Development of Gait

Question 1

Neurologic Factors

Answer 1

Modulation of central pattern generators located in the SC or brainstem
Contributions from descending neural input and ascending neural input and ascending peripheral input
Con’t adaptation of motor output based on stability requirements and demands of the specific task and env’t

Question 2

Biomechanics Factors

Answer 2

ROM
Muscle strength
Bone structure and composition
Body componsition

Question 3

0-9 months

Answer 3

Development of head and trunk ext against gravity
Increase in LL and muscle mass

Question 4

0-9 months position of lower extremity

Answer 4

Hip ER > IR
Femoral anteversion 40-50º
Knees in genu varum
Everted ankle
Supported walking

Question 5

0-9 months
- Supported walking with…

Answer 5

Wide ABD, ER, and flexion at hips
Bowed legs and everted heel

Question 6

What time frame does the onset of walking occur?

Answer 6

9-15 months

Question 7

9-15 Months

Answer 7

Wide BOS
Mediolateral stability better than antero-posterior stability in walking
Anticipatory postural adjustments for gait initiation present
Compensatory postural adjustments still immature

Question 8

9-15 months
- Wide BOS

Answer 8

Hip abd, flexion and ER
Internal torsion at tibia with bow-legs
Full foot initial contact
Heel remains eeverted

Question 9

During 9-15 months what develops?

Answer 9

Sufficient extensor strength is the critical variable for onset of walking

Question 10

9-15 months
- COM

Answer 10

Lower thoracic level

Question 11

18-24 months

Answer 11

Straighter lower limbs
Reduced BOS during walking
No more excessive hip ABD
No more genu varum
Consistent heel strike by 24 months

Question 12

18-24 months con’t

Answer 12

Everted heel
Improvement in dynamic balance and extensor strength
Distinct gait events start emerging
Increase in LL, bringing COM closer to lower limbs

Question 13

18-24 months
- Distinct gait events

Answer 13

Knee flexion at initial stance in response to heel strike
Knee extension in MS
Increase in stance phase
Improved cadence

Question 14

18-24 months
- average amount of steps

Answer 14

9000 steps/equivalent to 29 football fields in a given day

Question 15

3-7 years

Answer 15

Joint angles mature into adult pattern
Joint torques remain immature
Knees in valgus
Reduction in femoral anteversion
Reduction in heel eversion
Mature EMG pattern
Walking velocity normalized for height is consistent with adults

Question 16

3-7 years
- COM

Answer 16

Located at 3rd lumbar vertebra