate, interlimb stepping patterns, step parameters, and motor activity level.
Results:
Treadmill practice elicited steps in infants with MMC (14.4 steps/minute during the year) but less so than in infants with TD (40.8 steps/minute). Responsiveness was affected by lesion level but varied markedly among infants. Interlimb stepping was less readily alternating, but step parameters were similar to those produced by their peers with TD. Finally, holding infants with MMC on a moving treadmill resulted in greater motor activity (17% during the year) than holding infants on a nonmoving treadmill.
Discussion And Conclusion:
Infants with MMC responded to the treadmill by stepping (but less so than infants with TD) and showing increased motor activity, but they demonstrated a different developmental trajectory. Future studies are needed to explore the impact of enhancing sensory input during treadmill practice to optimize responses in infants with MMC.
