Kinematics associated with treadmill walking in Rett syndrome

Abstract

Background and purpose

Individuals with Rett syndrome suffer from severely impaired cognitive and motor performance. Current movement-related therapeutic programs often include traditional physical therapy activities and assisted treadmill walking routines for those individuals who are ambulatory. However, there are no quantitative reports of kinematic gait parameters obtained during treadmill walking. The purpose of this research was to characterize the kinematic patterns of the lower limbs during treadmill walking as speed was slowly increased.

Methods

Seventeen independently ambulatory females diagnosed with a methyl-CpG-binding protein 2 gene mutation walked on a motorized treadmill while joint kinematics were obtained by a camera-based motion capture system and analysis software.

Results

Stride times progressively decreased as treadmill speeds increased. There were significant main effects of speed on sagittal knee and hip ranges of motion and hip velocity. There were large joint asymmetries and variance values relative to other ambulatory patient populations, although variance values decreased as walking speed increased.

Conclusions

The results indicate that individuals with Rett syndrome can adapt their kinematic gait patterns in response to increasing treadmill speed, but only within a narrow range of speeds. We suggest that treadmill training for ambulatory individuals with Rett syndrome may promote improved walking kinematics and possibly provide overall health benefits.

Implications for rehabilitation

• Walking is an activity that can counter the negative impacts of the sedentary lifestyle of many individuals with disabilities, including those individuals with Rett syndrome.

• Documentation of the lower limb kinematic patterns displayed during walking by ambulatory females with Rett syndrome can be used by clinicians to evaluate their patients’ gait performance in response to therapeutic and pharmacological interventions designed to promote walking.

• The ability to adapt to increases in treadmill speed suggests that a training program of treadmill walking may be effective in promoting improved gait performance in individuals with Rett syndrome.

Keywords:

• Rett
• walking
• kinematics
• training
• physical activity

Acknowledgements

The authors would like to thank all of the participants, their families and the health care professionals working with them for the efforts in support of this research.

Disclosure statement

The authors report no declaration of interest.

Data deposition

The data supportive of this study can be found on Figshare at 10.6084/m9.figshare.7784789

Additional information

Funding

Funding for this research was provided by the Blue Bird Circle. Houston, TX through a grant awarded to Bernhard Suter with additional funding provided by the Kayla Schwartz Fund.