Motor learning with self-controlled feedback improves walking ability in obstacle stepping tasks in children with down syndrome: a quasi-experimental study

To determine the effects of motor learning with self-controlled feedback on obstacle stepping task in children with down syndrome.

Fourteen children with DS (7 males, 7 females; mean age 12y 11mo, SD 1y 9mo, age range 9y–15y) participated in a quasi-experimental study, by conducting four phases of testing: pre-acquisition phase, post-acquisition phase, retention phase (24 hours after the acquisition phase) and transfer phases on day 1, day 7, and day 14, using the Standardized Walking Obstacle Course (SWOC). In the acquisition phase, participants practiced walking across ten obstacles over a distance of five meters for three rounds, receiving self-controlled feedback when requested under the supervision of a physiotherapist. In total, they covered a distance of fifteen meters with thirty obstacles.

Children with DS showed a significant increase in the average number of successful obstacle clearances during the retention phase, achieving 5.79 times (95% confidence interval [CI] 3.66–7.91) out of 10 attempts, compared to the pre-acquisition phase. The duration of walking (in seconds) from SWOC significantly decreased from the pre-transfer phase, reduced from 26.27 seconds (95% confidence interval [CI] 23.70-28.83) to 22.97 seconds (95% confidence interval [CI] 21.43-24.52) and 22.96 (95% confidence interval [CI] 20.88-25.05) on transfer days 1 and 7, respectively. Although no significant decreased was found on transfer day 14, the walking duration from SWOC was reduced to 23.97 seconds (95% CI 22.41–26.07) compared to the pre-transfer phase.

In the post-training retention phase and on transfer days 1 and 7, motor learning with self-controlled feedback enhanced walking ability in obstacle stepping tasks for children with DS. Additionally, more frequent and repeated training may be necessary to attain long-term retention and performance on transfer day 14. 

Motor learning with self-controlled feedback training could be a useful intervention for children with Down syndrome to improve walking ability in obstacle stepping tasks.