Temporal and spatial gait parameters analysis in non-pathological Mexican children

doi:10.1016/j.gaitpost.2010.03.010

Gait & Posture

Volume 32, Issue 1, May 2010, Pages 78-81

https://doi.org/10.1016/j.gaitpost.2010.03.010 Get rights and content

Abstract

Objective

To examine temporal and spatial gait parameters in Mexican healthy pediatric subjects to describe normal values which could serve as reference data to eventually compare pathological patterns of the Mexican infant gait.

Materials and methods

Descriptive study that analyzed the gait of 120 children (61 boys and 59 girls) between the ages of 6 and 13 years old. Modifying factors (age, gender, and footwear) were recorded and its impact over temporal and spatial gait parameters was assessed. The data was stratified according to the modifying factors. A GAITRite^® System was used for recording the gait data.

Results

Significant differences were noted for the following factors: age and the use of footwear. As the individual advances in age, a decrease in number of steps, normalized velocity, velocity, cadence, normalized cadence, normalized step and stride length was observed. In contrast, step and stride length increased. Use of footwear increased velocity (normalized and non-normalized), normalized cadence, step and stride length (normalized and non-normalized), and percentage of stance GC phase; cadence and swing GC percentage diminished. Gender stratification showed no significant differences in any temporal and spatial gait parameters. There were also found significant differences with those reported for normal adult and pediatric gait in the literature.

Conclusion

Age and footwear modified gait pattern in the studied sample, while gender apparently did not exert any influence on it.

Introduction

In order to analyze gait, it is necessary to study different temporal and spatial parameters; among some of the most important of these are: gait cycle (GC) time and duration of each GC phase; step length, stride length, and toe in/out (angle of step) [1], [2], [3], [4], [5], [6].

During the first years of life, humans learn to walk instinctively by experimenting with their own bodies until they find an individual walking style. Despite the individual nature of this process, there are sufficient similarities to develop a characteristic human walking pattern. This pattern, however, presents several individual intrinsic and extrinsic modifying factors [7], [8], [9]. To evaluate the specific characteristics of a certain pathological gait pattern, it is necessary to compare it to parameters studied in “normal” individuals, clinically healthy, for each type of population, and according to age and gender [1], [10], [11]. The use of non-dimensional parameters allows comparison among populations; however, its use is not yet widely diffused. Previous studies evaluating normal gait patterns have been performed predominantly among Anglo-Saxon populations [3], [5]. We believe, however, that these cannot be employed to evaluate gait parameters, due to the obvious anthropometric differences between the Anglo-Saxon and Mexican populations. On the other hand, certain kinematic parameters have not been considered and might provide additional information for the analysis. Two studies that analyze gait parameters among 30 Mexican children (the majority was 4 years old) have already been published. Reported data, however, is not sufficient for a further evaluation of infant gait, which also requires information for different age ranges and temporal and spatial factors. To date, this data is not available [1], [4].

The main objective of the present study was to identify and analyze temporal and spatial gait patterns among healthy Mexican children to define normal values. From these normal patterns, we could subsequently identify pathological gait patterns among Mexican children, thus providing valuable data for further study of this gait type.

Section snippets

Methods

A descriptive study was conducted at the Human Motion Analysis Laboratory of the National Rehabilitation Institute facilities in Mexico City. Temporal and spatial gait parameters of healthy children were measured. Sample extraction was carried out from a population of students of a private school (Instituto Montini, A.C., Mexico City).

Results

A population of 133 individuals was studied. Thirteen of these subjects were eliminated from the sample due to an evident pathological gait pattern during clinical assessment. Analyzed sample comprised 61 boys and 59 girls between the ages of 6 and 13 years (Table 1); average age was 9.4 (1.8) years (youngest 6, and oldest 13 years of age); average height was 139.73 (11.18) cm and mean weight was 37.57 (10.87) kg. Body mass index (BMI) was 18.7 (3.5) kg/m² (min. 12.6 kg/m², and max. 29.3 kg/m²) and

Discussion

The present study intended to explore gait parameters among a representative sample of Mexican children in order to identify relevant information which can be used in later studies of interest to our institution.

According to the results obtained when grouping the sample by age intervals, there is evidence that age might be a relevant gait modifying factor thus, prior to perform any comparison, it would be recommendable to carefully select an appropriate group of age in order to obtain reliable

Conclusions

The gait in children is influenced by a set of neurological and muscle-skeletal adaptations that determine a pattern which evolves and optimizes as the individual matures. Results obtained from this study suggest that gait pattern of children may be affected by the age and by the use of footwear. Gender, however, appears not to be a significant modifying gait factor between 6 and 13 years of age.

Finally, there is evidence that children populations might exhibit differences between gait

Conflict of interest

The authors have no conflict of interest.

Grant and financial support

The source of support was exclusively internal (National Rehabilitation Institute).

We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated.

Acknowledgements

This study was possible thanks to the support of Ma. del Pilar Cantú-Latapi, M.A., Director of the Instituto Montini, A.C., Elementary School; also to Penélope Garduño-Gutiérrez, Ph.D. and Mónica Rodríguez-Varagnolo, Ph.D., both with doctoral degrees in Physical Therapy and Rehabilitation, the personnel at the Human Motion Laboratory of the National Rehabilitation Institute in Mexico City and to Lucienne López Moreno. We would like to thank all the children and their parents and teachers who

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A comparison of young children's spatiotemporal gait measures in three common types of footwear with different sole hardness
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It is unknown what the impact of sole hardness is on young children’s gait. Yet, this feature is commonly marketed as having differing benefits for young children’s walking and development.
What are the differences in spatiotemporal measures of gait during walking and running in three common types of young children’s footwear with a soft sole, compared to a hard sole?
The study used a quasi-experimental design, with the condition order randomised using a Latin square sequence. Forty-seven children were recruited (aged 2–4 years). Participants walked or ran the length of a GAITRite mat in a randomized order in a soft (Shore 48–53) or hard soled (Shore 60–65) sneaker, boot and sandal condition. Linear regression analyses were used to investigate the difference between footwear for the different gait parameters including velocity, cadence, step time, swing percentage, stance percentage, double support time and the toe in/out angle.
Children walked with a shorter stride length in the hard-soled sandals compared to the soft- soled sandals (p < 0.05). There were no other differences in spatiotemporal variables in the soft versus hard soled sandals during walking or running (p > 0.05). There were no differences in any spatiotemporal gait variables during walking or running in soft versus hard- soled runners and no differences in walking or running in soft versus hard-soled boots (p > 0.05).
There were few differences in spatiotemporal parameters between soft and hard-soled footwear in both walking and running in three different types of footwear. This may be a positive finding for footwear designers and manufacturers, as a harder sole appeared to have limited impact on spatiotemporal gait parameters.
A comparison of young children's spatiotemporal measures of walking and running in three common types of footwear compared to bare feet
2020, Gait and Posture
Clinicians and footwear manufacturers often advise young children to wear soft-soled footwear when they are first learning to walk. There is limited evidence as to why this advice is given, and if soft-soled shoes are as close to barefoot as thought.
What are the differences in spatiotemporal measures of gait during walking and running in three common types of children’s footwear with a soft-soled compared to barefoot in young children?
The study used a quasi-experimental design, with the condition order randomised using a Latin square sequence. Forty-seven children were recruited (2 - 4 years). Participants walked or ran the length of a GAITrite mat in a randomized order for barefoot and soft-soled sneaker, boot and sandal conditions. Linear regression analyses were used to investigate the main effect of each soft-soled footwear compared to bare feet in the different gait parameters.
For walking and running trials, cadence decreased whereas step time and stride length increased in all footwear types compared to the barefoot condition. While wearing sneakers and sandals increased the stance percentage for walking and running trials, compared to barefoot, this difference was only apparent during the running trial for the boots. Likewise, although double support time increased for both the boots and sneakers in walking and running, compared to barefoot, this difference was only observed in the sandals during walking.
This research found that various types of soft-soled footwear impacted gait compared to the barefoot condition, with some differences seen between walking and running trials. These findings challenge the assumption that soft-soled footwear facilitate a similar gait to barefoot walking and running, although the clinical significance of these differences is unknown.
Normative database of spatiotemporal gait parameters using inertial sensors in typically developing children and young adults
2020, Gait and Posture
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The Mobility Lab® system has been shown to be valid and repeatable in healthy young adults [4], and was partially validated in typically developing children (ages 3.0–8.3) against 3D motion analysis [6], but test-retest repeatability in children is still lacking. Previous studies have presented normative data for spatiotemporal gait parameters in children utilizing 3D motion capture [19] and GAITRite® [20–23]. A partial normative database utilizing the APDM Mobility Lab® system has been established in adults [1], but has yet to be established in children.
Inertial sensors are increasingly useful to clinicians and researchers to detect gait deficits. Reference values are necessary for comparison to children with gait abnormalities.
To present a normative database of spatiotemporal gait and turning parameters in 164 typically developing children and young adults ages 5−30 utilizing the APDM Mobility Lab® system.
Participants completed the i-WALK test at both self-selected (SS) and fast as possible (FAP) walking speeds. Spatiotemporal gait and turning parameters included stride length, stride length variability, gait speed, cadence, stance, swing, and double support times, and foot strike, toe-off, and toe-out angles, turn duration, peak turn velocity and number of steps to turn.
Absolute stride length and gait speed increased with age. Normalized gait speed, absolute and normalized cadence, and stride length variability decreased with age. Normalized stride length and all parameters of gait cycle phase and foot position remained unaffected by age except for greater FSA in children 7−8. Foot position parameters in children 5−6 were excluded due to aberrant values and high standard deviations. Turns were faster in children ages 5–13 and 7–13 in the SS and FAP conditions, respectively. There were no differences in number of steps to turn. Similar trends were observed in the FAP condition except: normalized gait speed did not demonstrate a relationship with age and children ages 5–8 demonstrated increased stance and double support times and decreased swing time compared to children 11−13 and young adults (ages 5−6 only). Females ages 5−6 demonstrated increased stride length variability in the SS condition; males ages 7−8 and 14–30 ha d increased absolute stride length in the FAP condition. Similarities and differences were found between our values and previous literature.
This normative database can be used by clinicians and researchers to compare abnormal gait patterns and responses to interventions.
Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3–101 years
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The purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics.
In 1000 healthy males and females aged 3–101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed^® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3–9 years, adolescents aged 10–19 years, adults aged 20–59 years and older adults aged over 60 years.
A comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength.
This study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.
Attentional load of walking in children aged 7–12 and in adults
2017, Gait and Posture
The amount of attentional resources necessary to walk in children, and how they evolve during childhood remains unclear. This study examined children's gait parameters in different dual-task conditions. 53 children, divided into two age groups (7–9 and 10–12 years old), and 18 adults walked on a mat in three different cognitive conditions: watching a video (video condition), listening its soundtrack (audio condition), and without any additional task (control condition). Questions were asked at the end of the video and audio conditions to make sure that participants were paying attention to the stimuli. A GAITRite® system was used for recording the gait data. Results showed an increase of velocity and step duration, and a decrease of cadence and percentage of double limb support duration from 7 years of age to adulthood during dual-task walking compared with single-task walking. This improvement seemed to be linear from 7 years to adults' age. The interference of dual-task on gait was larger for the video than for the auditory task and decreased with age. We concluded that walking requires a significant amount of attentional resources in children and that children rely more than adults on visual processes for walking.
Reference data for performances on the standardized walking obstacle course in children developing typically
2016, Gait and Posture
Citation Excerpt :
Examining the data, more time and number of steps were needed while carrying a tray versus not carrying the tray, but stumbles and steps of the path not changing indicate stability throughout tasks [8]. On average, as children increased in height and age the number of steps and cadence decreased comparable with existing pediatric data [9]. The coefficients of variation for the conditions of W and WG are fairly constant across the ages and differ slightly from WT condition.
To establish reference performance groups on the Standardized Walking Obstacle Course (SWOC) a pathway to screen ambulation for children developing typically.
SWOC tests ambulation under three conditions: walk (W), walk with tray (WT) and walk wearing sunglasses (WG). One trial consisted of standing up, walking the course in one direction and sitting down. Children (n = 355) completed two trials per condition. Trial measures included time to complete (seconds) and numbers of steps, stumbles, and steps off path.
Trial 1 and trial 2 for time and number of steps are significantly different (p = 0.0005), but highly correlated (r = 0.93 and r = 0.96) therefore their average was used to establish reference data. Gender was not a significant factor. Age and height predict performances in all conditions, but measures between age groups were not always significantly different. Significant different measures by height groups could be established across all conditions, therefore reference data was established using three height groups.
Reference values will assist clinicians to compare a child’s performance on the SWOC based on an individual height because this can vary within and between ages thus screening for possible ambulation limitations.

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View full text

Temporal and spatial gait parameters analysis in non-pathological Mexican children

Abstract

Objective

Materials and methods

Results

Conclusion

Introduction

Section snippets

Methods

Results

Discussion

Conclusions

Conflict of interest

Grant and financial support

Acknowledgements

Gait Posture

Análisis de parámetros cinemáticos de la marcha normal. Estudio y análisis de patrones de marcha normal

Rev Mex Med Fis Rehabil

La marcha humana

Marcha normal y patológica

Estudio de patrones cinemáticos de marcha normal pediátrica. Estandarización de marcha normal en población pediátrica mexicana

Acta Ortop Mex

Biomecánica de la marcha humana normal y patológica

Biomecánica del movimiento humano de Williams y Lissner

Development of gait in childhood. Part I: Method

Devel Med Child Neurol

Development of gait in the normal child

J Pediat Orthop

Footprint sequences of normal children under five years old

Devel Med Child Neurol