Eficácia do treino de marcha precoce em crianças com Síndrome de Down

Abstract

Down syndrome (DS) is the most prevalent chromosomal anomaly in humans and the most common form of congenital intellectual disability. Children with DS present delay in gait development when compared to children with typical neuropsychomotor development. Among the interventions aimed at gait acquisition in children with DS, the treadmill intervention is a good example of specific training for this task. The aim of the present study was to investigate the effectiveness of early gait training on gait acquisition in children with DS. A systematic review of randomized clinical trials (RCTs) was performed. A comprehensive search of articles was carried out between January and February 2022 in EMBASE, PubMed, Web of Science, CENTRAL, CINAHL, PEDro and Scielo databases, with no language or date restrictions. The PEDro and GRADE scales were used to assess methodological quality and certainty of evidence, respectively. Three studies involving 85 children with a mean age of 13.4 months were included in the review. The methodological quality of the studies was classified as moderate (4.3 points on the PEDro Scale). The results of the studies show that standardized high-intensity gait training (PAI) on a treadmill is indicated to accelerate the acquisition of independent gait in children with DS. Furthermore, the use of Supraleolar orthoses during gait training in children with DS is not recommended. The certainty of the evidence was rated low. This systematic review provides the most up-to-date evidence on the effectiveness of early gait training in children with DS. Larger and more controlled studies are still needed.