Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia, USA.
Phys Ther. 2010 Sep;90(9):1265-76. doi: 10.2522/ptj.20090281. Epub 2010 Jul 22.
Infants with Down syndrome (DS) have delayed walking and produce less-coordinated walking patterns.
The aim of this study was to investigate whether 2 treadmill interventions would have different influences on the development of joint kinematic patterns in infants with DS.
Thirty infants with DS were randomly assigned to a lower-intensity, generalized (LG) treadmill training group (LG group) or a higher-intensity, individualized (HI) treadmill training group (HI group) and trained until walking onset. Twenty-six participants (13 in each group) completed a 1-year gait follow-up assessment.
During the gait follow-up assessment, reflective markers were placed bilaterally on the participants to measure the kinematic patterns of the hip, knee, and ankle joints. Both the timing and the magnitude of peak extension and flexion at the hip, knee, and ankle joints, as well as peak adduction and abduction at the hip joint, in the 2 groups were compared.
Both the LG group and the HI group showed significantly advanced development of joint kinematics at the gait follow-up. In the HI group, peak ankle plantar flexion occurred at or before toe-off, and the duration of the forward thigh swing after toe-off increased.
Joint kinematics in the lower extremities were evaluated in this study. It would be interesting to investigate the effect of treadmill interventions on kinematic patterns in the trunk and arm movement.
The timing of peak ankle plantar flexion (before toe-off) in the HI group implies further benefits from the HI intervention; that is, the HI group may use mechanical energy transfer better at the end of stance and may show decreased hip muscle forces and moments during walking. It was concluded that the HI intervention can accelerate the development of joint kinematic patterns in infants with DS within 1 year after walking onset.
唐氏综合征（Down syndrome，DS）患儿行走延迟，步态协调性差。
本研究旨在探讨两种跑步机干预方式对 DS 患儿关节运动学模式发展的影响是否不同。
30 名 DS 患儿被随机分为低强度、泛化（lower-intensity，generalized，LG）跑步机训练组（LG 组）或高强度、个体化（higher-intensity，individualized，HI）跑步机训练组（HI 组），并接受训练直至开始行走。26 名参与者（每组 13 名）完成了为期 1 年的步态随访评估。
在步态随访评估中，在参与者的双侧放置反射标记物，以测量髋关节、膝关节和踝关节的运动学模式。比较两组髋关节、膝关节和踝关节的屈伸峰值时相和幅度，以及髋关节的内收和外展峰值时相。
LG 组和 HI 组在步态随访时关节运动学均显著提前发育。HI 组中，踝关节跖屈峰值出现在或早于足趾离地时，足趾离地后的大腿前摆时间延长。
本研究仅评估了下肢的关节运动学。研究跑步机干预对躯干和手臂运动的运动学模式的影响将是有趣的。
HI 组踝关节跖屈峰值（足趾离地前）的时相提示 HI 干预具有进一步的益处，即 HI 组可能在站立末期更好地利用机械能传递，且在行走过程中髋关节肌肉力和力矩减小。研究得出结论，HI 干预可在行走起始后 1 年内加速 DS 患儿关节运动学模式的发展。
