Anticipatory postural adjustments and kinematic analysis of step ascent and descent in adults with Down syndrome.
Adults with Down syndrome show slow, wobbly stair climbing driven by oversized early trunk sway—target these pre-step adjustments and consider dance-based balance drills.
01Research in Context
What this study did
Diemer et al. (2023) filmed the adults with Down syndrome walking onto and off a single 17 cm step. They used 3-D motion cameras to track body sway, foot speed, and tiny pre-step muscle shifts called anticipatory postural adjustments.
Each person did 10 step-ups and 10 step-downs. The team compared the numbers with the adults without disabilities matched for age and sex.
What they found
The Down syndrome group took twice as long to lift or lower their foot. Their hips and knees moved in short, choppy arcs instead of one smooth sweep.
They also made bigger, earlier trunk sway right before the step. These extra-large anticipatory postural adjustments still left them 30 % slower and shakier than controls.
How this fits with other research
Perry et al. (2024) extends these findings. They showed that adults who dance three times a week have much smaller sway when simply standing still. Together the two papers hint that the same balance problems seen on stairs can be trimmed by regular dance practice.
Pitchford et al. (2019) used a similar lab set-up but tested kids with mixed intellectual disabilities. They also found wider sway and longer sway paths, confirming that balance trouble starts young and lasts into adulthood.
Dembo et al. (2023) calibrated hip accelerometers for this exact population. Their cut-points let you count slow, cautious stair climbs as light activity, so you can track real-world practice after today’s session.
Why it matters
If you teach stair climbing, plan for longer transfer times and expect bigger trunk sway. Start with a lower step, give light hand support, and praise early weight-shift tries. Add dance or rhythm games shown by Perry et al. (2024) to shrink sway during daily standing. Use the accelerometer cut-points from Dembo et al. (2023) to prove the extra steps your client takes each week.
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02At a glance
03Original abstract
BACKGROUND: Step ascent and descent is one of the most common daily tasks. Although it is generally considered a rather simple movement, it may not be so easy for participants with Down syndrome. METHODS: A kinematic analysis of step ascent and descent was conducted, and a comparison between 11 adult participants with Down syndrome and 23 healthy participants was carried out. This analysis was accompanied by a posturographic analysis with the aim of evaluating aspects relating to balance. The principal aim of postural control was to investigate the trajectory of the centre of pressure, while the kinematic analysis of movement included the following: (1) the analysis of anticipatory postural adjustments, (2) the calculation of spatiotemporal parameters and (3) the evaluation of articular range of motion. RESULTS: A general instability for participants with Down syndrome, highlighted in the postural control by an increased anteroposterior and mediolateral excursion, when the test was conducted with both open and closed eyes, was found out. Regarding anticipatory postural adjustments, this deficit in balance control was revealed by the execution of small steps before completing the movement and by a much longer preparation time anticipating the movement. In addition, the kinematic analysis reported a longer ascent and descent time and a lower velocity, accompanied by a greater rising of both limbs in ascent, which indicates an increased perception of the obstacle. Finally, a wider trunk range of motion in both the sagittal and frontal planes was revealed. CONCLUSIONS: All the data confirm a compromised balance control that could be associated with damage to the sensorimotor centre.
Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13022