The influence of dual-task conditions on movement in young adults with and without Down syndrome.
Walking while thinking exposes hidden gait problems in adults with Down syndrome.
01Research in Context
What this study did
The team asked young adults with Down syndrome to walk while doing a second task. They compared their steps to same-age peers without disabilities.
The lab set-up measured stride length, width, and speed. Everyone walked alone first, then while counting backwards.
What they found
When the brain had to do two things at once, the Down syndrome group took shorter, wider, and slower steps. Their gait looked less steady and less efficient.
The neurotypical group barely changed. The extra task exposed a hidden motor-control cost in Down syndrome.
How this fits with other research
Falcomata et al. (2012) saw the same dual-task drop, but in working-memory tests. Together the papers show the extra load hits both mind and body.
Salami et al. (2014) seems to disagree. They found adults with Down syndrome kept normal mechanical efficiency while dodging obstacles. The key difference is task type: obstacle avoidance adds physical demand, not mental. Dual-task adds mental load, so gait falls apart.
Micai et al. (2021) meta-analysis confirms small but real inhibition deficits in Down syndrome. The gait data now link those deficits to real-world walking safety.
Why it matters
If your client has Down syndrome, treat dual-task settings as a balance probe. Start strength and postural training early. Teach caregivers to cue one step at a time in busy halls or while talking. Reducing cognitive load while walking can prevent stumbles and boost independence.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Count aloud with the client while they walk a 10-step line; note any wider or slower steps, then add brief balance drills before the next trial.
02At a glance
03Original abstract
This investigation compared spatial and temporal movement parameters of a sample of young adults with Down syndrome (DS) (N=12) and individuals without disabilities (IWD) (N=12) under dual-task conditions. Subjects performed a walking task at a preferred speed in isolation and again while holding a plate and cup, carrying tray and cups, talking on a phone, or buttoning a shirt. Spatial and temporal values were compared using a 2 (group) × 5 (conditions) repeated measures analysis of variance. Analysis of spatial components separately indicated that step length, step width, stride length and stride width revealed significant group and condition interactions (p ≤.01). Temporal components yielded significance in velocity and single-leg support time (p ≤.01). The current results support the notion that along with impairments to qualitative motor skills, individuals with DS are also impaired in higher order executive functioning (EF), as measured by a dual-task paradigm. It was concluded that movements are less efficient and functional in individuals with DS when an additional task is encountered while walking. We theorized that the motor program was sufficient for general locomotion but was not sufficiently developed to allow individuals with DS to modify or alter their movements to changing cognitive conditions that increasingly taxed EF. As gait and balance are trainable in this population, we recommend developing appropriate exercise and motor skill interventions during childhood and adolescents to increase strength, stability, and more "robust" ambulatory motor schema.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.06.038