Joint stiffness and gait pattern evaluation in children with Down syndrome.

Hypotonia, ligament laxity and motor alterations are characteristic for patients with Down syndrome (DS). The purpose of this study was the evaluation of typical gait pattern of subjects with Down syndrome and the quantification of their joint stiffness, connected with ligament laxity and hypotonia, as a possible compensation. 98 children with DS (mean age: 11.7 years; range: 6-15 years) and 30 healthy children (control group (CG); mean age: 11 years; range: 5-13 years) underwent full 3D gait analysis at self-selected speed. Subjects with DS walked with more hip flexion during the whole gait cycle, knee flexion in stance phase, a limitation of the knee range of motion, and plantarflexion of the ankle at initial contact. Ankle power was limited as evident in terminal stance and pre-swing, represented by a low propulsive capacity at push-off, too. Hip joint stiffness was increased in general in patients with DS versus normal subjects while ankle joint stiffness revealed a lower value instead.

[1]  E. Donoghue,et al.  Some Factors Affecting Age of Walking in a Mentally Retarded Population , 1970, Developmental medicine and child neurology.

[2]  G. Molnar Analysis of motor disorder in retarded infants and young children. , 1978, American journal of mental deficiency.

[3]  M. Latash,et al.  Organization of a simple two-joint synergy in individuals with Down syndrome. , 1996, American journal of mental retardation : AJMR.

[4]  R. B. Davis,et al.  A gait analysis data collection and reduction technique , 1991 .

[5]  M Gough,et al.  Lower limb extensor moments in children with spastic diplegic cerebral palsy. , 2004, Gait & posture.

[6]  M. S. Valle,et al.  Analysis of ankle kinetics during walking in individuals with Down syndrome. , 2001, American journal of mental retardation : AJMR.

[7]  Giancarlo Ferrigno,et al.  Elite: A Digital Dedicated Hardware System for Movement Analysis Via Real-Time TV Signal Processing , 1985, IEEE Transactions on Biomedical Engineering.

[8]  G. Yeo,et al.  Birth prevalence of Down syndrome in Singapore from 1993 to 1998. , 2002, Singapore medical journal.

[9]  R Bronks,et al.  Gait of children with Down syndrome. , 1980, Archives of physical medicine and rehabilitation.

[10]  M. Latash,et al.  Kinematic and electromyographic characteristics of single-joint movements of individuals with Down syndrome. , 1991, American journal of mental retardation : AJMR.

[11]  M. Woollacott,et al.  Dynamics of postural control in the child with Down syndrome. , 1985, Physical therapy.

[12]  N. Roizen,et al.  Down's syndrome , 2003, The Lancet.

[13]  P. Crenna,et al.  Moment-angle relationship at lower limb joints during human walking at different velocities. , 1996, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[14]  J. Carr,et al.  Mental and motor development in young mongol children. , 2008, Journal of mental deficiency research.

[15]  J. Adler,et al.  Biomechanical management of children and adolescents with Down syndrome. , 1991, Journal of the American Podiatric Medical Association.

[16]  R. B. Davis,et al.  Gait characterization via dynamic joint stiffness , 1996 .

[17]  J. Bodensteiner,et al.  Hypotonia, Congenital Hearing Loss, and Hypoactive Labyrinths , 2003, Journal of child neurology.

[18]  N. Virji-Babul,et al.  Stiffness and postural stability in adults with Down syndrome , 2004, Experimental Brain Research.