Gait and postural control patterns and rehabilitation in Down syndrome: a systematic review.
Matteo Zago, Natalia Almeida Carvalho Duarte, Luanda André Collange Grecco and 3 others
PMID 32273655WHAT IT FOUND
People with Down syndrome walk with a wider base and shorter steps to stay stable, using stiff hips and knees to compensate for weak ankles.
Early, intensive treadmill training helps children walk sooner and more efficiently, but adults see little change.
Key findings
01Individuals with Down syndrome consistently show reduced gait velocity, shorter step length, and increased step width compared to typically developing controls.
02High-intensity treadmill training in toddlers led to independent walking at an average of 19.2 months, compared to 21.7 months for low-intensity training.
03Adults with Down syndrome showed minimal changes in gait patterns after treadmill training, unlike children.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The included studies had varied protocols and outcome measures, preventing a statistical meta-analysis. Only five of the included studies reported random and concealed allocation, limiting the certainty of the intervention effects. Therapists were not blinded in any study, introducing potential bias in outcome assessment. Most studies focused on children and young adults; data on older adults and gait decline with aging was scarce. The review excluded studies with a PEDro score below 5, which may have omitted some relevant but methodologically weaker evidence.
Declared interests
The authors declare that they have no competing interest.
The easy way to misread this
Do not expect treadmill training to significantly alter gait patterns in adults with Down syndrome. The evidence for efficacy is strong for toddlers and children, but adults showed minimal changes in gait parameters after training.