Our Mission: To conduct and disseminate basic scientific research to better understand the complexity of individuals with Down syndrome and to utilize this knowledge to drive clinical services. We describe complexity as the dynamic interactions of biological and psychological factors that contribute to the overall quality of the individual's motor behavior. As we learn more about the relevant factors that may alter behavior, this information is used to design and test interventions to improve the quality of functioning in people with Down syndrome. Our goal is to share this information with scientists, parents, and professionals around the world through presentations and publications of current research, discussion of review papers, and organization of seminars. As part of the University of Michigan and the Division of Kinesiology, we create interdisciplinary and collaborative learning opportunities for researchers at the undergraduate through post-doctoral levels. The ultimate outcome will be a significant increase in the number of people conducting research and scholarship related to individuals with Down syndrome, hopefully leading to meaningful development of movement, play, and sport skills.

Faculty:   Dr. Dale Ulrich (ulrichd@umich.edu), Director   Dr. Rosa Angulo-Barroso (rangulo@umich.edu), Director for Research   Dr. Beverly Ulrich (bdulrich@umich.edu), Faculty member and Dean of the Division Postdoctoral Researchers:   Masa Kubo (mkubo@umich.edu)   Jerry Wu (wjhwu@umich.edu) Doctoral Students:   Meghann Lloyd (meghann@umich.edu)   Julia Looper (jlooper@umich.edu)   Sandra McKay (smckay@umich.edu)   Chad Tiernan (chadwt@umich.edu) Research Assistant:   Rachel Wernholm (rwernhol@umich.edu)

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Research

Modulation of leg coordination patterns in infants with and without disability
	Investigator(s): Rosa Angulo-Barroso (rangulo@umich.edu) We have designed an experimental protocol to engage the infant in the production of more coordinated movement via a contingent reinforcement paradigm. In this study, infants will be positioned supine on a crib from where they can see a mobile. During the first 2 minutes, infants will move spontaneously but they will not receive any type of reinforcement. After this, and for the next 10 minutes, infants will receive the reinforcement (i.e. movement and sound from the mobile) every time they produce a predetermined coordinated movement. To complete the session, infants will receive 2 minutes of extinction during which the mobile will not move. Through this study we hope to gain a better understanding of the process by which infants learn and use different forms of coordination. We further hope that this study will be the initiation of a potential intervention program to reinforce functional movement in infants with DS.
Infants' capacity to select and remember complex leg movement patterns
	Investigator(s): Rosa Angulo-Barroso (rangulo@umich.edu) We want to expand on the previous research and look at the memory capacity of infants with and without DS between 2-6 months of age. The purpose of this study is to examine infants' memory capacity to remember complex leg movements. To gain the visual and auditory reinforcement from an overhead mobile, the infant must select and remember the successful leg movement. The same testing protocol used in the previous study will be followed in this study with the exception of the number of testing sessions. Following the first testing session, infants will be tested 2 more times in the same experimental task, each session separated 48 hours apart from each other. The questions to answer are: Can infants select and remember a complex leg movement pattern as a result of changes in the environment? What is the effect of practice on the quantity and quality of their movements?
The design of an optimal treadmill training protocol to improve onset of gait in infants with Down syndrome
	Investigator(s): Dale Ulrich (ulrichd@umich.edu) Based on our current findings that regular treadmill exercise results in earlier onset of locomotor behavior in infants with Down syndrome, our goal is to investigate manipulations of the onset, duration and intensity of the treadmill training. Our current research indicates that we were successful in reducing the delay in onset of walking by more than 100 days through treadmill training provided by the parent in their home. We are confident that by fine tuning the treadmill training procedures we can continue to reduce this delay and observe additional benefits to the child.
Treadmill exercise and infants with Down syndrome: impact on cardiovascular health and pattern of physical activity
	Investigator(s): Dale Ulrich (ulrichd@umich.edu) The patterns of physical activity and obesity in individuals with DS may represent a risk for cardiovascular problems. The purpose of this study is to investigate whether an early treadmill exercise intervention can provide benefits to the cardiovascular system of infants with DS. This study will establish the developmental profile of physical activity and heart rate patterns in infants with DS over a longitudinal period. The relationship among biological factors, physical activity, and heart rate level will be tested. For more details about this study, as well as summary of preliminary results, see the Abstract and Overview of Proposal documents. We will also analyze changes in physical activity and heart rate as a result of treadmill exercise.
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A longitudinal study of leg movement patterns in infants with and without Down syndrome
	Investigators: Rosa Angulo-Barroso (rangulo@umich.edu) and Dale Ulrich (ulrichd@umich.edu), The purpose of this project is to study the relationship between spontaneous leg movement patterns and the onset of developmental milestones in infants with and without DS. Infants generate multiple spontaneous movements in the early months of life. This activity is thought to be an exploratory process by which infants learn how to control their own bodies. Furthermore, we hypothesize that those infants that produce, and therefore practice, more coordinated movements, will demonstrate an earlier onset of functional motor milestones, such as pulling to stand or walking, compared to those that produce less coordinated movements. Infants with and without DS will be followed longitudinally from 3 months of age until they walk independently. We will analyze spontaneous activity differences in infants with DS who were born with and without cardiac problems. We will also analyze changes in activity level following heart surgery.
Longitudinal study of early treadmill performance in infants born prematurely
	The purpose of this study is to determine if and when infants at risk for Cerebral Palsy will respond to the treadmill.  We will follow the developmental trajectory of their response pattern, the developmental factors influencing their response, and whether their response provides information useful for predicting a diagnosis of Cerebral Palsy and the onset of walking.  With our results, we hope to determine if and when a treadmill intervention program can be used with this population.
Relationship between kicking and motor milestones in infants with Down syndrome: An early intervention study
	Investigators: Meghann Lloyd (meghann@umich.edu) and Dale Ulrich (ulrichd@umich.edu) Previous research on kicking in infants has demonstrated that infant kicking is a pre-requisite to learning to walk independently. Participants in this study will be randomly assigned to two groups. One will receive the Kick and Drive Gym and the other will receive the Tummy Time Gym. The Tummy Time Gym is designed to facilitate reaching skills. Both kicking and reaching are essential skills for the physical and cognitive development for children with Down syndrome. This study is designed to investigate the effect of increased kicking on infants with Down syndrome using the Kick and Drive Gym, which is available in most toy stores.
Understanding and modeling the gait patterns of individuals with Down Syndrome
	Investigators: Beverly Ulrich (bdulrich@umich.edu) and Ugo Buzzi (ubuzzi@umich.edu) This project includes several studies funded by the National Institutes of Health (NIH).  The broad goal is to examine how mathematically modeling the dynamics of walking in persons with Down syndrome (DS) can help us understand the strategies they use to accomplish this functional behavior.  In our studies we will be working with new walkers, following the changes in their walking patterns over time, as well as preadolescents and elderly person with DS.  In addition, we are conducting validation studies and exploring options for modifying the equations in order to account for behavior as precisely and accurately as possible.  By understanding better the walking strategies “chosen” by persons with DS, we may be able to assist therapists in creating better intervention strategies. Recently, we completed the first study in which we analyzed the walking patterns of preadolescents with and without DS when they walked overground and on a treadmill at varied speeds.  Our data show that children with DS produce significantly higher levels of stiffness and forcing than their peers with typical development (TD) when walking on a treadmill, at all speeds.  Yet, when walking overground, stiffness values are not different although children with DS generate greater overall forces to maintain their body's forward momentum (paper in progress, Ulrich, Haehl, Buzzi, Kubo, & Holt).