Autism & Developmental

Walking on treadmill with Rett syndrome-Effects on the autonomic nervous system.

Larsson et al. (2018) · Research in developmental disabilities 2018
★ The Verdict

A six-minute treadmill walk can smooth breathing in girls with Rett syndrome, yet their energy systems stay inefficient.

✓ Read this if BCBAs working with Rett syndrome in clinic or school gyms.
✗ Skip if Practitioners serving only verbal, high-endurance clients.

01Research in Context

01

What this study did

Larsson et al. (2018) asked girls with Rett syndrome to walk on a treadmill. Each girl set her own fastest comfy speed.

The team watched heart rate, breathing, and energy use during the short walk. They wanted to know if a six-minute stroll could calm the nervous system.

02

What they found

The girls could finish the walk and their breathing rhythm briefly looked more typical.

Yet their bodies burned energy in an inefficient way, so the overall effect was mixed.

03

How this fits with other research

Capio et al. (2013) also used treadmill training, but with preterm babies. Both studies saw better movement quality without big gains in later skills.

Verschuren et al. (2010) showed kids with cerebral palsy have poor aerobic capacity. Gunilla’s girls looked similar: they could walk, but their engines ran less smoothly.

Rosenthal et al. (1980) found autistic children had low heart-rate responses to sounds. Gunilla’s team saw the opposite in Rett: brief autonomic calming instead of under-reactivity. The difference may lie in the task—passive listening versus active walking.

04

Why it matters

If you serve clients with Rett syndrome, a slow treadmill warm-up can steady breathing before therapy. Keep sessions short and watch for fatigue, because energy use stays inefficient. Pair the walk with preferred music or toys to keep motivation high.

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Start your session with a two-minute slow treadmill walk and count breaths per 15 seconds to spot calming.

02At a glance

Intervention
other
Design
quasi experimental
Sample size
26
Population
developmental delay
Finding
mixed
Magnitude
small

03Original abstract

People with Rett syndrome have deficient central autonomic control, which may interfere with walking. We have limited knowledge regarding the effects of exertion during physical activity in Rett syndrome. The aim was to investigate the autonomic responses during walking on a treadmill in Rett syndrome. Twenty-six females, 12 with Rett syndrome and 14 healthy females were included. All individuals started on the treadmill by standing still, followed by walking slowly with progressive speed until reaching maximum individual speed, which they kept for 6 min. Heart rate (HR), systolic (SBP), diastolic (DBP), mean arterial blood pressures (MAP), cardiac vagal tone (CVT), cardiac sensitivity to baroreflex (CSB), transcutaneous partial pressures of oxygen (pO2), carbon dioxide (pCO2), and breathing movements were recorded simultaneously and continuously. Autonomic responses were assessed by MAP, CSB and CVT during walking at 3 and 6 min. The changes in CSB and CVT in people with Rett syndrome compared to controls indicated more arousal, but only when the treadmill was started; as they continued walking, the arousal dropped to control level. People with Rett syndrome exhibited little changes in pCO2 whereas the controls showed increased values during walking. This suggests poor aerobic respiration in people with Rett syndrome during walking. Five people with Rett syndrome had Valsalva type of breathing at rest, three of those had normal breathing while walking on the treadmill while the remaining two started but soon stopped the Valsalva breathing during the walk. Our results show that individuals with Rett syndrome can walk for up to 6 min at their own maximum sustainable speed on a treadmill. Energy production may be low during walking in Rett syndrome, which could cause early tiredness. A treadmill can be used in people with Rett syndrome, but must be introduced slowly and should be individually tailored. We propose that walking promotes regular breathing in Rett syndrome.

Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.08.010