Treadmill training of infants with down syndrome: Evidence-based developmental outcomes

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 t o 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 i ntervention or control group. All infants were karyotyped trisomy 21 and be gan participation in the study when they could sit alone for 30 seconds (Ba yley Scales of Infant Development, Second Edition 1993, item 34). Infants r eceived traditional physical therapy at least every other week. In addition , intervention infants received practice stepping on a small, motorized tre admill, 5 days per week, for 8 minutes a day, in their own homes. Parents w ere trained to support their infants on these specially engineered miniatur e treadmills. Every 2 weeks research staff went into the homes and tested i nfants' overall motor progress by administering the Bayley Scales of Infant Development, Second Edition,(1) monitored growth status via a battery of 1 1 anthropometric measures, and checked parents' compliance with physical th erapy and treadmill intervention. The primary measures of the intervention' s effectiveness were comparisons between the groups on the length of time e lapsed 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 indep endently significantly faster (73.8 days and 101 days, respectively) than t he 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 siz e 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 wit h DS learn to walk earlier than they normally would. Current research is ai med at 1) improving the protocol to maximize outcome; 2) determining the im pact of treadmill practice on walking gait patterns; 3) testing the applica tion to other populations with a history of delays in walking; and 4) deter mining the long-term benefits that may accrue from this form of activity.