Gait adaptations in response to perturbations in adults with Down syndrome.
OBJECTIVE
Ligamentous laxity, hypotonia and physiologic changes associated with aging lead to gait adaptations to increase control during comfortable unperturbed walking in adults with Down syndrome (DS). These changes appear at earlier ages than changes associated with aging in adults with typical development (TD) [1]. Here we describe gait adaptation and stability when gait is perturbed in relatively older adults with DS compared to their peers with TD.


METHODS
A volunteer sample of 14 adults with DS and 14 adults with TD, all 35-65 years of age, participated.


METHODS
We used 3D motion analysis to capture walking patterns at self-selected pace and in seven environmentally relevant perturbation conditions. We tested for group differences in gait parameters and amount of variability by condition: specifically percent stance, step width and stride length, velocity and frequency. To quantify overall change in gait parameters and variability from baseline to each condition, we created summative parameters of the overall percent change from baseline to each condition for each dependent variable.


RESULTS
Adults with DS and TD made small but complex adjustments in gait parameters and variability in response to perturbations.


CONCLUSIONS
Overall adults in both groups maintained group differences in gait patterns while adapting well to anticipated perturbations.
Smith
Beth A
BA
Balance Disorders Laboratory, Department of Neurology, Oregon Health and Science University, Portland, OR 97006, United States. smitbeth@ohsu.edu
Ashton-Miller
James A
JA
Ulrich
Beverly D
BD
D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry; D004314:Down Syndrome / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology
Am J Phys Med Rehabil. 2007 Feb;86(2):125-32
17251694
J Neuroeng Rehabil. 2008 Nov 14;5:29
19014583
Phys Ther. 2007 Jun;87(6):766-77
17442836
J Mot Behav. 2006 May;38(3):229-37
16709562
Ann Neurol. 2003 Oct;54(4):433-8
14520653
J Intellect Disabil Res. 1996 Dec;40 ( Pt 6):535-43
9004114
Hum Mov Sci. 2004 Sep;23(2):133-56
15474174
Res Dev Disabil. 2004 Jul-Aug;25(4):385-97
15193672
Arch Phys Med Rehabil. 2007 Feb;88(2):187-91
17270516
Orthop Clin North Am. 1981 Jan;12(1):57-71
6451852
Dev Med Child Neurol. 2005 Mar;47(3):171-6
15739721
J Am Geriatr Soc. 1997 Mar;45(3):313-20
9063277
Brain. 2004 Apr;127(Pt 4):811-24
14985261
N Engl J Med. 1988 Dec 29;319(26):1701-7
3205267
Am J Ment Defic. 1986 Mar;90(5):490-500
3953681
J Biomech. 2004 Jun;37(6):935-8
15111081
Mech Ageing Dev. 1998 Sep 15;105(1-2):89-103
9922121
J Biomech. 2000 Nov;33(11):1433-40
10940402
Clin Rehabil. 2005 Mar;19(2):216-23
15759538
Gait Posture. 2007 Jun;26(1):113-9
16959488
Clin Genet. 2002 Nov;62(5):390-3
12431254
J Neurol Phys Ther. 2006 Sep;30(3):120-9
17029655
Can J Public Health. 1992 Jul-Aug;83 Suppl 2:S7-11
1468055
J Intellect Disabil Res. 2005 Feb;49(Pt 2):125-33
15634321
J Intellect Disabil Res. 1992 Aug;36 ( Pt 4):337-47
1525439
Gait Posture. 2008 Oct;28(3):448-55
18359229
Ment Retard Dev Disabil Res Rev. 2001;7(3):172-8
11553933
Am J Ment Retard. 1991 Sep;96(2):189-201
1834096
Phys Ther. 2000 Sep;80(9):896-903
10960937