A biomechanical study of gait initiation in Down syndrome

Abstract

Background Gait Initiation (GI) is a functional task that challenges the balance control requiring weight shift and a transition from standing to walking. Individuals with Down Syndrome (DS) walk with low velocity, prolonged stance and shorter steps beside an increased support base. However, no studies performed GI analysis on this population. The aim of this study is to quantitatively characterize the GI task in subjects with DS compared with a typically developed control group. Methods Seventeen individuals with DS (17 to 40 years) and 19 healthy subjects (17 to 40 years) were enrolled in the study. Data were acquired using an optoelectronic motion capture system and force plates in order to measure the displacement and velocity of Center of Mass (CoM) and the trajectory of Center Of Pressure (CoP). All participants were asked to stand barefoot on the first force platform and received a verbal cue to begin walking for 6 gait initiation trials (three starting with each foot). The CoP duration, velocity, length and excursion were calculated during the anticipatory postural adjustments phases (APAs) and the locomotor (LOC) phase. For the analysis of the CoM, its displacements in antero-posterior (AP) and medio-lateral (ML) during the APAs and LOC phases. Statistical analysis was conducted to compare the two groups. Results Regarding CoP measures, when compared to control group, individuals with DS presented higher durations, lower velocities, longer lengths during the second APA and total phases, and shorter lengths during the first APA and LOC phases. The group with DS also presented longer CoP excursion during the second APA, whereas a shorter excursion was present during the first APA and LOC phases. The AP excursion in CoM is reduced in the participants with DS. Conclusions Our results could be useful in the rehabilitation of individuals with DS as they suggest to reinforce exercise programs to improve balance in AP and ML directions, which is demonstrated to be impaired in these subjects.

Development of temporal and spatial characteristics of anticipatory postural adjustments during gait initiation in children aged 3–10 years

“…The COP trajectories during APAs along the AP and ML axes are controlled by the "coordination" pattern between the ventrodorsal muscles (dominated by ankle muscles) and ML muscles (dominated by hip muscles) (Winter, 2009). Thus, the COP trajectory of APAs could detect the development of coordination patterns and direction specificities in APAs and may be an effective parameter (Corsi et al, 2019). To the best of our knowledge, only one study addresses the detailed COP trajectory during GI (Malouin & Richards, 2000).…”

Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study

“…Gait initiation is a functional task that is classically used in the literature as an experimental paradigm to investigate how the central nervous system (CNS) controls balance in dynamical conditions in both healthy adults [e.g., (31)(32)(33)(34)(35) for recent articles] and pathological patients [e.g., (36)(37)(38)(39)(40) for recent articles]. Gait initiation appears to be the major biomechanical model, complementary to the classical clinical test, in order to predict postural disorders in elderly fallers and non-fallers (41)(42)(43)(44).…”

Does Customized Handle Toothbrush Influence Dental Plaque Removal in Children with Down Syndrome? A Randomized Controlled Trial

“…Many researches have studied the manual dexterity of persons with Down syndrome and found that such persons suffered from difficulties in hand movement and control [ 40 ]. Despite such difficulties, it is possible to improve manual dexterity skills by constant training and by external support tools [ 41 ]. It has been found that training children on hands movement enhances children’s hands movement control [ 22 ].…”