Gait

Question 1

What is gait?

Answer 1

A repetitive sequence of limb movements that safely advance the body forward with minimal energy expenditure.

Question 2

What factor influence gait development?

Answer 2

Gait must be energy efficient.

• all components of the body must be ready for gait (e.g. cardiac, motor, environment, anatomy, sensory, respiratory, CNS)
• birth history is important - prematurity, low birth weight, complicated pregnancies/births can impact
• environmental factors - trauma/abuse, excessive equipment use, lack of opportunity
• illness - e.g. extended hospital stay, bed bound

Question 3

What must a child first be able to do before it can walk?

Answer 3

sit, creep (quad rock), bear stand, kneel, cruise and squat (not always)

Question 4

What are the 5 determinants of gait?

Answer 4

1. Duration of single leg stance (should increase with age)
2. Walking velocity (should increase with age)
3. Step length (should increase with age)
4. Ratio of pelvic span to ankle spread (increase with age)
5. Cadence - (decreases with age, becomes more energy efficient)

Question 5

What gait features would you expect to see in a new walker?

Answer 5

• wide base of gait
• increased knee/ankle flexion
• abducted arms, extended elbows
• ER of hips in swing
• no reciprocal arm swing
• flat foot fall pattern
• sporadic movements
• increase cadence to increase speed

Question 6

What gait features would you expect to see in a 2 y.o. walker?

Answer 6

• narrowed base of gait
• step length increases
• walking velocity increases
• pelvic tilt and ER of hips diminishes
• more ext during propulsion
• heel strike may emerge
• reciprocal arm swing emerges

Question 7

What gait features would you expect to see in a 3 y.o. walker?

Answer 7

Adult walking pattern achieved, except shorter stride length and higher cadence.

• further narrowed base of gait
• low walking velocity
• smoother movements (more coordinated)
• more obvious heel strike
• less ER of hips again
• genu valgum and lateral tibial torsion

Question 8

What gait features would you expect to see in a 4-7 y.o. walker?

Answer 8

• increased lumbar lordosis (due to ant pelvic tilt)
• genu valgum should resolve
• tibial torsion reaches maturity by 7
• hip ER and IR equalise

Question 9

What gait features distinguish a 7 y.o. child from a 3 y.o. child?

Answer 9

Gait pattern is very similar to 3 y.o. but stride length increases and a mature walking pattern is easily distinguishable.