Treadmill Training - Did It Help?

I was recently asked if treadmill training helped Matthew take steps on his own. Matthew was born with hypotonia. His physical therapist (PT) had remarked that it was mild from what she has seen in her many years of experience. Matthew started taking more than 3 independent steps when he was 21 months old. According to the article An overview of the development of infants with Down syndrome (0-5 years), children with Down syndrome begin to walk independently between 13 to 48 months old. According to the same article, kids without Down syndrome walk independently in the age range 9 to 17 months old.

To be honest, I think it was more of a combination of things we did that helped. Not to mention, Matthew was very self-motivated too. He giggled everytime he took a few steps without support, as seen in the video on a previous post "Walking". At the time he started walking, he was receiving physical therapy twice a month, 45 minutes to 1 hour per session, at home.

We tried treadmill training for about 2 months starting when Matthew was 19 months old. I have a video of him on the treadmill on a previous post "Treadmill Training for Babies with Down Syndrome. At 19 months, Matthew was already able to push a sturdy push toy several feet forward but he still needed to improve his stability and balance. He could also pull to stand and cruise sideways holding on to furniture.

Without a push toy, we had him walking with 2-hand support (hands above his shoulders). We had him walk barefoot on our front lawn and in our house. We also had him walk with shoes on. We walked up and down a 30-degree slope on the one side of our house to help improve his leg strength.

When he felt more stable, we tried to switch holding his hands in front of him instead of above his shoulders. Then we gradually decreased support, going from 2 hands to just 1.

Motivators
We keyed in to what motivated him. He loved balls (and still does). Showing him how to "kick" an air-filled, light ball by walking into it (with hand support of course) motivated him to move forward.

Our cat, Yuri, also motivated him. I always had to be careful that he didn't grab a handful of fur.

There were also a select number of toys that motivated Matthew to walk from point A to point B on his own. But I believe his biggest motivator Bill or I. He got the most enjoyment out of walking to and from Bill and I.

Other Factors
Matthew has hypotonia. It causes laxity in the joints (hips, knees and ankles) that may make it more difficult to walk without support. I'm thankful Matthew didn't have much issue with that. His ankles rolled inward slightly but they were strong enough that Matthew felt stable enough on his feet to walk. He did not require orthotics.

When he did start walking, his physical therapist looked for compensatory movement patterns paying close attention to his gait, trunk position and overall posture. This article "Physical Therapy for Children with Down Syndrome" by Patricia C. Winders provides a lot of good information on physical therapy and explains compensatory movement patterns.

Did Treadmill Training Help?
I think it might have just a tiny bit since we didn't do it often enough. I tried to get up to 8 minutes per day but the most he ever wanted to be on it was close to 2 minutes. It might have helped more if we did it more frequently during the day and added more play elements to the activity to keep his interest. It was worth doing though just as an additional exercise for him.

If it didn't interest him at all, we wouldn't have tried it. Forcing him to do something he doesn't like would only teach him how to get out of doing it. Ultimately, I think it's the strongest motivating factor that will help - with most milestones. Of course, it is also important to look at and address any physical attributes (tone, posture, joint laxity, overall strength) that might be an obstacle to walking independently.

Also, some kids might just need more time to gain the confidence for this awesome milestone.

Question For Readers
Did you try treadmill training? Did it help your child?

Related post:
Treadmill Training for Babies with Down Syndrome
"Walking"

Treadmill Training For Babies With Down Syndrome

Now that Matthew is a master crawler and showing more interest in walking, we are working on learning to walk. A few of the activities we've been doing to help him achieve his next goal include:

• cruising along furniture
• walking with two-hand support - We started out with me behind him and his hands up higher than his shoulders. Then we eventually switched to being in front of him, guiding him to take steps towards us while holding on to our fingers with his arms at shoulder level or lower. This second position is actually better as we notice that he has to rely on his stomach muscles more and learn to balance as he takes steps.
• walking with his push walker (and lately, the laundry basket.) Watch the video of him pushing his walker at my blog post Have Walker, Will Travel.
• walking with one-hand support

The book Gross Motor Skills in Children with Down Syndrome by Patricia C. Winders clearly explains these activities in more detail.

Last week, we started treadmill training. My dad had first found an article about it on yahoo news in 2007, about a month after Matthew was born. I had forgotten about it until about 2 weeks ago when I came across "Treadmill Training Helps Down Syndrome Babies Walk Months Earlier" on bio-medicine.org. Then yesterday, Ruby's Mom at Ruby's Life blogged about a new tiny treadmill made just for babies.

ScienceDaily () -- Kinesiologsts developed a tiny treadmill to help infants with Downs Syndrome learn to balance themselves earlier. Typically, these children learn how to walk at 24 to 28 months, later than the 12 months for those without Downs. The treadmill exercise, used about 8 minutes a day, helps to reinforce the underlying pattern of coordination in the legs. This repetition helps build core muscles and support the drive to stand up. After the babies take eight to 10 steps without help, they are outfitted with light reflecting markers. The information from these markers is recorded on cameras, revealing gait, speed and width of their steps. Researchers show walking is occuring six months sooner with the treadmill.

To read the rest of the article, go to Baby Treadmill Kinesiologists Design Tiny Treadmill To Help Balance Baby Steps In Downs Syndrome Infants

Babies Can Start Treadmill Training As Early As 8 to 10 Months Of Age
Had I remembered the yahoo news article on treadmill training when Matthew was 8 months old, I don't think I would've started it that early with him. Matthew is not as motor-driven as other toddlers his age. He's more of an observer and a thinker. So I usually find that it helps him a lot if I let him watch me show him how something works several times before he tries it himself. My guess is that he would not have tolerated treadmill training when he was 8 months old. Every kid is different though. Other parents may be successful at starting treadmill training with their babies early.

Matthew's physical therapist (PT) supports treadmill training as a supplement to our therapy sessions and suggested that we have him walk on the treadmill with shoes sometimes and without shoes other times. She says this will help improve his leg and foot strength and balance. It takes a little bit more effort when walking with shoes than without. Also, the treadmill offers a different walking experience.

We don't have the mini treadmill that the ScienceDaily article mentions. The Bio-Medicine article states that these treadmills cost about $1,200 each. There should be some hospitals and Down Syndrome Organizations that might rent it out but we didn't explore that option. We have a regular treadmill that we set to the slowest pace and I hold him under his arms in front of me as he walks. The articles on treadmill training recommend 8 minutes of walking but Matthew is only able walk for a minute at a time. It works for me as I can only squat for a minute at a time. So while he's building his core muscles, I'm getting some much needed strength training too. Win-win! The plan is to slowly get him up to 8 minutes, following his lead on how much he wants to walk on the treadmill.

Is Walking Earlier Really Better?
The ScienceDaily article states that babies with Down syndrome learn to walk between 24 to 28 months without treadmill training. The milestone chart inAn Overview of the Development of Infants with Down Syndrome (0-5 years) on the Down Syndrome Online website shows the average age range for children with Down syndrome to walk alone or independently is 13 to 48 months. I know a little girl with DS, who is walking at 18 months, and a boy with DS who walked at 27 months. Both kids are doing great.

So will walking earlier advance a child's cognitive development, social skills development and language? Probably, simply because it gives the child mobility, the ability to explore his environment. What about crawling? Crawling is mobility too and seems to offer its own set of benefits that walking doesn't such as building trunk, arm, head, and neck strength, eye-hand coordination, coordination of both sides of the body, and stability. Don't we all catch up with each other later on? Kim Ayres at Ramblings of the Bearded One candidly commented on one of my previous posts, "if you look at any group of people, can you guess who were the early or late walkers? Once we get there, it makes no difference." So true. Everyone learns at their own pace, Down syndrome or not.

So why exactly are we doing treadmill training with Matthew? Simply because we can. I view it as just another tool, a very interesting one. Whether or not treadmill training does indeed make him walk sooner than later or improve the quality of his walk remains to be seen. I like to offer Matthew different opportunities to develop certain skills whenever possible. If he didn't like it, we wouldn't be doing it at all.

Related Post:
Walking