Patterns of Gait Variability Across the Lifespan in Persons with and Without Down Syndrome

Overview

Journal J Neurol Phys Ther

Specialty Neurology

Date 2011 Nov 5

PMID 22052133

Citations 8

Authors

Beth A Smith

Nicholas Stergiou

Beverly D Ulrich

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Greater gait variability has been observed in persons with Down syndrome (DS). An understanding of baseline patterns of variability, how these patterns relate to adaptive control of gait, and whether increasing or decreasing variability is better is necessary for physical therapists to determine whether and when to intervene. Our aim was to describe patterns of gait variability across the lifespan in persons with DS.

Methods: We examined differences in patterns of gait variability in new walkers, preadolescents, and adults with DS and typical development (TD). We collected kinematic data, while participants walked on a treadmill, and analyzed the data using the nonlinear measures of Lyapunov Exponent (LyE) and Approximate Entropy (ApEn).

Results: Beyond the greater gait variability demonstrated across the lifespan in persons with DS compared with their peers with TD, we report herein significant differences in nonlinear measures of patterns of variability. Preadolescents demonstrated higher LyE and ApEn values than new walkers and adults, suggesting that they are more adaptive in their use of variability during gait.

Conclusion: From a clinical perspective, our results suggest that it may be of value to focus interventions on increasing adaptive use of variability during gait in new walkers and adults with DS. Experience with increased variability through practice under variable conditions or with perturbations may improve adaptive use of variability during gait.

Citing Articles

Physical Training Chronically Stimulates the Motor Neuron Cell Nucleus in the Ts65Dn Mouse, a Model of Down Syndrome.

Inguscio C, Lacavalla M, Cisterna B, Zancanaro C, Malatesta M Cells. 2023; 12(11).

PMID: 37296609 PMC: 10252427. DOI: 10.3390/cells12111488.

Variability and coordination patterns of walking with different speeds in active and non-active children with Down syndrome: A cross-sectional case-control study.

Vali Noghondar N, Saberi Kakhki A, Sohrabi M, Alirezaei Noghondar F Int J Dev Disabil. 2022; 68(5):723-731.

PMID: 36210898 PMC: 9542406. DOI: 10.1080/20473869.2021.1893923.

Auditory and Visual External Cues Have Different Effects on Spatial but Similar Effects on Temporal Measures of Gait Variability.

Vaz J, Rand T, Fujan-Hansen J, Mukherjee M, Stergiou N Front Physiol. 2020; 11:67.

PMID: 32116777 PMC: 7026509. DOI: 10.3389/fphys.2020.00067.

Sample Entropy Identifies Differences in Spontaneous Leg Movement Behavior between Infants with Typical Development and Infants at Risk of Developmental Delay.

Smith B, Vanderbilt D, Applequist B, Kyvelidou A Technologies (Basel). 2017; 5(3).

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Gait dyspraxia as a clinical marker of cognitive decline in Down syndrome: A review of theory and proposed mechanisms.

Anderson-Mooney A, Schmitt F, Head E, Lott I, Heilman K Brain Cogn. 2016; 104:48-57.

PMID: 26930369 PMC: 4801771. DOI: 10.1016/j.bandc.2016.02.007.

References

Black D, Chang C, Kubo M, Holt K, Ulrich B . Developmental trajectory of dynamic resource utilization during walking: toddlers with and without Down syndrome. Hum Mov Sci. 2008; 28(1):141-54. PMC: 2655241. DOI: 10.1016/j.humov.2008.08.004. View

Smith B, Stergiou N, Ulrich B . Lyapunov exponent and surrogation analysis of patterns of variability: profiles in new walkers with and without down syndrome. Motor Control. 2010; 14(1):126-42. PMC: 2958097. DOI: 10.1123/mcj.14.1.126. View

Smith B, Kubo M, Black D, Holt K, Ulrich B . Effect of practice on a novel task--walking on a treadmill: preadolescents with and without Down syndrome. Phys Ther. 2007; 87(6):766-77. DOI: 10.2522/ptj.20060289. View

Latash M, Anson J . Synergies in health and disease: relations to adaptive changes in motor coordination. Phys Ther. 2006; 86(8):1151-60. View

Ohgi S, Morita S, Loo K, Mizuike C . Time series analysis of spontaneous upper-extremity movements of premature infants with brain injuries. Phys Ther. 2008; 88(9):1022-33. PMC: 2527216. DOI: 10.2522/ptj.20070171. View

Harbourne R, Stergiou N . Movement variability and the use of nonlinear tools: principles to guide physical therapist practice. Phys Ther. 2009; 89(3):267-82. PMC: 2652347. DOI: 10.2522/ptj.20080130. View

Hausdorff J, Nelson M, Kaliton D, Layne J, Bernstein M, Nuernberger A . Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise. J Appl Physiol (1985). 2001; 90(6):2117-29. DOI: 10.1152/jappl.2001.90.6.2117. View

Kornatz K, Christou E, Enoka R . Practice reduces motor unit discharge variability in a hand muscle and improves manual dexterity in old adults. J Appl Physiol (1985). 2005; 98(6):2072-80. DOI: 10.1152/japplphysiol.01149.2004. View

Callisaya M, Blizzard L, Schmidt M, McGinley J, Srikanth V . Ageing and gait variability--a population-based study of older people. Age Ageing. 2010; 39(2):191-7. DOI: 10.1093/ageing/afp250. View

10.

Sosnoff J, Voudrie S . Practice and age-related loss of adaptability in sensorimotor performance. J Mot Behav. 2009; 41(2):137-46. PMC: 2637458. DOI: 10.3200/JMBR.41.2.137-146. View

11.

Smith B, Ulrich B . Early onset of stabilizing strategies for gait and obstacles: older adults with Down syndrome. Gait Posture. 2008; 28(3):448-55. PMC: 2633770. DOI: 10.1016/j.gaitpost.2008.02.002. View

12.

Stergiou N, Moraiti C, Giakas G, Ristanis S, Georgoulis A . The effect of the walking speed on the stability of the anterior cruciate ligament deficient knee. Clin Biomech (Bristol). 2004; 19(9):957-63. DOI: 10.1016/j.clinbiomech.2004.06.008. View

13.

Georgoulis A, Moraiti C, Ristanis S, Stergiou N . A novel approach to measure variability in the anterior cruciate ligament deficient knee during walking: the use of the approximate entropy in orthopaedics. J Clin Monit Comput. 2006; 20(1):11-8. DOI: 10.1007/s10877-006-1032-7. View

14.

Panzer V, Bandinelli S, Hallett M . Biomechanical assessment of quiet standing and changes associated with aging. Arch Phys Med Rehabil. 1995; 76(2):151-7. DOI: 10.1016/s0003-9993(95)80024-7. View

15.

Hausdorff J . Gait dynamics, fractals and falls: finding meaning in the stride-to-stride fluctuations of human walking. Hum Mov Sci. 2007; 26(4):555-89. PMC: 2267927. DOI: 10.1016/j.humov.2007.05.003. View

16.

Barak Y, Wagenaar R, Holt K . Gait characteristics of elderly people with a history of falls: a dynamic approach. Phys Ther. 2006; 86(11):1501-10. DOI: 10.2522/ptj.20050387. View

17.

Darling W, Cooke J, Brown S . Control of simple arm movements in elderly humans. Neurobiol Aging. 1989; 10(2):149-57. DOI: 10.1016/0197-4580(89)90024-9. View

18.

Stergiou N, Harbourne R, Cavanaugh J . Optimal movement variability: a new theoretical perspective for neurologic physical therapy. J Neurol Phys Ther. 2006; 30(3):120-9. DOI: 10.1097/01.npt.0000281949.48193.d9. View

19.

Berg K, Williams J, Maki B . Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992; 83 Suppl 2:S7-11. View

20.

Ulrich B, Haehl V, Buzzi U, Kubo M, Holt K . Modeling dynamic resource utilization in populations with unique constraints: preadolescents with and without Down syndrome. Hum Mov Sci. 2004; 23(2):133-56. DOI: 10.1016/j.humov.2004.06.002. View