Article

Children with Down syndrome (DS) often display delayed onset of
independent walking. Treadmill training is an effective intervention that leads
to an earlier walking onset. In addition, orthoses often are provided to infants
with DS to increase stability and promote earlier independent walking. However,
this early use of orthoses has not been scientifically verified in infants with DS. The purpose of this study was to provide insight into the
developmental outcomes of early orthosis use in combination with treadmill
training in infants with DS compared with treadmill training alone. DESIGN: This
study was a randomized controlled trial. SETTING: This study was conducted in
participants' homes and in the motor development laboratory.
INTERVENTION: Seventeen infants with DS entered the study when they could pull
themselves to a standing position. They were randomly assigned to either a
control group (which received treadmill training) or an experimental group (which
received treadmill training and orthoses). During monthly visits to the infants'
homes, 3 minutes of treadmill stepping was recorded and each child's motor
development skills were tested. The treadmill training ended once the child took
3 independent steps. One month following walking onset, developmental tests were
readministered. MEASUREMENTS: The Gross Motor Function Measure (GMFM) was used to
test motor skill development. RESULTS: The average (SD) time in the study was 268
(88) days for the control group and 206 (109) days for the experimental group.
All infants showed significantly increased GMFM scores over time. At 1 month of
walking experience, the control group had higher GMFM scores than the
experimental group, with higher standing and walking, running, and jumping
subscale scores. Limitations of this study included a small sample
of convenience, a statistical model that may have reduced validity at the tail end, and a lack of blinding in the GMFM scorer. CONCLUSIONS:
Orthoses may have a
detrimental effect on overall gross motor skill development.

Langue : ANGLAIS