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Gross Motor Acquisition in Infants with Down Syndrome Using Hip Helpers®: An Exploratory Matched-Pair Case Series
Catherine M Andrea1, Megan B Flores2, Marianne Hanover3
1Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, St. Augustine, FL, USA.
Insights
A parent-implemented Hip Helpers® program for infants with Down syndrome (DS) showed variable gross motor skill gains, with delayed crawling. Further research is needed to confirm effectiveness.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Genetics
Background:
- Infants with Down syndrome (DS) often experience delays in gross motor skill acquisition.
- Early intervention is crucial for optimizing developmental outcomes in children with DS.
Purpose of the Study:
- To explore trends in gross motor skill acquisition in infants with Down syndrome (DS) using a parent-implemented Hip Helpers® home program.
- To assess the feasibility and potential impact of the Hip Helpers® garment on motor development.
Main Methods:
- Prospective exploratory matched-pair case series involving four infants with Trisomy 21 Down syndrome.
- Participants engaged in a Hip Helpers® home program with monthly Gross Motor Function Measure (GMFM-88) assessments.
- Intervention use was discontinued when participants achieved specific motor milestones.
Main Results:
- Gross Motor Function Measure (GMFM-88) change scores varied, with the most significant improvements observed in Sitting (Dimension B).
- Crawling onset appeared delayed in infants using the Hip Helpers® garment, indicating a potential tradeoff.
- No adverse events were reported during the study period.
Conclusions:
- The Hip Helpers® home program did not demonstrate accelerated gross motor skill acquisition compared to typical development in infants with DS.
- The study suggests potential feasibility but did not measure acceptability.
- Larger studies are required to validate findings, incorporating objective adherence measures and standardized feasibility/acceptability tools.
Aims:
To explore trends in gross motor skill acquisition associated with a parent‑implemented Hip Helpers® home program in two matched pairs of infants with Down syndrome (DS).
Methods:
In this prospective exploratory matched‑pair case series, two 6-month-old (Child A1 and Child A2) and two 9-month-old (Child B1 and B2) children with Trisomy 21 DS participated in a Hip Helpers® home program (two daily 30-minute sessions during active play). Pairs had similar motor abilities and continued usual therapies. Use of Hip Helpers® for child A2 and B2 was discontinued when the children could pull themselves to a standing position. Testing using the Gross Motor Function Measure (GMFM-88) occurred monthly until each participant was able to take three independent steps.
Results:
GMFM-88 change scores were variable across pairs, with the largest gains in Sitting (Dimension B). Crawling began later in garment users, suggesting a potential tradeoff. No adverse events were reported.
Conclusions:
Neither child who participated in the Hip Helpers® home program showed a faster acquisition of gross motor skills than is predicted for children with DS who do not use the garment. Feasibility was suggested; acceptability was not measured. Larger studies with objective adherence and standardized feasibility/acceptability tools are needed.

