Normal development of Gait Flashcards
When is walking generally achieved?
9-15 mo of age. 11.2 is average
What are the 5 major attributes of normal walking?
Stability in stance, sufficient foot clearance in swing, appropriate positioning of the foot for initial contact, adequate step length, energy conservation
What age range is there accelerated brain growth?
3-10 mo.
What are the precursors to ambulation?
adequate motor control and CNS maturation, Adequate ROM/strength/bone structure/composition/proprioception & sensation, dynamic balance, sufficient extensor strength for SLS.
Which precursor to ambulation is acquired in the first 9 mo
development of antigravity muscle control & strength
kicking = hip flexor, prone = hip extensor, kneeling cruising etc important for SLS.
Standing posture
wide BOS, hips ABducted/flexed/slight ER, tibiofemoral varus, mild internal tibial torsion, heels everted
Initial gait pattern
wide BOS, increased hip/knee flexion, full foot initial contact in plantar flexion, might have toe grasp. (Arches begin to appear at 2-slowly develop until 4.), increased cadence, footdrop in swing phase, decreased duration SLS, “high guard” of UE, increased lumbar lordosis d/t decreased core muscles, some kids toe walk (need to be aware if it doesn’t stop).
Gait at 18-24 mo of age
Varus angulation gone, limb is straight. Range of ABduction decreased (decreased BOS), strength/balance improved, still no heel strike but more AP movement over planted foot. increased velocity, decreased cadence.
When does normal heel strike begin?
around 24 mo. Depends on refined motor control, strength, dynamic balance to sustain stability of small BOS
Gait at 3-3 1/2 years of age
Should be fairly mature pattern. reciprocal arm swing, emergence of knee flexion wave and heelstrike with DF, sharp rise in velocity, decreased BOS, SLS increased, increased anterior pelvic tilt.
When is the gait pattern fully mature?
7 y.o. walking velocity increases from 1yo-7yo., step length increases until growth is complete
Structural changes as aging continues
tibiofemoral angle returned to neutral, femoral anteversion is almost resolved, heel position is neutral, mature equilibrium responses.
How is running defined?
Having a period of flight when neither foot is touching the ground.
When does running begin?
6-7 mo after the child first begins to walk.
