Lotan, M., Isakov, E., & Merrick, J.(2004). Improving functional skills and physical fitness in children with Rett syndrome. Journal of Intellectual Disability Research, 48(8), 730-735.

The purpose of the present study was to investigate if children with Rett Syndrome (RS) who performed regular low intensity exercise regularly on a treadmill would improve physical fitness and/or functional ability with measurable results.

Participants were four girls with RS aged 8.5-11 years (mean: 10 years), all with independent mobility and with typical characteristics of RS stage III.

The training took place on a 1400 model treadmill (Trimline, capable of very low speeds < 0.5 k/h) over a 2-month period. Initial exercise sessions lasted 5 minutes, but were gradually lengthened over the first 3 weeks of training to 30 minutes each. Each participant had 36 to 50 training sessions, averaging 41 practice days for each child. Tests were performed at three intervals, designated times 1, 2, and 3 months apart with interventions taking place between tests 2 and 3. Each test included a physical fitness measure and a functional test. The physical fitness of the participating children could not be measured with formal tests because such tests require walking 1-1.5 mile distances which are beyond the capability of the participants. Because of the above-mentioned limitations, pulse measurement was used to evaluate aerobic physical condition. Functional measurement was based on a scale especially established for the study. The scale was a 31 item motor-functioning tool that measures the ability of participants to knee-walk and knee-stand, to get up to a standing position, the duration of walking different paths, and to go up and down stairs and slopes. All tests were analyzed with paired student t-tests and Pearson r correlations.

At the end of the training program, the children’s physical fitness had improved considerably (P <0.05). General functional abilities had also improved (P<0.0001). Although all items of the functional ability measure showed significant positive change, some of the 31 items showed statistically significant improvements (knee walking, going up and down stairs and speed of walking for 25 meters). Pearson correlations showed a high linkage (r =-0.76) between functional improvement and change in physical fitness. The study demonstrated that children with RS who performed regular low intensity exercise regularly on a treadmill demonstrated improvements in physical fitness and/or functional ability.