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Using a Treadmill Intervention to Promote the Onset of Independent Walking in Infants With or at Risk for Neuromotor Delay

Beth A. Smith, Erin Bompiani

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.1 Each article in this PTJ series summarizes a Cochrane review or other scientific evidence resource on a single topic and presents clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on an infant with Down syndrome. Can a treadmill intervention positively affect the onset of independent walking and overall motor development in a preambulatory infant with Down syndrome?

Delayed attainment of locomotion can have widespread, long-lasting negative effects on motor, social, and cognitive capabilities.25 Treadmill training is one intervention often used and studied to promote the development of walking in children with or at risk for neuromotor delay. Although there is evidence to support the use of treadmill training to promote earlier onset of independent walking in infants with Down syndrome,6,7 its effectiveness for other outcomes and for other clinical populations remains unclear.810 The treadmill is of specific interest because it provides a way to elicit stepping practice in preambulatory infants. When held supported on a treadmill, infants as young as 1 month will perform coordinated alternating stepping movements that share many kinematic patterns with adult …

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