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Background: While mini-trampolines have been used among a variety of groups including children as an intervention tool, the motor behavior children adopt while hopping on this soft, elastic surface is unknown. Identifying coordinative structures and their stability for hopping on a mini-trampoline is imperative for recommending future interventions and determining appropriateness to populations with motor dysfunctions.Research Question: Do children demonstrate similar biomechanical and coordination patterns as adults while hopping on a mini-trampoline?Methods: Fifteen adults aged 18-35 years and 14 children aged 7-12 years completed bouts of continuous two-legged hopping in-place on a stiff surface for 10 s at a time and on a mini-trampoline for 30 s at a time. 3-D motion capture tracked whole-body movement. We evaluated whole-body vertical stiffness as a ratio of peak vertical force and peak vertical displacement, as well as spatiotemporal parameters of hopping. Coordinative structures were evaluated as continuous relative phase angles of the foot, shank, thigh, and pelvis segments.Results and Significance: Adults did not modify whole-body vertical stiffness on a mini-trampoline, while children increased whole-body vertical stiffness to compensate for the reduced surface stiffness. Both groups conserved the coordinative structure for hopping on a mini-trampoline by modulating hopping cycle timing. Moreover, children hopped with an adult-like coordinative structure, but required greater shank-thigh and thigh-pelvis out-of-phase motion. However, the consistency of their coordination was diminished compared to adults. Children aged 7-12 years old have formed a stable coordinative structure for spring-mass center-of-mass dynamics that is preserved on this soft, elastic surface. However, children might be developing control strategies for preferred whole-body vertical stiffness, particularly when required to dampen peak vertical forces. These results highlight the importance of evaluating the emerging motor behavior to manipulated environmental constraints, particularly when considering the utility and appropriateness of mini-trampoline interventions for children with motor dysfunctions. [ABSTRACT FROM AUTHOR]

Background: Children with Down syndrome (DS) are known for their reduced balance control, and typically take longer to develop motor skills and display less coordinated movement patterns. Hopping in-place is a gross motor skill requiring whole-body vertical stiffness and horizontal movement control, particularly when attempting to modify hopping frequency. However, there is a lack of knowledge of the hopping capacity of children with DS.Research Question: The purpose of this study was to assess the ability of children with DS aged 5-11 years old to continuously hop in-place on two legs and compare their biomechanical patterns to those of typically developing (TD) children.Methods: This observational study included 14 children with DS and 16 TD children. Subjects were asked to complete 20 s trials of two-legged hopping in-place at a self-selected frequency, and four metronome guided conditions: preferred (self-selected frequency), moderate (20% increase), fast (40% increase) and slow (20% decrease). Two sample independent t-tests were conducted on whole-body vertical stiffness, horizontal center-of-mass movement, and toe displacement between hops for the self-selected hopping condition and two-way ANOVAs were used for the metronome conditions.Results and Significance: Our findings suggest that children with DS might not be able to continuously hop in-place until the age of 7 years old, and were unable to hop for as long in duration as their TD peers. Children with DS self-selected a faster hopping frequency, and demonstrated an increased medial-lateral center-of-mass movement during the stance phase of hopping, suggesting reduced balance control. Moreover, children with DS were unable to correctly modify their hopping frequency when cued by a metronome and exhibited an inability to modulate whole-body vertical stiffness and constrain horizontal or vertical movement. These results demonstrate the utility of a future hopping intervention to improve whole-body vertical stiffness and balance control in children with DS. [ABSTRACT FROM AUTHOR]

Highlights: [•] We study postural response in children using unilateral Achilles tendon vibration. [•] Both 6- and 10-year-old children show a directionally specific postural response. [•] Both 6- and 10-year-old children display an adult-like timing of postural response. [•] Only 10-year-old children show some adult-like spatial pattern in the AP direction. [ABSTRACT FROM AUTHOR]

Highlights: [•] We study vertical GRF and impulse of treadmill walking in children with DS and TD. [•] Children with DS produce less efficient propulsion during treadmill walking. [•] A faster speed helps children with DS increase propulsive duration and impulse. [•] External ankle load helps children with DS increase propulsive force and impulse. [ABSTRACT FROM AUTHOR]

Abstract: This longitudinal study investigated the long-term effect of different treadmill interventions on the development of gait patterns in infants with Down syndrome (DS). Thirty infants with DS (mean age 10.0 months, S.D. 1.9 months) were randomly assigned to either a “low intensity-generalized” (LG) training group, or a “high intensity-individualized” (HI) training group. Treadmill intervention was conducted in infants’ homes until they walked three steps independently. Twenty-five participants completed a 1-year gait follow-up after the treadmill intervention. Six basic gait parameters were examined: normalized velocity, cadence, step length, step width, double support percentage, and dynamic base. Principal component analysis (PCA) conducted for the set of the six basic gait parameters demonstrated that the first principal component (PC1) accounted for 83.8% of the variance. A two-way ANOVA with repeated measures conducted with PC1 scores revealed a significant visit effect and group difference; both groups significantly increased PC1 scores over time, and the HI group produced significantly higher PC1 scores than the LG group. Specifically, the HI group produced significantly higher normalized velocity and cadence, and lower double support percentage than the LG group. In addition, both groups significantly reduced foot rotation asymmetry over time although no difference was found between the two groups. We concluded that the HI treadmill intervention provided a better long-term effect on the development of basic gait parameters than the LG training, and the reduction of foot rotation asymmetry over time was not differentially affected by the different training protocols. [Copyright &y& Elsevier]

Background: Backward walking and fast walking have distinctive gait patterns in adults; however, there is minimal literature describing these gait modifications in typically developing children. Additionally, most of previous research focused on overground backward walking, but not on a treadmill.Research Question: How do typically developing children adapt their gait patterns, including spatiotemporal parameters, joint kinematics, and muscle activation, to changes in direction and speed during treadmill walking?Methods: We recruited 19 children (10 M/9 F) aged 6-12 years. Treadmill conditions included forward and backward walking at three speeds: slow (75 % of normal speed), normal speed, and fast (125 % of normal speed). Subjects completed a 2-minute trial under each condition. Spatiotemporal, kinematic, kinetic and electromyography data were collected and analyzed. Correlations between forward and time-reversed backward walking were calculated for joint angles and vertical ground reaction force.Results: During backward walking, children (a) decreased step lengths and increased step widths and foot clearance, (b) decreased peak hip and knee flexion and increased peak ankle dorsiflexion, and (c) increased muscle activity at the vastus lateralis, rectus femoris, and tibialis anterior. At faster speeds, children increased step lengths and inconsistently increased overall muscle activity. Both the hip and knee showed high correlation between forward and time-reversed backward walking, while correlation at the ankle was low.Significance: Overall, children adapt their gait to changes in direction and speed of treadmill walking in similar ways to adults. However, notable differences emerged in that children limited their ankle range of motion. Our results suggest that, while many aspects of gait are mature enough by this age to adapt to backward walking on a treadmill, neuromuscular control at the ankle may still be lacking in children while walking backward on a treadmill. [ABSTRACT FROM AUTHOR]

Background: The Wartenberg pendulum test is a common clinical test that is used to measure stiffness about the knee in persons with and without disabilities such as cerebral palsy and Down syndrome (DS). Adults and adolescents with DS show fewer number of swing cycles and a lower relaxation index than healthy controls. However, it is not clear if children with DS show a similar trend compared to typically developing (TD) children.Research Question: Was the knee joint kinematics different between children with and without DS during the pendulum test?Methods: Thirteen children with DS and 13 TD children participated in this study. There were two load conditions: no load (NL) and with ankle load (AL) equal to 2 % of the subject's body weight. Five trials of a pendulum test were collected for each condition.Results: The DS group showed a smaller first flexion excursion, a lower relaxation index, lower mean and peak velocities and accelerations during the first and second flexion and extension, and greater variability of acceleration during the first flexion than the TD group across both load conditions. This suggests that the DS group may have greater stiffness of the knee than the TD group to compensate for joint instability.Significance: The pendulum test appears to be a valid test to evaluate the passive stiffness of the knee in children with DS. The lower relaxation index in children with DS suggests that larger bursts of quadriceps may be activated during a pendulum test, particularly in the first flexion excursion, to assure the knee joint stability. [ABSTRACT FROM AUTHOR]

Background: The timed up-and-go (TUG) test consists of multiple functional activities of daily living performed in a sequence, with the goal to complete the test as quickly as possible. Considering children with Down syndrome (DS) have been shown to take longer to complete the TUG test, it is imperative to identify which tasks are problematic for this population in order to individualize physical interventions.Research Question: Is the biomechanical pattern of each functional task during the TUG test different between children with DS and typically developing (TD) children?Methods: Thirteen children with DS and thirteen TD children aged 5-11 years old completed the TUG test. Kinematic data was captured using a Vicon motion capture system. We visually coded the TUG test into five phases: sit-to-stand, walk-out, turn-around, walk-in, and stand-to-sit. We focused on the center-of-mass (COM) movement in the sit-to-stand phase, spatiotemporal parameters in the walk-out phase, and intersegmental coordination in the turn-around phase.Results and Significance: Children with DS took longer to complete the entire test, as well as each of the five phases. During the sit-to-stand phase, children with DS produced smaller peak vertical COM velocity, medial-lateral COM excursion, and peak knee and hip extension velocity compared to TD peers. Children with DS walked at a slower velocity during the walk-out phase. Both groups demonstrated a similar intersegmental coordination pattern between the head, thorax, and pelvis during the turn-around phase although children with DS had slower average and peak angular velocity at the head, thorax, and pelvis. Our results suggest that children with DS were less able to anticipate transitioning between motor tasks and took longer to initiate motor tasks. Our TUG analysis provides the detailed insights to help evaluate individual motor tasks as well as the transition from one task to another for clinical populations. [ABSTRACT FROM AUTHOR]

Background: Children with Down syndrome (DS) often show underdeveloped motor ability and adaptation. Stair ascent is a common task to examine locomotor function and external ankle load is often used to perturb the stability of a system and observe the emergence of new patterns.Research Question: How do stair height and external ankle load affect locomotor adjustments in 5-to-11-year-old children with typical development (TD) and with DS during stair ascent?Methods: Fourteen children with DS and 14 age- and sex-matched children with TD participated in this study. They walked along a 5-m walkway and ascended 3-step staircases of different heights (low, moderate, and high) with or without ankle load. A 3D motion capture system was used for data collection. Dependent variables included stance time and toe-to-stair distance before stair ascent, and vertical toe clearance and horizontal toe velocity during stair ascent. Mixed ANOVAs with repeated measures were conducted for statistical analysis.Results: The DS group presented a longer stance time and a shorter toe-to-stair distance than the TD group before stair ascent. External ankle load affected, to a greater extent, the DS group than the TD group in stance time and toe-to-stair distance. During stair ascent, while the TD group generally maintained toe clearance and decreased horizontal toe velocity with the increase of stair height, the DS group decreased toe clearance and maintained horizontal toe velocity. Particularly, the DS group displayed a greater toe clearance than the TD group in the LS condition but a smaller toe clearance in the HS condition. In addition, external ankle load increased toe clearance and decreased horizontal toe velocity in both groups.Significance: Children with DS display underdeveloped locomotor adjustments during stair ascent. External ankle load appears to help the DS group regulate toe clearance and horizontal toe velocity for different stair heights. [ABSTRACT FROM AUTHOR]

Background: Increasing walking speed and including bilateral external ankle load have been shown to improve aspects of the gait pattern of children with Down syndrome (DS). However, it is unknown if speed and ankle load improves the cycle-to-cycle variability in a similar way.Research Question: How do changes of walking speed and external ankle load impact spatiotemporal variability during treadmill walking in children with and without DS?Methods: Thirteen children with DS (aged 7-10 years) and thirteen age- and sex-matched typically developing (TD) children participated in this study. Subjects completed two bouts of 60-second treadmill walking at two different speeds (slow and fast) and two load conditions (no load and ankle load equaling to 2% bodyweight at each side). Kinematic data was captured using a Vicon motion capture system. Mean and coefficient of variance of spatiotemporal gait variables were calculated and compared between children with and without DS.Results and Significance: Across all conditions, the DS group took shorter and wider steps than the TD group, but walked with a similar swing percentage, double support percentage, and foot rotation angle. Further, the DS group demonstrated greater variability of all spatiotemporal parameters, except for step width and foot rotation angle. Our results indicated that children with DS can modulate their spatiotemporal gait pattern accordingly like their TD peers when walking faster on a treadmill and/or with an external ankle load. Smaller step width variability in the DS group suggests that mediolateral stability may be prioritized during treadmill walking to safely navigate the treadmill and complete walking tasks. Similar temporal parameters but distinct spatial parameters in the DS group suggest that they may have developed similar rhythmic control but are confined by their spatial movement limitations. [ABSTRACT FROM AUTHOR]

Whole body vibration (WBV) can affect postural control and muscular activation. The purpose of this study was to investigate the center-of-mass (COM) movement of children and young adults before, during, immediately after, and 5min after 40-s WBV in quiet standing. Fourteen young adults (mean age 24.5 years) and fourteen children (mean age 8.1 years) participated in the study. A full-body 35-marker set was placed on the participants and used to calculate COM. Forty-second standing trials were collected before, during, immediately after, and 5min after WBV with an frequency of 28Hz and an amplitude of <1mm. Two visual conditions were provided: eyes-open (EO) and eyes-closed (EC). COM variables included time-domain measures (average velocity, range, sway area and fractal dimension), frequency-domain measures (total power and median frequency), and detrended fluctuation analysis (DFA) scaling exponent in both anterior-posterior (AP) and medial-lateral (ML) directions. Results show that during WBV both children and adults increased average velocity and median frequency, but decreased range and the DFA scaling exponent. Immediately after WBV both groups increased the range, but showed pre-vibration values for most of the COM variables. Comparing to adults, children displayed a higher COM velocity, range, fractal dimension, and total power, but a lower DFA scaling exponent at all phases. The results suggest that both children and adults can quickly adapt their postural control system to WBV and maintain balance during and after vibration. Children display some adult-like postural control during and after WBV; however, their postural development continues into adolescence. [ABSTRACT FROM AUTHOR]