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PubMed1999

A video review of the diagnosis of psychogenic gait: appendix and commentary.

The gait and other clinical features of 22 patients presenting to our hospital over the last 10 years are shown on video. In 12 patients, a diagnosis of psychogenic gait was made; in the remainder, the gait abnormality was the result of a neurologic disease. Psychogenic gaits are compared and contrasted with "organic" gaits. In one patient, the psychogenic gait occurred in the setting of a neurologic disease. The "traditional" approach to psychogenic gait, attempting to exclude underlying neurologic and psychiatric disease and seeking evidence for primary and secondary gain, was found to be of limited value. More useful were the features of the gait itself, in particular, exaggerated effort, extreme slowness, variability throughout the day, unusual or uneconomic postures, collapses, convulsive tremors, and distractibility; certain aspects of the history were also helpful. A list of comments is provided. The diagnosis of psychogenic gait, particularly in the elderly, remains fraught with hazard, and a balance has to be sought between subjecting an anxious patient to needless investigations and yet not losing sight of the fact that the patient may be elaborating on symptoms of genuine disease. The bizarre gait of some neurologic disorders, particularly dystonia and chorea, may be a pitfall for the unwary.

Adolescent↗
PubMed2002

Non-neurological factors are implicated in impairments in gait and mobility among patients in a clinical dementia referral population.

Although gait abnormalities have been previously noted in dementia, their non-neurological correlates have not been examined. We used data on 900 consecutive outpatients assessed from 1994 to 1999 in the University of Nebraska Geriatric Assessment Clinic Data Base (UN-GAC) to examine the prevalence of gait disorders and the relationship of gait disorders to physical illness in Alzheimer's disease (AD) and non-AD dementia. Gait disorders were very prevalent at each level of cognitive function [58.7% for CDR=0, 68.0% for CDR=0.5, 57.9% for CDR=1, 68.1% for CDR=2 and 76.9% for CDR=3, p=0.02] and were more frequently observed in AD patients with poorer cognitive function. Among all demented patients, 45.0% of those without gait impairment were ADL independent compared to 11.8% of those with gait impairment. In adjusted logistic regression models, the presence of a gait disorder among AD patients was significantly associated with older age (Odds Ratio (OR)=1.09, 95% Confidence Intervals (CI)=1.04-1.15), special sensory (2.19, 1.17-4.12), and lower GI (3.57, 1.97-6.47) dysfunction. The prevalence of gait disorders is high in even mildly demented persons and associated with common and often treatable organ system dysfunction. Because gait disorders are also associated with a high prevalence of ambulatory disability, attention to co morbid illnesses implicated in gait impairment may reduce the burden of disability in this population.

Activities of Daily Living↗
PubMed1996

Hamstrings and psoas lengths during normal and crouch gait: implications for muscle-tendon surgery.

Crouch gait, one of the most common movement abnormalities among children with cerebral palsy, is characterized by persistent flexion of the knee during the stance phase. Short hamstrings are thought to be the cause of crouch gait; thus, crouch gait is often treated by surgical lengthening of the hamstrings. In this study, a graphics-based model of the lower extremity was used in conjunction with three-dimensional kinematic data obtained from gait analysis to estimate the lengths of the hamstrings and psoas muscles during normal and crouch gaits. Only three of 14 subjects with crouch gait (four of 20 limbs with knee flexion of 20 degrees or more throughout stance) had hamstrings that were shorter than normal by more than 1 SD during walking. Most (80%) of the subjects with crouch gait had hamstrings of normal length or longer, despite persistent knee flexion during stance. This occurred because the excessive knee flexion was typically accompanied by excessive hip flexion throughout the gait cycle. All of the subjects with crouch gait had a psoas that was shorter than normal by more than 1 SD during walking. These results emphasize the need to consider the geometry and kinematics of multiple joints before performing surgical procedures aimed at correcting crouch gait.

Adolescent↗
PubMed1998

Gait analysis in patients with Parkinson's disease and motor fluctuations: influence of levodopa and comparison with other measures of motor function.

Although clinical rating scales and simple timed tests of motor function are widely used to assess motor response to therapy, gait analysis may provide an alternative measure of this response. We studied 15 patients with PD complicated by motor fluctuations, first to determine changes in temporal and spatial gait parameters following levodopa, secondly to assess the stability of repeated gait measures and timed tests in "off" and "on" states, and thirdly to determine the use of gait analysis in the assessment of the dopaminergic response. Gait analysis (velocity, stride length, cadence, and double limb support), clinical rating scales (modified Webster scale and Hoehn and Yahr stage), and timed tests of motor function (hand tapping and stand-walk-sit time) were performed before ("off") and after ("on") a levodopa challenge. Stride length and gait velocity increased following medication whereas cadence and double limb support did not. Most gait measures and the stand-walk-sit time were stable over three consecutive trials in both "off" and "on" states. Of the gait measures, only cadence in the "off" state changed significantly whereas the tapping count improved with repeated trials in both "off" and "on" states. Changes in stride length, gait velocity, and tapping count following levodopa correlated with changes in clinical rating scales following treatment. Measurement of gait parameters provides a reliable, objective alternative to rating scales and timed tests in assessing the dopaminergic response in patients with PD and motor fluctuations.

Aged↗
PubMed2003

Concurrent validity of the Berg Balance Scale and the Dynamic Gait Index in people with vestibular dysfunction.

BACKGROUND AND PURPOSE: The Berg Balance Scale is a reliable and valid measure that is used to assess characteristics of balance. The Dynamic Gait Index is a relatively new measure that has been used to record dynamic gait tasks in people with vestibular dysfunction. The purpose of the present study was to determine the concurrent validity of the Dynamic Gait Index with the Berg Balance Scale in people with vestibular disorders. METHOD: A retrospective review of the charts of people who met the criteria of having completed both the Berg Balance Scale and the Dynamic Gait Index during their first physiotherapy visit. Seventy patients (19 male, 51 female) were identified through the retrospective review of the charts of people referred for vestibular rehabilitation with varying diagnoses of vestibular and balance dysfunction. All were seen at a tertiary medical centre in an outpatient physiotherapy setting. Their age range was from 14 to 88 years (mean 65 years). RESULTS: Correlation between the scores on the Dynamic Gait Index and the Berg Balance Scale was moderate but significant by use of the Spearman rank order correlation (r = 0.71; p < 01). No difference was found between scores on the Dynamic Gait Index or Berg Balance Scale based on gender or diagnosis. A significant difference was identified on the Berg Balance Scale between older and younger people with vestibular disorders. Using previously established criteria to determine increased risk of falling, the Berg Balance Scale and the Dynamic Gait Index agreed 63% of the time. CONCLUSIONS: The moderate correlation between the Dynamic Gait Index and the Berg Balance Scale establishes the concurrent validity of the Dynamic Gait Index in people with vestibular dysfunction. Both these measures provide valuable information to clinicians about patients' functional balance capabilities. However, the lack of perfect correlation indicates that the tests measure different aspects of balance. The Dynamic Gait Index appears to be a more sensitive assessment tool in identifying people with vestibular disorders who are at increased risk for falling, based on currently published criteria.

Adolescent↗
PubMed2004

Systematic review of quantitative clinical gait analysis in patients with dementia.

INTRODUCTION: Diminished mobility often accompanies dementia and has a great impact on independence and quality of life. New treatment strategies for dementia are emerging, but the effects on gait remains to be studied objectively. In this review we address the general effects of dementia on gait as revealed by quantitative gait analysis. METHODS: A systematic literature search with the (MESH) terms: 'dementia' and 'gait disorders' in Medline, CC, Psychlit and CinaHL between 1980-2002. Main inclusion criteria: controlled studies; patients with dementia; quantitative gait data. RESULTS: Seven publications met the inclusion criteria. All compared gait in Alzheimer's Disease (AD) with healthy elderly controls; one also assessed gait in Vascular Dementia (VaD). The methodology used was inconsistent and often had many shortcomings. However, there were several consistent findings: walking velocity decreased in dementia compared to healthy controls and decreased further with progressing severity of dementia. VaD was associated with a significant decrease in walking velocity compared to AD subjects. Dementia was associated with a shortened step length, an increased double support time and step to step variability. DISCUSSION: Gait in dementia is hardly analyzed in a well-designed manner. Despite this, the literature suggests that quantitative gait analysis can be sufficiently reliable and responsive to measure decline in walking velocity between subjects with and without dementia. More research is required to assess, both on an individual and a group level, how the minimal clinically relevant changes in gait in elderly demented patients should be defined and what would be the most responsive method to measure these changes.

Aged↗
PubMed2001

Chronic bilateral pallidal stimulation and levodopa do not improve gait in the same way in Parkinson's disease: a study using a video motion analysis system.

Chronic bilateral internal globus pallidus (GPi) stimulation allows control of levodopa induced dyskinesias (LID) and motor symptoms in severe Parkinson's disease (PD). The effect on gait has not been clearly established. Different results have been reported, mostly consisting of clinical data. The aim of this study was to evaluate, by means of a video motion analysis system (optoelectronic VICON system), the influence of bilateral GPi stimulation on gait in PD. Five patients underwent bilateral GPi stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances (items 29 and 30 of the motor UPDRS), as well as spatial and temporal gait measurements (namely cadence, velocity, stride and step times, single and double limb support times, stride and step lengths) were analysed in off condition (the patient had received no treatment for 12 hours or merely the lowest dose of levodopa allowing him to walk for the gait analysis) and in the on drug condition (after administration of 200 mg of levodopa). The gait analysis was performed with the VICON system. In off condition, there was a statistically significant improvement after surgery for UPDRS III and gait (clinically assessed). In on drug condition, there was a significant improvement for LID whereas UPDRS III and clinical assessment of gait were unchanged. The VICON system also showed that surgery improved gait especially in off condition, but also in on drug condition. Our method allowed exact quantification of the influence of surgery on gait characteristics. As compared with levodopa treatment, the effect of stimulation seems to be different. Indeed, the results suggest only limited effects of pallidal stimulation on the control of stride length and rather point to compensatory additional mechanisms.

Aged↗
PubMed2006

Stumbling with optimal phase reset during gait can prevent a humanoid from falling.

The human biped walking shows phase- dependent transient changes in gait trajectory in response to external brief force perturbations. Such responses, referred to as the stumbling reactions, are usually accompanied with phase reset of the walking rhythm. Our previous studies provided evidence, based on a human gait experiment and analyses of mathematical models of gait in the sagittal plane, that an appropriate amount of phase reset in response to a perturbation depended on the gait phase at the perturbation and could play an important role for preventing the walker from a fall, thus increasing gait stability. In this paper, we provide a further material that supports this evidence by a gait experiment on a biped humanoid. In the experiment, the impulsive force perturbations were applied using push-impacts by a pendulum-like hammer to the back of the robot during gait. The responses of the external perturbations were managed by resetting the gait phase with different delays or advancements. The results showed that appropriate amounts of phase resetting contributed to the avoidance of falling against the perturbation during the three-dimensional robot gait. A parallelism with human gait stumbling reactions was discussed.

Biomechanical Phenomena↗
PubMed1997

Neural control of interlimb oscillations. II. Biped and quadruped gaits and bifurcations.

Behavioral data concerning animal and human gaits and gait transitions are simulated as emergent properties of a central pattern generator (CPG) model. The CPG model is a version of the Ellias-Grossberg oscillator. Its neurons obey Hodgkin-Huxley type equations whose excitatory signals operate on a faster time scale than their inhibitory signals in a recurrent on-center off-surround anatomy. A descending command or GO signal activates the gaits and triggers gait transitions as its amplitude increases. A single model CPG can generate both in-phase and anti-phase oscillations at different GO amplitudes. Phase transitions from either in-phase to anti-phase oscillations or from anti-phase to in-phase oscillations can occur in different parameter ranges, as the GO signal increases. Quadruped vertebrate gaits, including the amble, the walk, all three pairwise gaits (trot, pace, and gallop), and the pronk are simulated using this property. Rapid gait transitions are simulated in the order--walk, trot, pace, and gallop--that occurs in the cat, along with the observed increase in oscillation frequency. Precise control of quadruped gait switching uses GO-dependent modulation of inhibitory interactions, which generates a different functional anatomy at different arousal levels. The primary human gaits (the walk and the run) and elephant gaits (the amble and the walk) are simulated, without modulation, by oscillations with the same phase relationships but different waveform shapes at different GO signal levels, much as the duty cycles of the feet are longer in the walk than in the run. Relevant neural data from spinal cord, globus pallidus, and motor cortex, among other structures, are discussed.

Animals↗
PubMed2005

The evolution of clinical gait analysis part III--kinetics and energy assessment.

Historically, clinical applications of measurements of force and energy followed electromyography and kinematics in temporal sequence. This sequence is mirrored by the order of topics included in this trilogy on the Evolution of Clinical Gait Analysis, with part I [Sutherland DH. The evolution of clinical gait analysis part I: kinesiological EMG. Gait Posture 2001;14:61-70.] devoted to Kinesiological EMG and part II [Sutherland DH. The evolution of clinical gait analysis part II - kinematics. Gait Posture 2002;16(2):159-179.] to Kinematics. This final review in the series will focus on kinetics as it relates to gait applications. Kinematic measurements give the movements of the body segments, which can be compared with normal controls to identify pathological gait patterns, but they do not deal with the forces controlling the movements. As a major goal of scientifically minded clinicians is to understand the biomechanical forces producing movements, the objective measurement of ground reaction forces is essential. The force plate (platform) is now an indispensable tool in a state-of-the-art motion analysis laboratory. Nonetheless, it is not a stand-alone instrument as both kinematic and EMG measurements are needed for maximum clinical implementation and interpretation of force plate measurements. The subject of energy assessment is also given mention, as there is a compelling interest in whether walking has been made easier with intervention. The goals of this manuscript are to provide a historical background, recognize some of the important contributors, and describe the current multiple uses of the force plate in gait analysis. The widespread use of force plates for postural analyses is an important and more recent application of this technology, but this review will be restricted to measurements of gait rather than balance activities. Finally, this manuscript presents my personal perspective and discusses the developments and contributors that have shaped my thoughts and actions, and which I have found to be particularly noteworthy or intriguing. Just as in parts I and II, emphasis has been placed on the early development. All subtopics and important contributors, in this third and certainly most challenging of the review papers, have not been included. Some may find that my perceptions are incomplete. I accept responsibility for all deficiencies, as none were intended. Letters to selected contributors and their responses reveal how each contributor built on the work of others. The level of cooperation and sharing by these early investigators is extraordinary. Had they wished to withhold information about their own work, clinical gait analysis would have been severely delayed.

Biomechanical Phenomena↗
PubMed2005

Do dynamic and static clinical measurements correlate with gait analysis parameters in children with cerebral palsy?

The present study documents the correlation between gait analysis data and clinical measurements and evaluates the combined predictive value of static and dynamic clinical measurements on gait data of children with cerebral palsy. Two hundred patients were evaluated using a set of measurements of range of motion (ROM), alignment, spasticity, strength and selectivity, and by three-dimensional gait analysis. Fair to moderate correlations were found between clinical measurements and gait data, the overall highest correlation being 0.60. Clinical data of strength and selectivity had the highest degree of significant correlations with gait data, compared to the ROM and spasticity. ROM, spasticity and strength measurements for the hip in the coronal plane and spasticity of rectus femoris most frequently showed fair to moderate correlations to gait data. Time and distance and EMG parameters mainly correlated with strength and selectivity parameters. Unexpectedly, alignment parameters only fairly correlated with hip rotation in stance. Multiple regression analysis revealed that adding dynamic clinical measurements (spasticity, strength and selectivity) to a static model (ROM) enhanced the link between clinical measurements and gait data. The variance of gait parameters was better explained by a combined model of static and dynamic clinical measurements, compared to a purely static model. However, R(2)-values were low. Gait analysis data cannot be sufficiently predicted by a combination of clinical measurements. The independence of the measurements supports the notion that both, clinical examination and gait analysis data provide important information for delineating the problems of children with CP.

Cerebral Palsy↗
PubMed2006

Increasing the number of gait trial recordings maximises intra-rater reliability of the CODA motion analysis system.

OBJECTIVE: This study investigates the optimum number of gait trial recordings to maximise intra-rater reliability with the CODA motion analysis system in a normal population. Potential sources of variability in test-retest experimental procedures will be discussed. BACKGROUND: The most recent study by [Maynard V, Bakheit AMO, Oldham J, Freeman J. Intra-rater and inter-rater reliability of gait measurements with CODA mpx30 motion analysis system. Gait Posture 2003;17:59-67] that evaluated the Cartesian Optoelectronic Dynamic Anthropometer (CODA) motion analysis system exhibited poor correlation for intra-rater reliability of kinematic and kinetic parameters. It is unknown what the optimum number of gait trials is required during testing to represent an individuals gait pattern during normal walking. DESIGN: Ten healthy subjects (mean 28.5 years) were tested on two occasions by an experienced well trained rater during normal walking to establish intra-rater reliability using 1-2, 1-4, 1-6, 1-8, and 1-10 gait trial recordings to represent the mean. The 3D kinematic, kinetic parameters of hip, knee and ankle joints and spatio-temporal parameters were recorded during normal walking. Intra-class correlation coefficient and Bland and Altman limits of agreement were chosen to analyse the results. RESULTS: Spatio-temporal parameters exhibited least test-retest variability, as measurement of only two gait trials to represent the mean produced similar variability in test-retest as when higher numbers of trials were measured. Kinematic parameters were more variable than kinetic while for both variability decreased with increasing numbers of trials measured and would advocate measuring 10 gait trials for future analysis when measuring these parameters. CONCLUSIONS: Generally intra-rater reliability improves when larger number of gait trial recordings represent a subject's gait.

Adult↗
PubMed2006

Age-related differences in spatiotemporal markers of gait stability during dual task walking.

Increased stride-to-stride variability during walking characterizes gait instability and predicts falling in older adults. Walking while performing cognitive tasks (dual task walking) is also associated with increased risk of falling. The purpose of the study was to examine whether gait velocity and stride-to-stride variability in gait velocity differ in older adults compared with middle-aged and younger adults during normal and dual task walking conditions. Sixty older (n=20, mean age=81 years), middle-aged (n=20, mean age=48 years), and young adults (n=20, mean age=25 years) participated in the study. Gait parameters were quantified with GAITRite instrumentation. In the dual task condition, participants spelled five-letter words in reverse while walking across the walkway. Across groups, gait velocity was slower (p<0.001) and stride-to-stride variability in gait velocity was greater (p=0.001) in dual task walking. Older subjects walked more slowly than did middle-aged and younger subjects and the difference in gait velocity was greatest in the dual task condition (p<0.05). Variability in stride velocity was increased in older subjects compared with middle-aged and younger subjects (p<0.05). Additionally, in older subjects, impaired walking performance was associated with impaired cognitive performance in dual task walking. The gait changes observed in dual task walking characterize decreased gait stability and indicate that cognitively demanding tasks during walking have a destabilizing effect on gait and may place older people at a greater risk of falling.

Adult↗
PubMed2005

[Gait changes encountered after a total knee prosthesis with or without posterior cruciate ligament preservation].

PURPOSE OF THE STUDY: We wanted to check whether the differences in joint kinematics between the normal and prosthesis knee, with or without preservation of the posterior cruciate ligament, have an effect on knee flexion-extension during gait and on gait performance. MATERIAL AND METHODS: A control group of nine subjects was compared with two groups of subjects with total knee prostheses, with (n = 10 patients) or without (n = 6 patients) preservation of the posterior cruciate ligament. Gait was studied on flat ground at three different walking speeds. We measured the principal temporospatial gait parameters as well as knee flexion and extension angles using continuous electrogoniometry. Non-parametric statistical tests were used to analyze data due to the small number of subjects in each group. RESULTS: The flexion-extension cycles were different between the control group and the prostheses groups, but there was no difference between the two prostheses groups. Measurements made during gait confirmed this result, demonstrating a modification of the temporospatial parameters and a decrease in knee flexion during weight bearing in the prostheses groups compared with the control group. The statistical analysis demonstrated a correlation between these two results. DISCUSSION: The individual nature of gait parameters hindered data analysis. Indeed, there are many different ways to walk "normally". We were however able to demonstrate the following points. The theoretical differences in joint kinematics between prostheses with or without preservation of the posterior cruciate ligament did not have any effect on gait. There were however significant differences between the control group and the prostheses groups, and these differences depended on walking speed. The most interesting results concerned the changes in the weight-bearing phase. Flexion during this phase was related to walking speed and was decreased in amplitude in both prostheses groups. This lesser amplitude in knee flexion probably affected the quality of gait because it was correlated with decreased temporospatial parameters related to gait performance. CONCLUSION: This decreased amplitude of flexion during gait, which cannot be expected from motion measurements without weight bearing, can be explained by an interaction between joint kinematics, the musculoligamentary system and the locomotor schema.

Arthroplasty, Replacement, Knee↗
PubMed2003

[Relationship between gait speed and strength parameters in multiple sclerosis].

INTRODUCTION: Recent studies have focused on correlation between strength and gait parameters in hemiplegia, suggesting the interest for strength training in patients with central nervous system lesions. The aim of this study was to evaluate this correlation in multiple sclerosis (MS) patients with special regard to the different clinical forms including proprioceptive loss or cerebellar ataxia. PATIENTS AND METHOD: Gait speed and muscular function were performed in 27 patients with moderate affected gait (EDDS < 6). Gait speed was evaluated with Locometre and peak-torques of quadriceps and hamstrings were evaluated with isokinetic dynamometer. Patients were separated in three groups related to their deficiency: spastic group (8 patients), spastic with proprioceptive loss (12 patients) and spastic with cerebellar ataxia (7 patients). Gait parameters were evaluated in 10 healthy subjects as control group. RESULTS: Gait speeds (spontaneous and maximal) and peak torques of quadriceps and hamstring were similar in the three groups. In the whole patients group, gait speed was reduced and related to hamstring peak torque (r = 0.56 at spontaneous speed and 0.51 at high speed) but not with quadriceps peak torque. Patients with proprioceptive loss exhibited not only a higher correlation between gait speed and hamstring torque (r = 0.76 and 0.65 respectively) than other patients but also with quadriceps torque (r = 0.66 and 0.59 respectively) when patients in other groups did not. CONCLUSION: As it was previously pointed out in hemiplegic patients, MS patients exhibit some correlation between gait speed and muscle strength, mainly with hamstrings. These correlations can change in special sensory conditions suggesting that patients with sensory loss use different muscular strategies to maintain gait speed. Strength training may therefore be discussed in MS including specific modalities as a function of clinical parameters.

Biomechanical Phenomena↗
PubMed1999

Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors.

OBJECTIVE: To determine, using the Muscular Utilization Ratio (MUR) method, whether plantarflexor weakness is among the factors preventing stroke subjects from walking at faster speeds. Potential compensations by the hip flexors were also examined. DESIGN: A convenience sample of 17 chronic stroke subjects in a context of a descriptive study. BACKGROUND: Gait speed is correlated with the residual strength of the muscles involved in gait in stroke subjects. However, it has not been established if this residual strength limits gait speed. METHODS: Kinetic and kinematic data for comfortable and maximal gait speeds were collected on the paretic side, and were used to determine the moments in plantarflexion (mechanical demand: MUR numerator) during the push-off phase. The maximal potential moment (MUR denominator) of the plantarflexors during gait was predicted using an equation derived from dynamometric data collected with a Biodex system. The MURs of the plantarflexors were then calculated at every 1% interval of the push-off phase. The pull-off phase of gait and the hip flexor strength were also examined. RESULTS: Ten subjects of the sample had a MUR value between 80 and 150% at maximal gait speed. These subjects produced the lowest peak torques in plantarflexion. Each of the four fastest subjects of this group had a large hip flexion moment during the pull-off phase of gait and produced high hip flexion torque values on the dynamometer. Each of the seven remaining subjects had a MUR value under 70% when they walked at maximal speed. CONCLUSIONS: Weakness of the plantarflexors should be considered as one factor limiting gait speed in 10 hemiparetic subjects. Some subjects with weak plantarflexors could walk rapidly because they compensated with the hip flexors. For the remaining stroke subjects, factors other than weakness of the plantarflexors have to be considered in order to explain the reduction in their gait speed.

Adolescent↗
PubMed1983

Development of gait at slow, free, and fast speeds in 3- and 5-year-old children.

The purpose of this study was to describe and statistically analyze 3- and 5-year-old children's gait at slow, free, and fast speeds in terms of stride length, step length (adjusted for leg length), stride width, included angle of feet, and cadence. The study also correlated gait factors and motor development. Gait patterns were recorded with a clinical, footprint method. In general, stride length and cadence were significantly different for age and speed, and step length and stride width were significantly different only for speed. Included angle of feet was not significant for age or speed. Motor ability as measured by the McCarthy Scales of Children's Abilities correlated only with stride length and cadence. It was concluded that gait patterns in 3- and 5-year-old children are not fully mature. Perhaps the interrelationship between gait factors, age, and speed, as well as the relationships among gait factors, present a more realistic analysis of gait in these children than if the variables were considered in isolation. Further research is needed to determine how variability of a child's gait decreases and which gait factors and conditions can be used appropriately to determine gait maturity.

Age Factors↗
PubMed2002

Is base of support greater in unsteady gait?

BACKGROUND AND PURPOSE: We investigated dynamic interfoot distance (IFD) throughout the gait cycle in people with unsteady gait caused by vestibulopathy and in people without known neuromuscular pathology. We expected that the subjects with unsteady gait would use a greater IFD than subjects without neuromuscular pathology and that this IFD would be correlated with other measures of locomotor stability. SUBJECTS AND METHODS: Simultaneous whole-body (11-segment) dynamic kinematic data were collected from 22 subjects with vestibulopathy and 22 subjects without known neuromuscular pathology who were matched for age, height, weight, and body mass index. Two trials each of the participants' gait at preferred speed and paced gait at 120 steps/min were analyzed with a repeated-measures design with multiple dependent variables. Quantitative data were analyzed descriptively and with inferential statistics. RESULTS: Interfoot distance at preferred gait speed did not differentiate unsteady subjects with vestibulopathy from the comparison subjects. Paced gait IFD total range and IFD in single-limb support differed between groups, but IFD at heel-strike did not. However, IFD at heel-strike, the traditional measure of "base-of-support width," was correlated with measurements of whole-body center-of-gravity stability (r=.32-.55). DISCUSSION AND CONCLUSION: Gait at preferred speed permitted the unsteady subjects and the comparison subjects to select similar IFD values, but at the cost of slower gait in the unsteady subjects. When required to walk at a "normal" pace of 120 steps/min, subjects with vestibulopathy increased their IFD. These data suggest that wide-based gait alone cannot differentiate between subjects with and without balance impairments. Base of support and other whole-body kinematic variables are mechanical compensations of vestibulopathic instability. Further studies are needed to determine whether development of active control of these whole-body control variables can occur after vestibular rehabilitation.

Adult↗