A eficácia das abordagens de treinamento em esteira na capacidade de marcha em crianças com Síndrome de Down: revisão sistemática de ensaios clínicos randomizados

Abstract

Introduction: The development of gross and fine motor skills in a child with Down syndrome (DS) is generally delayed. The most affected phase is obtaining the ability to walk independently, which consequently influences the beginning of all other motor and cognitive skills. Objective: To investigate the effectiveness of treadmill training approaches on walking capacity in children under six years old diagnosed with DS. Methodology: The search was conducted on Medline, Embase, Web of Science, PEDro and Scopus, with no language or date restrictions for randomized controlled clinical trials (RCTs). Trial selection, data extraction, and assessment of the methodological quality of included trials were conducted independently by two reviewers, with discrepancies resolved by a third reviewer. Mean differences (MDs) with 95% confidence intervals (CI) were used. Methodological quality was assessed using the PEDRO scale. Results: the high-intensity protocol (individualized protocol based on step frequency, 5x/week) favors better results when compared to low-intensity training on the treadmill (treadmill speed between 0.2 and 0.18 m/s, time of 8 min/day, 5 days a week). Low-intensity training when associated with conventional physical therapy in babies with DS provides an earlier onset of independent walking. Conclusion: The treadmill intervention, either alone or associated with other interventions, has positive effects on acquiring independent and early walking in babies and children with DS.