Motor Development 3

Question 1

Emergence of Locomotion

Answer 1

Combination of factors lead to ambulation Interaction between anatomy and environment

Dependent on:
Mechanics and structure
Neurological factors
Cognition
Perception

Question 2

Pre-Gait Locomotion

Answer 2

Thrusting arms and legs
Bearing weight
Propping, rolling, pushing up on extended arms
Rolling, crawling, creeping
Scooting, pivoting, standing
Bouncing, cruising, lowering
Stepping
Standing

Question 3

Birth to 9 months

Answer 3

Fat > muscle
Alignment:
Hip flexion contracture
Hip ER PROM > hip IR PROM
Femoral anteversion (FA)
Genu varum
Slight internal tibial torsion (ITT)

Question 4

9–15 Months

Answer 4

Initial standing:
COM is higher than in older child
Hip flexion/ER/ABD
Internal tibial torsion and knee varus
Everted heel

Initial gait:
Coactivation on EMG
Increase stability
Major requirement is net extensor moment
Full foot contact at IC
Increase in muscle content

Question 5

Characteristics of Early Walking

Answer 5

Decreased stride length
Decreased gait speed
Increased stance time (50% in double support for first 2 months)
Increased base of support
Decreasing degrees of freedom by using high guard
Toe clenching
Decreased coordination
Increased co-activation

Question 6

18–24 Months

Answer 6

Alignment:
Varus at knee has resolved
No change in FA, but improved hip extension ROM
Hip abduction decreases to normal limits

Gait:
Improved PA loading in stance
True heel strike not present until end of this phase
Role of walking experience
Decreasing co-activation

Question 7

3–3 ½ Years

Answer 7

Alignment:
Valgus alignment of TFA
FA continues to decrease, but still > adult
COM is lower

Gait:
Joint angles approximate adult gait by 3.5 yrs
Mature EMG pattern
Improving balance
Velocity normalized to height = adults

Question 8

6-7 Years

Answer 8

Alignment:
Neutral TFA
FA mostly resolved, but slightly > adult
COM is slightly elevated compared to adult Neutral Heel

Gait:
At seven, patterns are mature
Spatiotemporal variables will continue
to change with growth hips

Question 9

Development of Mature Gait

Answer 9

Decrease in variability with experience
3-year old approximates adult gait
-Kinematics
-Muscle activation patterns (EMG)
-Time in SS (38% of gait cycle)
-BOS
Gait speed
1 year old: 0.38 m/sec
Adult: 1.2 m/sec

Question 10

Changes in Gait Kinematics

Answer 10

Less time in double support
Walking velocity will increase
Cadence will decrease
Step length will increase
BOS will decrease
Development of arm swing

Question 11

Changes in Motor Control

Answer 11

Motor control improves drastically
Stopping and starting
Negotiating uneven surfaces
Transitioning from walking to running, etc.
Dual task, such as walking and talking

Question 12

Advanced Forms of Locomotion

Answer 12

Additional types of locomotion:
Ascending/descending stairs
Jumping
Running
Galloping
Skipping

Question 13

Gait Analysis in Pediatrics

Answer 13

Visual observation
Video observation
Standardized assessment tool
Measurement: Manual or with a mat
Three-dimensional computerized analysis