Advertisement

Gait performance and dual-task costs in school-aged children with Down syndrome

Published:November 21, 2022DOI:https://doi.org/10.1016/j.braindev.2022.11.001

      Abstract

      Objective

      This cross-sectional observational study aimed to assess gait performance, its correlation with physical functions, and its dual-task costs in children with Down syndrome (DS), to investigate their gait adaptations.

      Methods

      Gait performance with or without movie-watching tasks was evaluated in 17 children with DS (age, 6–12 years) and 51 age- and sex-matched controls, using three-dimensional gait analysis. We compared participants’ demographics, physical functions, and gait performance without tasks between the two groups. In the DS group, correlations between physical functions, the intelligence quotient, and gait variables were assessed. Dual-task costs for gait variables were also compared between the two groups.

      Results

      Children with DS showed poorer balance function and muscle strength and lower gait quality than the control group. In the DS group, there was a significant positive correlation between gait speed, step length, and intelligence quotient. There were no correlations between the balance function, muscle strength, intelligence quotient, and gait quality. Dual-task costs for gait speed, step length, and cadence were greater in the DS group; however, there was no significant difference in dual-task costs for gait quality between the two groups.

      Conclusion

      These findings highlight the importance of providing appropriate interventions for motor functions in school-aged children with DS based on their gait performance in single- and dual-task conditions, as well as on their intelligence quotient.

      Keywords

      Abbreviations:

      DS (Down syndrome), FTSST (Five times sit-to-stand test), GDI (Gait deviation index), IQ (Intelligence quotient), SLST (Single-leg standing time), 3DGA (Three-dimensional gait analysis)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Brain and Development
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Lagan N.
        • Huggard D.
        • Mc Grane F.
        • Leahy T.R.
        • Franklin O.
        • Roche E.
        • et al.
        Multiorgan involvement and management in children with Down syndrome.
        Acta Paediatr. 2020; 109: 1096-1111
        • Weijerman M.E.
        • de Winter J.P.
        Clinical practice. The care of children with Down syndrome.
        Eur J Pediatr. 2010; 169: 1445-1452
        • Mik G.
        • Gholve P.A.
        • Scher D.M.
        • Widmann R.F.
        • Green D.W.
        Down syndrome: orthopedic issues.
        Curr Opin Pediatr. 2008; 20: 30-36
        • Zago M.
        • Duarte N.A.C.
        • Grecco L.A.C.
        • Condoluci C.
        • Oliveira C.S.
        • Galli M.
        Gait and postural control patterns and rehabilitation in Down syndrome: a systematic review.
        J Phys Ther Sci. 2020; 32: 303-314
        • Maïano C.
        • Hue O.
        • Tracey D.
        • Lepage G.
        • Morin A.J.S.
        • Moullec G.
        Static postural control among school-aged youth with Down syndrome: A systematic review.
        Gait Posture. 2018; 62: 426-433
        • Rigoldi C.
        • Galli M.
        • Mainardi L.
        • Crivellini M.
        • Albertini G.
        Postural control in children, teenagers and adults with Down syndrome.
        Res Dev Disabil. 2011; 32: 170-175
        • Kraan C.M.
        • Tan A.H.J.
        • Cornish K.M.
        The developmental dynamics of gait maturation with a focus on spatiotemporal measures.
        Gait Posture. 2017; 51: 208-217
        • Galli M.
        • Rigoldi C.
        • Brunner R.
        • Virji-Babul N.
        • Giorgio A.
        Joint stiffness and gait pattern evaluation in children with Down syndrome.
        Gait Posture. 2008; 28: 502-506
        • Rigoldi C.
        • Galli M.
        • Albertini G.
        Gait development during lifespan in subjects with Down syndrome.
        Res Dev Disabil. 2011; 32: 158-163
        • Hocking D.R.
        • Menant J.C.
        • Kirk H.E.
        • Lord S.
        • Porter M.A.
        Gait profiles as indicators of domain-specific impairments in executive control across neurodevelopmental disorders.
        Res Dev Disabil. 2014; 35: 203-214
        • Horvat M.
        • Croce R.
        • Tomporowski P.
        • Barna M.C.
        The influence of dual-task conditions on movement in young adults with and without Down syndrome.
        Res Dev Disabil. 2013; 34: 3517-3525
        • Pena G.M.
        • Pavão S.L.
        • Oliveira M.F.
        • de Campos A.C.
        • Rocha N.A.
        Dual-task effects in children with neuromotor dysfunction: a systematic review.
        Eur J Phys Rehabil Med. 2019; 55: 281-290
        • Boonyong S.
        • Siu K.C.
        • van Donkelaar P.
        • Chou L.S.
        • Woollacott M.H.
        Development of postural control during gait in typically developing children: the effects of dual-task conditions.
        Gait Posture. 2012; 35: 428-434
        • Raven J.
        • Raven J.C.
        • Court J.
        Manual for Raven’s progressive matrices and vocabulary scales.
        Oxford Psychologists Press, Oxford1998
        • Ito T.
        • Sugiura H.
        • Ito Y.
        • Noritake K.
        • Ochi N.
        Relationship between the skeletal muscle mass index and physical activity of Japanese children: A cross-sectional, observational study.
        PLoS ONE. 2021; 16: e0251025
        • Liao H.F.
        • Mao P.J.
        • Hwang A.W.
        Test-retest reliability of balance tests in children with cerebral palsy.
        Dev Med Child Neurol. 2001; 43: 180-186
        • Wang T.H.
        • Liao H.F.
        • Peng Y.C.
        Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy.
        Clin Rehabil. 2012; 26: 664-671
        • Ito T.
        • Noritake K.
        • Ito Y.
        • Tomita H.
        • Mizusawa J.
        • Suguira H.
        • et al.
        Three-dimensional gait analysis of lower extremity gait parameters in Japanese children aged 6 to 12 years.
        Sci Rep. 2022; 12: 7822
        • Leboeuf F.
        • Baker R.
        • Barré A.
        • Reay J.
        • Jones R.
        • Sangeux M.
        The conventional gait model, an open-source implementation that reproduces the past but prepares for the future.
        Gait Posture. 2019; 69: 235-241
        • Ito Y.
        • Ito T.
        • Sugiura H.
        • Kidokoro H.
        • Sugiyama Y.
        • Mizusawa J.
        • et al.
        Physical functions and gait performance in school-aged children born late preterm.
        Early Hum Dev. 2021; 163105478
        • Stansfield B.W.
        • Hillman S.J.
        • Hazlewood M.E.
        • Lawson A.M.
        • Mann A.M.
        • Loudon I.R.
        • et al.
        Normalisation of gait data in children.
        Gait Posture. 2003; 17: 81-87
        • Schwartz M.H.
        • Rozumalski A.
        The Gait Deviation Index: a new comprehensive index of gait pathology.
        Gait Posture. 2008; 28: 351-357
        • Massaad A.
        • Assi A.
        • Skalli W.
        • Ghanem I.
        Repeatability and validation of gait deviation index in children: typically developing and cerebral palsy.
        Gait Posture. 2014; 39: 354-358
        • Schott N.
        • El-Rajab I.
        • Klotzbier T.
        Cognitive-motor interference during fine and gross motor tasks in children with Developmental Coordination Disorder (DCD).
        Res Dev Disabil. 2016; 57: 136-148
        • Cherng R.J.
        • Liang L.Y.
        • Chen Y.J.
        • Chen J.Y.
        The effects of a motor and a cognitive concurrent task on walking in children with developmental coordination disorder.
        Gait Posture. 2009; 29: 204-207
        • Piitulainen H.
        • Kulmala J.P.
        • Mäenpää H.
        • Rantalainen T.
        The gait is less stable in children with cerebral palsy in normal and dual-task gait compared to typically developed peers.
        J Biomech. 2021; 117110244
        • Tracy J.B.
        • Petersen D.A.
        • Pigman J.
        • Conner B.C.
        • Wright H.G.
        • Modlesky C.M.
        • et al.
        Dynamic stability during walking in children with and without cerebral palsy.
        Gait Posture. 2019; 72: 182-187
        • Wu T.
        • Liu J.
        • Hallett M.
        • Zheng Z.
        • Chan P.
        Cerebellum and integration of neural networks in dual-task processing.
        Neuroimage. 2013; 65: 466-475
        • Hamner T.
        • Udhnani M.D.
        • Osipowicz K.Z.
        • Lee N.R.
        Pediatric brain development in Down syndrome: a field in its infancy.
        J Int Neuropsychol Soc. 2018; 24: 966-976
        • Shiohama T.
        • Levman J.
        • Baumer N.
        • Takahashi E.
        Structural magnetic resonance imaging-based brain morphology study in infants and toddlers with Down syndrome: the effect of comorbidities.
        Pediatr Neurol. 2019; 100: 67-73