Quantitative 3D evaluation of step ascent and descent in individuals with Down syndrome--analysis of a daily challenging task.
Adults with Down syndrome climb and descend steps more slowly and with more trunk and ankle motion, revealing a balance challenge you can ease with extra time and balance practice.
01Research in Context
What this study did
The team filmed adults with Down syndrome while they walked up and down a single step.
Special 3-D cameras tracked how each joint moved and how long each foot stayed on the ground.
They compared these clips to adults without Down syndrome who were the same age.
What they found
Adults with Down syndrome took more time on each step.
They bent their trunks and ankles farther and wobbled side-to-side more than the control group.
They also kept both feet on the ground longer, showing less stable balance.
How this fits with other research
Diemer et al. (2023) ran almost the same step test and saw the same slow, shaky pattern.
Their extra data on “anticipatory postural adjustments” confirms the 2013 picture.
Perry et al. (2024) looked at quiet standing instead of stairs and found a twist: adults with Down syndrome who danced had much steadier sway.
This extends the 2013 work by showing balance can improve with practice.
Rigoldi et al. (2011) saw higher-frequency sway during standing, matching the side-to-side instability found here even though the task was different.
Why it matters
You now know that stair work is extra hard for adults with Down syndrome because they use bigger, slower motions and stay in double stance longer.
Build extra time into stair routines and keep a hand rail or staff hand available.
Add short, fun balance games or dance breaks during sessions; the 2024 dance study shows this can tighten sway and may carry over to safer stair climbing.
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02At a glance
03Original abstract
BACKGROUND: Step ascent and descent can perturb stability increasing the incidence of falls, especially in older individuals with functional limitations and intellectual disabilities, such as those with Down syndrome (DS). The aim of this study was to investigate the biomechanics and motor coordination of step ascent and descent in adults with DS and compare them with a group of healthy individuals, considering movement kinematics and kinetics. METHOD: Fourteen adults with DS and 12 similarly aged adults without DS who were free of known motor problems were quantitatively assessed during ascending and descending a step using an optoelectronic system (BTS SMART-D), force platforms and video recording. Kinematic and kinetic parameters were identified and calculated for each study participant and comparisons were made between the DS and a control group (CG). RESULTS: Despite similar age ranges, subjects in the DS group performed the step ascent and descent movements slower, with longer duration and with a more accentuated range of motion of the trunk and of the ankle joint than those in the CG. Additionally, the double stance phase on the step was substantially longer in the DS group when represented as a percentage of the entire stepping sequence (ascent, double stance on the step and descent). In terms of kinetics, ground force platform data revealed that the DS subjects showed higher instability in the medio-lateral direction during double support phase than similarly aged CG subjects and cannot be attributed to age-associated changes in stability. CONCLUSIONS: These findings help to elucidate the complex biomechanical strategy of people with DS during a step ascent and descent movement task and may have a major role in the multidimensional evaluation and tailored management for them.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01627.x