EXPLORING THE BENEFITS OF A DYNAMIC HARNESS SYSTEM USING PARTIAL BODY WEIGHT SUPPORT ON GROSS MOTOR DEVELOPMENT FOR INFANTS WITH DOWN SYNDROME

Purpose/Hypothesis: Children with DS present with delayed motor development. Early intervention is crucial in pre-ambulatory stages to support development of mobility, exploratory play, and social interaction. Both enriched play environments and Partial-Body Weight Support (PBWS) training have shown promise for facilitating these developmental experiences in young children with DS, however, these interventions have not yet been widely explored in combination. This study explored the benefits of a dynamic portable PBWS harness system within an enriched play environment on gross motor development, movement counts, and mastery motivation of young children with DS.

Number of Subjects: 6

Materials/Methods: This study presents data from a subset of six participants from an overarching, randomized, multi-site crossover study funded by an APTA pediatric academy research grant. We deployed a portable dynamic harness system that provided PBWS for children to freely explore a 9’x9’ enriched play space in multiple positions. In this 9-week study, children participated in play and mobility sessions 3x/week for 6 weeks: 3 weeks with harness system engaged, and 3 weeks without harness system. Harness condition order was randomized. Assessments were completed during weeks 1, 6, and 9 using the Gross Motor Function Measure-88 (GMFM-88), parent reported Mastery Motivation Questionnaire dimensions, and activity counts using wrist, ankle, and trunk-worn accelerometers.

Results: Statistically and clinically significant improvements were evident in mean mid and post-study GMFM-88 scores compared to baseline values, with higher rates of change in the GMFM dimensions scores during the in-harness condition compared to the no-harness condition. No significant differences were found in the mastery motivation scores. Overall, activity counts increases were observed; however, this was not dependent on the harness condition.

Conclusions: Children with DS improved their gross motor skills across the intervention period, regardless of whether the dynamic portable harness system was engaged. However, the harness system did impact the rate of GMFM-88 dimensions change, indicating its potential value in supporting early intervention for children with DS. While children enjoyed the harness system and the enriched environment, parent reported mastery motivation remained steady. Though activity levels measured via accelerometry increased overall, the direct impact of the in-harness condition remains unclear.

Clinical Relevance: Combining a dynamic PBWS harness system with an enriched play environment is a promising tool for early intervention to support motor development and environmental exploration for young children with DS. Harness systems may be useful in home, school, or clinic settings to encourage mobility, play, and accelerate gross motor development.