Joint stiffness and gait pattern evaluation in children with Down syndrome

Hypotonia, ligament laxity and motor alterations are characteristic for patients with Down syndrome (DS). The purpose of this study was the evaluation of typical gait pattern of subjects with Down syndrome and the quantification of their joint stiffness, connected with ligament laxity and hypotonia, as a possible compensation. 98 children with DS (mean age: 11.7 years; range: 6-15 years) and 30 healthy children (control group (CG); mean age: 11 years; range: 5-13 years) underwent full 3D gait analysis at self-selected speed. Subjects with DS walked with more hip flexion during the whole gait cycle, knee flexion in stance phase, a limitation of the knee range of motion, and plantarflexion of the ankle at initial contact. Ankle power was limited as evident in terminal stance and pre-swing, represented by a low propulsive capacity at push-off, too. Hip joint stiffness was increased in general in patients with DS versus normal subjects while ankle joint stiffness revealed a lower value instead.