Physical Therapy Program, University of Puget Sound, 1500 N Warner St #1070, Tacoma, WA 98416-1070, USA.
Phys Ther. 2010 Mar;90(3):382-90. doi: 10.2522/ptj.20090021. Epub 2010 Jan 14.
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.
This study was a randomized controlled trial.
This study was conducted in participants' homes and in the motor development laboratory.
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.
The Gross Motor Function Measure (GMFM) was used to test motor skill development.
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.
Orthoses may have a detrimental effect on overall gross motor skill development.
唐氏综合征（Down syndrome，DS）患儿通常表现出独立行走的延迟。跑步机训练是一种有效的干预措施，可以使患儿更早开始行走。此外，DS 患儿通常会使用矫形器来增加稳定性并促进其更早地独立行走。然而，这种矫形器在 DS 患儿中的早期使用尚未得到科学验证。
本研究旨在深入了解与单独使用跑步机训练相比，在 DS 患儿中早期使用矫形器联合跑步机训练对其发育结果的影响。
本研究为一项随机对照试验。
本研究在参与者的家中和运动发育实验室进行。
17 名能够扶站的 DS 患儿入组本研究，他们被随机分配到对照组（接受跑步机训练）或实验组（接受跑步机训练和矫形器）。在每月对患儿家中的访问中，记录 3 分钟的跑步机踏步，并测试每个儿童的运动发育技能。当患儿独立行走 3 步时，跑步机训练结束。在行走开始后 1 个月，重新进行发育测试。
使用粗大运动功能测量量表（Gross Motor Function Measure，GMFM）来测试运动技能发育。
对照组的平均（标准差）研究时间为 268（88）天，实验组为 206（109）天。所有患儿的 GMFM 评分均随时间显著增加。在行走 1 个月后，对照组的 GMFM 评分高于实验组，且站立和行走、跑步和跳跃分量表评分更高。
本研究的局限性包括方便选择的小样本、可能在尾部降低有效性的统计模型以及 GMFM 评分者缺乏盲法。
矫形器可能对整体粗大运动技能发育产生不利影响。
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