***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study investigated how newly walking toddlers with Down syndrome ( DS ) , after different treadmill interventions , adopted clearance strategies and modified anticipatory locomotor adjustment patterns to negotiate an obstacle in their travel path . Thirty infants with DS ( about 10 months of age ) were recruited and r and omly assigned to either a lower-intensity , generalized ( LG ) treadmill training group , or a higher-intensity , individualized ( HI ) treadmill training group . Thirteen in each group completed a one-year-gait follow-up after the treadmill intervention . Initially , both groups chose to either crawl or walk over an obstacle . However , walking over the obstacle became their preferred clearance strategy over the course of the gait follow-up even though the height of the obstacle increased from visit to visit . The HI group used the strategy of walking over the obstacle at a considerably higher percentage than the LG group within 6 months after the training . When approaching the obstacle , both groups started to show consistent anticipatory locomotor adjustments about 6 months after the training . Both groups decreased velocity , cadence and step length , and increased step width at the last three pre-obstacle steps . It was concluded that the retention of the HI training effects led the HI group to predominantly walk over an obstacle earlier than the LG group within 6 months after treadmill intervention , and the two groups produced similar anticipatory locomotor adjustments in the last three steps before negotiating the obstacle Intellectual disability affects all spheres of people 's lives who suffer from it . It lowers the level of intellectual functioning , often stigmatizes , characteristically changing features , and decreases motor performance . Unfortunately , modern medicine can not cure intellectual disability ; however , there is a chance to improve the quality of life of people with mental retardation by means of physical exercises and by enhancing coordination , the quality of gait and efficiency in performing everyday activities . This paper deals with observations of static balance in 40 young females and males with mild Down syndrome , out of which 20 were subjected to a three-month sensorimotor training programme .  The participants performed exercises with rehabilitation balls and air pillows twice a week , and the remaining persons constituted a control group . The balance platform test conducted at the beginning of the experiment revealed that the level of static one-legged balance was similar in both groups . A significant difference was noted in the length of the path of the general centre of gravity ( COG ) and the time frame in which the vertical projection of COG remained within the 13 mm radius circle , between the result of the test conducted under visual control and with the eyes closed , both in the group of the participants performing exercises and the ones who did not do them . After the training sessions the results of both tests improved in the group of the persons subjected to the training programme , however differences between the groups were not statistically significant , apart from the comparison of the time of keeping COG within the 13 mm radius circle at the beginning and at the end of the experiment by the participants who were physically active . Our results lead to a conclusion that exercises with the use of unstable surfaces improve deep sensibility in people with mild mental retardation Objective : The aim of the study was to determine the effect of exercise training on strength and balance in children with Down ’s syndrome . Design : R and omized controlled trial . Setting : Rehabilitation school for special children . Subjects and intervention : Twenty-three children were r and omized to intervention and control group . The intervention group ( n = 12 ) underwent progressive resistive exercises for lower limbs and balance training for six weeks . The control group continued their regular activities followed at school . Outcome measure : A h and held dynamometer was used to measure the lower limb muscle strength . Balance was assessed by the balance subscale of Bruininks Oseretsky Test of Motor Proficiency ( BOTMP ) . Results : Following the training , the children in the intervention group showed a statistically significant improvement ( P < 0.05 ) in the lower limb strength of all the muscle groups assessed . The strength of knee extensors was 12.12 lbs in the control group versus 18.4 lbs in the experimental group ; in hip flexors it was 12.34 lbs in the control group versus 16.66 lbs in the experimental group post-intervention . The balance of the children also improved significantly with an improvement in scores of the balance subscale of BOTMP ( 19.50 in the experimental group versus 9.00 in the control group , P = 0.001 ) . Conclusion : This study suggests that a specific exercise training programme may improve the strength and balance in children with Down ’s Background Infants with Down syndrome ( DS ) have delayed walking and produce less-coordinated walking patterns . Objective The aim of this study was to investigate whether 2 treadmill interventions would have different influences on the development of joint kinematic patterns in infants with DS . Design Thirty infants with DS were r and omly assigned to a lower-intensity , generalized ( LG ) treadmill training group ( LG group ) or a higher-intensity , individualized ( HI ) treadmill training group ( HI group ) and trained until walking onset .  Twenty-six participants ( 13 in each group ) completed a 1-year gait follow-up assessment . Methods During the gait follow-up assessment , reflective markers were placed bilaterally on the participants to measure the kinematic patterns of the hip , knee , and ankle joints . Both the timing and the magnitude of peak extension and flexion at the hip , knee , and ankle joints , as well as peak adduction and abduction at the hip joint , in the 2 groups were compared . Results Both the LG group and the HI group showed significantly advanced development of joint kinematics at the gait follow-up . In the HI group , peak ankle plantar flexion occurred at or before toe-off , and the duration of the forward thigh swing after toe-off increased . Limitations Joint kinematics in the lower extremities were evaluated in this study . It would be interesting to investigate the effect of treadmill interventions on kinematic patterns in the trunk and arm movement . Conclusions The timing of peak ankle plantar flexion ( before toe-off ) in the HI group implies further benefits from the HI intervention ; that is , the HI group may use mechanical energy transfer better at the end of stance and may show decreased hip muscle forces and moments during walking . It was concluded that the HI intervention can accelerate the development of joint kinematic patterns in infants with DS within 1 year after walking onset BACKGROUND Longer life expectancy is result ing in increasing numbers of elderly adults with mental retardation . In elderly adults with Down syndrome ( DS ) , the maintenance of muscle strength , endurance , and dynamic balance are important to ensure quality of life and functional independence . The objective of this study was to compare isokinetic leg strength and dynamic balance of aged mentally retarded individuals with DS ( n = 16 , mean age 63 ) before and after a treadmill walking program lasting 6 months in comparison with a  nonwalking control group ( n = 10 ) with similar physical characteristics . METHODS Participants in the study undertook  leg strength testing on a dynamometer . Parameters measured included peak torque , peak torque % body weight , and average power % body weight . A " timed get-up and go " functional test for dynamic balance was also analyzed and compared prior to and after the treadmill program . RESULTS Knee extension and flexion isokinetic strength in elderly individuals with DS showed significant improvement after 6 months of treadmill training . Dynamic balance performance was also significantly improved ( p < .05 ) . CONCLUSIONS Aged adults with DS can significantly improve muscle strength and balance by adopting suitable programs of treadmill walking The main objective of this study is to underst and the differences in equilibrium control between normal subjects and those with Down syndrome . A total of 54 subjects participated voluntarily , divided into control group and Down syndrome group . The equilibrium of the subjects was tested under two conditions : bipedal support with eyes open and closed . The signals were analyzed in a time and frequency domain . The statistical parameters selected ( i.e. , RMS distance , mean velocity , mean frequency and sway area ) to analyze the behavior of the center of pressures ( CoP ) are calculated employing the result of the combination of the time series data in both directions ( i.e. result ant distance ) . In order to calculate the frequency b and s produced by the displacements of the CoP , a Fast Fourier Transform of the data was performed . The group with Down syndrome showed poorer static equilibrium control than the control group in the time domain . In the frequency domain , we found differences between the groups in the distribution of energy in the frequency b and s analyzed . In addition , we observed the existence of an interaction effect of the group and the condition tested ( p<0.001 ) . These findings show that in the absence of visual information , the control group increases the energy at low frequencies , while the group with Down syndrome decreases it . Additionally , the lower amount of energy observed in this b and under the ' eyes closed ' condition may serve to identify abnormalities in the functioning of the vestibular apparatus of individuals with Down syndrome and /or difficulties experienced by these individuals in extracting relevant information from this route Objective : Compare the effects of treadmill training and training with overground walking ( both without partial weight support ) on motor skills in children with cerebral palsy . Design : R and omized controlled clinical trial . Setting : Physical therapy clinics . Subjects : Thirty-six children with cerebral palsy ( levels I – III of the Gross Motor Functional Classification System ) r and omly divided into two intervention groups . Interventions : Experimental group ( 17 children ) su bmi tted to treadmill training without partial weight support . Overground walking group ( 18 children ) su bmi tted to gait training on a fixed surface ( ground ) . Training was performed for seven consecutive weeks ( two sessions per week ) , with four subsequent weeks of follow-up . Results : Both groups demonstrated improvements on the 6-minute walk test ( experimental group from 227.4 SD 49.4 to 377.2 SD 93.0 ; overground walking group from 222.6 SD 42.6 to 268.0 SD 45.0 ) , timed up- and -go test ( experimental group from 14.3 SD 2.9 to 7.8 SD 2.2 ; overground walking group from 12.8 SD 2.2 to 10.5 SD 2.5 ) , Pediatric Evaluation Disability Inventory ( experimental group from 128.0 SD 19.9 to 139.0 SD 18.4 ; overground walking group from 120.8 SD 19.0 to 125.8 SD 12.2 ) , Gross Motor Function Measure-88 ( experimental group from 81.6 SD 8.7 to 93.0 SD 5.7 ; overground walking group from 77.3 SD 7.0 to 80.8 SD 7.2 ) , Berg Balance Scale ( experimental group from 34.9 SD 8.5 to 46.7 SD 7.6 ; overground walking group from 31.9 SD 7.0 to 35.7 SD 6.8 ) after treatment . The experimental group demonstrated greater improvements than the overground walking group both after treatment and during follow up ( p < 0.05 ) . Conclusion : Treadmill training proved more effective than training with overground walking regarding functional mobility , functional performance , gross motor function and functional balance in children with cerebral palsy Purpose . To assess postural control in individuals with Down syndrome . Method . Sixty young adults with Down syndrome were assessed and compared to 10 non-h and icapped young . The subjects were asked to stay on a force platform for 30 seconds . Postural control  was evaluated in two conditions : open and closed eyes . The kinetic data carried out from the force platform ( i.e. , ground reaction forces and Center of Pression ( COP ) displacements ) were both evaluated in time domain and in frequency domain . Results . Patients with Down syndrome are characterized by instable postural control . In particular the data evaluation in frequency domain underlined for Down syndrome subjects versus control group an increase in frequency oscillation both in anterior-posterior and in medio-lateral direction , that are confirmed in time domain analysis only for medio-lateral direction . In DS no changes are evident between eyes open and eyes closed condition . Conclusion . This study finds that subjects with Down syndrome included in this research demonstrate that deficits in postural control system that may provide a partial explanation for function balance problems that are common in these subjects ABSTRACT PEDro is produced by the Centre for Evidence -Based Physiotherapy ( CEBP ) , located in Sydney , Australia .  PEDro is intended to be used to gain “ rapid access to bibliographic details and abstract s of r and omized controlled trials , systematic review s and evidence -based clinical practice guidelines in physiotherapy.”1 This column will provide some background information on the data base , as well as cover the basics of search ing its content People suffering from Ehlers-Danlos syndrome ( EDS ) hypermobility type present a severe ligament laxity that results in difficulties in muscle force transmission . The same condition is present in people suffering from Down syndrome ( DS ) even if their clumsy movements are due to cerebral and cognitive impairments . The aim of this study was to quantify the gait patterns of subjects with EDS and with DS using Gait Analysis ( GA ) . We quantified the gait strategy in 12 EDS individuals and in 16 participants with DS . Both pathological groups were compared to 20 age-matched healthy controls in terms of kinematics and kinetics . Results showed that DS individuals are characterized by a more compromised gait pattern than EDS participants , even if both groups are characterized by joint hypermobility . All the patients showed significant decreased of ankle stiffness probably due to congenital hypotonia and ligament laxity , while different values of hip stiffness . These findings help to eluci date the complex biomechanical changes due to joint hypermobility and may have a major role in the multidimensional evaluation and tailored management of these patients Children with Down ’s syndrome ( DS ) often have greater postural sway and delay in motor development . Muscle weakness and hypotonia , particularly of the lower extremities , are theorized to impair their overall physical health and ability to perform daily activities . Therefore , the aim of this study was to investigate the effects of isokinetic training on muscle strength and 
    Output:
    
[ Conclusion ] A number of compensatory patterns during movement was observed , with a direct influence on improvements in stability and postural control throughout daily life .
Intensive gait training at an early age appears to produce long-term improvements in this population .