Gait symmetry improves in childhood--a 4-year follow-up of foot loading data.

Children under 10 years of age are less efficient than adults regarding their dynamic balance control. The development of the somatosensory system is necessary for the control of posture and balance. The foot, as the final link between body and ground, transfers internal forces during gait. The coordination of force transfer needs to be balanced between both feet thus leading to a potential asymmetry of foot loading. The magnitude of asymmetry in infants' gait has been previously studied. However, the individual development and improvement of gait symmetry should also be considered. Therefore, the aim of this study was to retrospectively evaluate the longitudinal development of foot loading symmetries from the onset of independent walking. Sixty-two healthy infants were followed over the course of 4 years by means of plantar pressure distribution measurements (mean age of 15 months at study start and 63 months at the end). The subjects attended a total of nine measurements scheduled every 6 months. Foot loading data was recorded during walking with the emed(®) pressure platform to evaluate contact area, peak pressure, force-time integral, relative maximum force and contact time. An absolute symmetry index was calculated for all parameters. Furthermore, the infants' data were compared to the data of 26 healthy adults. The adults were measured once and the data acquisition followed exactly the same procedures as the infants' data. In conclusion, foot loading is asymmetric with the onset of independent walking and shows improved symmetry with increasing age dependent on the foot loading parameters.

[1]  E. Thelen Motor development: A new synthesis. , 1995 .

[2]  Michael Orendurff,et al.  The Effect of Walking Speed on Peak Plantar Pressure , 2004, Foot & ankle international.

[3]  F. Lacquaniti,et al.  Development of Independent Walking in Toddlers , 2007, Exercise and sport sciences reviews.

[4]  L Claes,et al.  Gait Asymmetry Following Successful Surgical Treatment of Ankle Fractures in Young Adults , 1995, Clinical orthopaedics and related research.

[5]  B. Bril,et al.  Postural requirements and progression velocity in young walkers. , 1992, Journal of motor behavior.

[6]  Ann Hallemans,et al.  Changes in foot-function parameters during the first 5 months after the onset of independent walking: a longitudinal follow-up study. , 2006, Gait & posture.

[7]  Dieter Rosenbaum,et al.  Evaluation of early walking patterns from plantar pressure distribution measurements. First year results of 42 children. , 2004, Gait & posture.

[8]  Vasilios Baltzopoulos,et al.  Comparison of Gait Patterns Between Healthy and Scoliotic Patients Using Time and Frequency Domain Analysis of Ground Reaction Forces , 1996, Spine.

[9]  R. White,et al.  The variability of force platform data in normal and cerebral palsy gait. , 1999, Clinical biomechanics.

[10]  T G McPoil,et al.  Symmetry of plantar pressures and vertical forces in healthy subjects during walking. , 2001, Journal of the American Podiatric Medical Association.

[11]  Isabelle Olivier,et al.  Developmental changes of static standing balance in children , 2005, Neuroscience Letters.

[12]  B. Nigg,et al.  Asymmetries in ground reaction force patterns in normal human gait. , 1989, Medicine and science in sports and exercise.

[13]  P. Komi,et al.  Gait asymmetry in patients with limb length discrepancy , 2004, Scandinavian journal of medicine & science in sports.

[14]  Blandine Bril,et al.  Development of postural control of gravity forces in children during the first 5 years of walking , 1998, Experimental Brain Research.

[15]  Y. Coello,et al.  Using effect size to quantify plantar pressure asymmetry of gait of nondisabled adults and patients with hemiparesis. , 2007, Journal of rehabilitation research and development.

[16]  H T Law,et al.  TEMPORAL AND SPATIAL PARAMETERS OF GAIT IN CHILDREN. I: NORMAL CONTROL DATA , 1993, Developmental medicine and child neurology.

[17]  Dieter Rosenbaum,et al.  Preliminary normative values for foot loading parameters of the developing child. , 2007, Gait & posture.

[18]  G. Giakas,et al.  Time and frequency domain analysis of ground reaction forces during walking: an investigation of variability and symmetry , 1997 .

[19]  Anne Kavounoudias,et al.  Cutaneous afferents from human plantar sole contribute to body posture awareness , 2002, Neuroreport.

[20]  L. Statham,et al.  Early walking patterns of normal children. , 1971, Clinical orthopaedics and related research.

[21]  Alain Belli,et al.  Influence of speed variation and age on the asymmetry of ground reaction forces and stride parameters of normal gait in children , 2004, Journal of pediatric orthopedics. Part B.

[22]  J R Potvin,et al.  The influence of horizontal velocity on interlimb symmetry in normal walking. , 2003, Human movement science.

[23]  V. S. Gurfinkel,et al.  Kinesthetic reference for human orthograde posture , 1995, Neuroscience.

[24]  M. Cornwall,et al.  Variability of plantar pressure data. A comparison of the two-step and midgait methods. , 1999, Journal of the American Podiatric Medical Association.

[25]  Adamantios Arampatzis,et al.  Symmetry and reproducibility of kinematic parameters during various running techniques. , 2003, Medicine and science in sports and exercise.

[26]  B. Nigg,et al.  Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. , 1987, Journal of manipulative and physiological therapeutics.