Pediatric gait

Question 1

at what age should you be concerned if the child is not walking independently?

Answer 1

18 months

Question 2

New walker 12-15 months

Answer 2

Short steps
Uneven steps
-Wide base of support ( step width)
-Hip abd and ER
-Ankles everted and pronated
-High guard position of arms
-Hips flexed—why do you think (lower COM)
-Lateral weight shift—no trunk rotation (“waddling”)
-Flat foot contact or forefoot initial contact
-With excessive hip flexion
 dorsiflexion during stance
-Little propulsive push off
-Small percentage can  speed when asked
Cadence = 175 steps/min

Question 3

how does LE present unitl around 2 years old?

Answer 3

Usually have the bowlegged and pigeon-toed appearance (internal tibial torsion and genu varum) until around 2 years old

Question 4

18-24 months

Answer 4

Heels strike emerges
-Facilitated by ankle DF in conjunction with KE by 2yo)
½ will show reciprocal arm swing
No more high guard
Most can increase walking speed when asked
Knee flexion is more consistent during stance phase
(PF of ankle with simultaneous KF by 2 yo)
Minimal push off
Trunk rotation begins
Step/stride length increases

Question 5

3-4 year old

Answer 5

Maturing gait pattern except for still with an increase cadence and decrease step length
BOS < width of pelvis
Notable weight shifting
increase pelvic rotation
Reciprocal arm swing well

Question 6

6-7 years old

Answer 6

• Mature gait pattern (all components)
• Mature gait pattern (all components)
• Step/stride length continues to increase as a function of leg length
• 7 year old cadence = 143 steps/min
• Adult = 114 steps/min

After 7– children also respond as adults to postural control

Question 7

Cultural Variations

Answer 7

Biologic and care giving differences affect motor development (evident in first__yrs)
Care giving practices can stimulate or calm
African heritage
motorically very responsive at birth with higher muscle tone and active anterior flexor control
Caregiving practices emphasize antigravity activities

Question 8

cultural variations continued

Answer 8

Asian and native American heritage
Lower muscle tone at birth
White and Hispanic heritage
Muscle tone and motor development between those of African and Asian heritage

*Girls across the board with better tone 		and development than boys*