Gait Development in the Growing Child
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Introduction[edit | edit source]
The development of gait is categorized into six stages: infant stepping, inactive period, supported locomotion, unsupported locomotion, mature similar gait, and mature gait. [1]
Children learn to walk at the age of 1-year. at this stage, walking speed is very slow, and support (supported locomotion) is needed to keep an upright position. [1]
During the maturation stage, gait speeds increase to mature values. Despite factor influencing gait and gait speed, such as growth and neuromaturation, are not fully developed, mature gait is said to be reached at the ages of 5-7. [1]
Until the end of puberty, changes in body structure and sensory motor development occur. [1]
In the developing child, large stride-to-stride variations are seen, including frequent falls, due to the immature control of posture and gait. [1][2]
Children at the age of 3 years are seen to have a mature gait. Any unsteadiness that can be visually observed develops into a stable gait pattern. Though, this does not mean that the gait has been fully matured. Gradual and progressive development in neuromuscular control and locomotor function continue beyond this age. There may be a decreased variability in gait after this age. [2]
It should be noted that different features of stride dynamics develop at different times, hence no two features develop to the same time. [2] There are differences between children of the same age. [1]
Occasionally, the adult gait pattern is seen to show variability between strides. It is seen that the healthy adult locomotor system has a 'memory' where the change from alternating strides shows a gradual 'hidden' temporal structure that is associated with a long range fractal organization. In individuals with neurological disease or the elderly, especially those who experience frequent falls, there is an increase in stride-to-stride variability, and there is altered temporal organization of stride time dynamics. [2]
It is likely that mature locomotion dynamics may be evident when all the contributing components are completely functioning. [2]
Gait speed is also commonly used to assess gait development. It is one of the basic characteristics used to assess and analyze gait parameters. There is high variability when comparing different steps taken in children. Age and body height are two factors which contribute to varying walking speed. [1]
Gait Speed[edit | edit source]
It is seen that walking speed can increase up to the age of 8 years, whereas an enhanced walking speed develops up to the age of 15. [1]
Stride to Stride Variation[edit | edit source]
Successive stride-to-stride changes represents the time between one stride and the previous stride. The degree of stride-to-stride variability decreases as healthy children mature. [2]
Stride-to-stride variability is largest in the 4-year old group, a little smaller in the 7-year old group, and the smallest n the 11-year old group. It is seen that there is a highly significant effect of age on variability. The SD and CV was higher in the 3-4 age group, than the 6-7 age group, and this was higher than the 11-14 age group. The stride-to-stride variability in the 11-14 years age group was similar to that found in healthy young adults. Through observation, even though it may appear that the stride dynamics of children are similar to those of adults, quantitatively it is seen that stride-stride control of gait dynamics is not fully matured by the age of 7. [2]
Analyzing stride time dynamics in children may provide insight into the development of neuromuscular control. Stride time dynamics would not be fully matured by the age of 3. [2]
The variability of stride time dynamics in younger children can be caused by many factors. It can be caused by a decresed walking speed, and thus decreased postural stability at the lower speeds.
Stride Dynamics and Height[edit | edit source]
It is seen that, after a certain age range, stride length increases linearly wit age. However, the relationship between stride length and age becomes constant subsequent to accounting for height or leg length.
There was a significant increase in walking speed in the 6-7 year old age group, compared to the 3-4 year old age group. However, relative velocity (velocity/height) was identical in these age groups.
The studies also showed that the average values of stride time and walking velocity were age dependent. These average values were lowest in the 3-4 age group, moderate in the 6-7 age group, and highest in the 11-14 age group.
It is noted that the temporal structure of gait variability is not fully developed in 7-year old children, whereas in the 11-14 year old age group the stride dynamics are similar to those found in healthy adults.
Interesting Information[edit | edit source]
Gait patterns in children are similar to those in elderly adults. This may be due to the emergence of primitive reflexes in elderly adults, or reduced balance control. There is also a similarity with the stride dynamics, seen between chil.dren, elderly dults, and individuals with neurological impairments.
There are some important differences to note.
It is seen that, throughout the lifespan, there is a negative relationship in the fractal scaling index. It is highest in children, lower in adults, and the lowest in elderly adults and those with neurological conditions.
Stride variability is seen to change in a U-shaped fashion, with it being high in children, low in adults, and high in elderly adults and those with neurological conditions
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Muller Juliane, Muller Steffen, Baur Heiner, Mayer Frank. Intra-individual gait speed variability in healthy children aged 1–15 years. Gait & Posture. 2013:38:631-636.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Hausdorff J.M, L. Zemany, C.K Peng, A.L Goldberger. Maturation of gait dynamics: stride-to-stride variability and its temporal organization in children. Journal of Applied Physiology. 1999:86(3):1040–1047.
