Effects of treadmill inclination on the gait of children with Down syndrome

► Walking on inclined surfaces could modify the kinematic gait parameters of children with Down syndrome (DS). ► In this study, children with DS walked on the treadmill carried out on 0% and 10% upward inclination. ► 10% inclination resulted in the children's gaits’ more closely approximating a gait of typically developing children. ► We suggest a possible benefit from the use of a 10% incline treadmill for the gait rehabilitation of this population. The goal of this study was to analyze the effects of upward treadmill inclination on the gait of children with Down syndrome (DS). Sixteen children with a mean age 8.43±2.25 years, classified at level I of the Gross Motor Function Classification System (GMFCS) and able to walk without personal assistance and/or assistive devices/orthosis were evaluated. Spatial-temporal variables were observed as well as the angular variation of hip, knee and ankle in the sagittal plane, while children walked on the treadmill carried out on 0% and 10% upward inclination. The results showed that children with DS presented changes in spatio-temporal variables (reduced cadence and increased cycle time and swing time) and in angular variables (increased hip, knee and ankle angles at initial contact; increased maximum hip flexion and maximum stance dorsiflexion; and reduced plantarflexion at pre-swing). Treadmill inclination seemed to act positively on the angular and spatio-temporal characteristics of gait in children with DS, demonstrating a possible benefit from the use of this type of surface in the gait rehabilitation of this population.