Two-legged hopping in autism spectrum disorders

[Motor impairments in children with autism spectrum disorders: causes and possibilities for correction]

Autism spectrum disorder (ASD) is characterized by triad of abnormalities in the form of developmental distortion with a lack of communicative abilities, behavioral and motor stereotypies. Etiology and pathogenesis of disease currently are unknown, but multifactorial causes of this pathology have been suggested. Although social disorders are considered a defining characteristic, motor disorders are a key feature of ASD. They are based on a postural control impairment, which is accompanied by delayed psychomotor development, reduced ability to motor synchronism in early childhood, modified arrangement of muscles, problems with balance and gait, postural instability, coordination deficiency, presence of motor dyspraxia and other abnormalities.

OBJECTIVE

To analyze current scientific data about motor disorders in ASD and their correction possibilities in children with this pathology.

MATERIAL AND METHODS

Analysis of publications, contained in PubMed and Google Scholar databases, which give consideration to motor disorders in children with ASD, was carried out. The search was done by keywords: motor disorders, children, autism spectrum disorder, causes, correction.

RESULTS AND CONCLUSION

Adaptive physical culture during individual training is one of the available and effective methods of physical rehabilitation in patients with ASD. Children with ASD need three levels of psychological support, each of which offers individual exercises, depending on the nature and severity of speech and cognitive impairment.

Muscle activation pattern during two-legged hopping in children with and without Down syndrome

This study aimed to characterize muscle activation and its variability during two-legged hopping in children with and without Down syndrome (DS). Seventeen typically developing (TD) children and 15 children with DS were recruited. As only 6 children with DS (4F/2M, 9.95 (1.71) years) completed the test, we used a 2(TD):1(DS) ratio to age- and sex-match 12 TD children. Subjects first hopped at a self-selected free frequency and then three metronome-cued conditions: slow, preferred, and moderate (80%, 100%, and 120% of free frequency, respectively). Across conditions, children with DS exhibited greater pre-activation before landing and greater shape and timing variability in gastrocnemius, vastus lateralis, and biceps femoris than TD children. However, this compensatory strategy limited their ability to change movement speed.

Variability of Coordination in Typically Developing Children Versus Children with Autism Spectrum Disorder with and without Rhythmic Signal

Motor coordination deficit is a cardinal feature of autism spectrum disorder (ASD). The evaluation of coordination of children with ASD is either lengthy, subjective (via observational analysis), or requires cumbersome post analysis. We therefore aimed to use tri-axial accelerometers to compare inter-limb coordination measures between typically developed (TD) children and children ASD, while jumping with and without a rhythmic signal. Children aged 5–6 years were recruited to the ASD group (n = 9) and the TD group (n = 19). Four sensors were strapped to their ankles and wrist and they performed at least eight consecutive jumping jacks twice: at a self-selected rhythm and with a metronome. The primary outcome measures were the timing lag (TL), the timing difference of the maximal acceleration of the left and right limbs, and the lag variability (LV), the variation of TL across the 5 jumps. The LV of the legs of children with ASD was higher compared to the LV of the legs of TD children during self-selected rhythm jumping (p < 0.01). Additionally, the LV of the arms of children with ASD, jumping with the rhythmic signal, was higher compared to that of the TD children (p < 0.05). There were no between-group differences in the TL parameter. Our preliminary findings suggest that the simple protocol presented in this study might allow an objective and accurate quantification of the intra-subject variability of children with ASD via actigraphy.

Lower extremity joint stiffness during walking distinguishes children with and without autism

How children with Autism Spectrum Disorder (ASD) and peers with typical development (TD) modulate lower extremity stiffness during walking could identify a mechanism for gait differences between groups. We quantified differences in lower extremity joint stiffness and linear impulses, along the vertical and anterior/posterior axes during over-ground walking in children with ASD compared to age- and gender-matched children with TD. Nine age- and gender-matched pairs of children, aged 5-12 years, completed the current study. Joint stiffness and linear impulses were computed in four sub-phases of stance: loading response, mid-stance, terminal stance, and pre-swing. The Model Statistic technique (α = 0.05) was used to test for statistical significance between the matched-pairs for each variable and sub-phase. Furthermore, dependent t-tests (α = 0.05) were utilized, at the group level, to determine whether significant differences existed between sub-phases. Results indicate that children with ASD may exhibit greater stiffness in pre-swing, and thus, produce inefficient propulsive forces during walking. We attribute these differences to sensory processing dysfunction previously observed in children with ASD.

Weighted Walking Influences Lower Extremity Coordination in Children on the Autism Spectrum

There is sparse quantitative research regarding gait coordination patterns of children on the autism spectrum, though previous studies, relying only upon observational data, have alluded to characteristically poor movement coordination. This study compared walking with a weighted vest, a backpack carriage, and an unloaded walking condition on lower extremity coordination among 10 male children (aged 8-17 years) on the autism spectrum. All participants completed 15 gait trials in the following three conditions: (a) unloaded, (b) wearing a backpack weighted with 15% body mass, and (c) wearing a vest weighted with 15% body mass. We used continuous relative phase analysis to quantify lower extremity coordination and analyzed data through both group and single-subject comparisons. We used the Model Statistic to test for statistical significance at each of the normalized data points for each segment couple (thigh-leg, leg-foot, and thigh-foot). The first 10 and last 10 stride blocks were tested for possible accommodation strategies. Group comparisons revealed no coordination changes among the three conditions (likely due to insufficient statistical power), while single-subject comparisons exposed significant decreased variability in gait coordination patterns ( p < .05) in both loaded conditions, relative to the unloaded condition. These participants exhibited variable coordination patterns during the unloaded gait. When walking with loads, coordination pattern variability of the lower extremities was decreased. This finding suggests that walking while carrying or wearing heavy objects may reduce the number of potential motor pattern choices and thus decrease the overall variability of lower extremity movement patterns. Additional research with a larger and more diverse participant sample is required to confirm this conclusion.

Vertical stiffness and balance control of two-legged hopping in-place in children with and without Down syndrome

BACKGROUND

Children with Down syndrome (DS) are known for their reduced balance control, and typically take longer to develop motor skills and display less coordinated movement patterns. Hopping in-place is a gross motor skill requiring whole-body vertical stiffness and horizontal movement control, particularly when attempting to modify hopping frequency. However, there is a lack of knowledge of the hopping capacity of children with DS.

RESEARCH QUESTION

The purpose of this study was to assess the ability of children with DS aged 5-11 years old to continuously hop in-place on two legs and compare their biomechanical patterns to those of typically developing (TD) children.

METHODS

This observational study included 14 children with DS and 16 TD children. Subjects were asked to complete 20 s trials of two-legged hopping in-place at a self-selected frequency, and four metronome guided conditions: preferred (self-selected frequency), moderate (20% increase), fast (40% increase) and slow (20% decrease). Two sample independent t-tests were conducted on whole-body vertical stiffness, horizontal center-of-mass movement, and toe displacement between hops for the self-selected hopping condition and two-way ANOVAs were used for the metronome conditions.

RESULTS AND SIGNIFICANCE

Our findings suggest that children with DS might not be able to continuously hop in-place until the age of 7 years old, and were unable to hop for as long in duration as their TD peers. Children with DS self-selected a faster hopping frequency, and demonstrated an increased medial-lateral center-of-mass movement during the stance phase of hopping, suggesting reduced balance control. Moreover, children with DS were unable to correctly modify their hopping frequency when cued by a metronome and exhibited an inability to modulate whole-body vertical stiffness and constrain horizontal or vertical movement. These results demonstrate the utility of a future hopping intervention to improve whole-body vertical stiffness and balance control in children with DS.

Examination of gait parameters during perturbed over-ground walking in children with autism spectrum disorder

BACKGROUND

Many children with Autism Spectrum Disorder (ASD) are school-aged and typically carry a backpack. It is important to understand how this task affects walking. Weighted vests (WVs) often prescribed to mitigate behavioral effects of ASD. The effects of backpack and WV walking have not been examined in children with ASD.

AIMS

To quantify differences in lower extremity mechanics in children with ASD during WV and backpack walking.

METHODS

Eight male participants completed 15 trials in three conditions: body mass, and carrying or wearing a backpack or WV with 15% added body mass. Three-dimensional kinematic data were collected and normalized to 100% of the gait cycle. The Model Statistic was utilized to test for bilateral asymmetries between the lower extremity joints at all points along the gait cycle.

RESULTS

Analysis revealed similar numbers of significant asymmetries in hip (71.0, 70.4, 60.6), knee (68.4, 71.5, 74.6), and ankle (64.1, 68.9, 68.4) for unloaded, backpack, and WV, respectively.

CONCLUSION

Participants exhibited individualized kinematic symmetry-responses to the loaded conditions compared to the unloaded condition. These findings suggest that 15% body mass backpack or WV does not affect gait symmetry in children with ASD.

Gender and autistic traits modulate implicit motor synchrony

Interpersonal motor synchrony during walking or dancing is universally observed across cultures, and this joint movement was modulated by physical and social parameters. However, human interactions are greatly shaped by our unique traits, and self-related factors are surprisingly little studied in the context of interpersonal motor synchrony. In this study, we investigated two such factors known to be highly associated with motor coordination: gender and autistic traits. We employed a real-world task extending our understanding beyond laboratory tasks. Participants of the same gender were paired up to walk and chat in a natural environment. A cover story was introduced so that participants would not know their walking steps were being recorded and instead believed that their location was being tracked by a global positioning system (GPS), so they would ignore the motor recording. We found that the female pairs’ steps were more synchronized than those of the males, and higher autistic tendencies (measured by the autism-spectrum quotient) attenuated synchronous steps. Those who synchronized better had higher impression rating increase for their walking partners (measured by interpersonal judgement scale) than those who synchronized less well. Our results indicated that the participants’ joint movements were shaped by predisposed traits and might share similar mechanism with social functions such as empathy.

Autism spectrum disorder and the cerebellum

The cerebellum has been long known for its importance in motor learning and coordination. Recently, anatomical, clinical, and neuroimaging studies strongly suggest that the cerebellum supports cognitive functions, including language and executive functions, as well as affective regulation. Furthermore, the cerebellum has emerged as one of the key brain regions affected in autism. Here, we discuss our current understanding of the role of the cerebellum in autism, including evidence from genetic, molecular, clinical, behavioral, and neuroimaging studies. Cerebellar findings in autism suggest developmental differences at multiple levels of neural structure and function, indicating that the cerebellum is an important player in the complex neural underpinnings of autism spectrum disorder, with behavioral implications beyond the motor domain.