Walking development in children

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Walking Development in Children
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• Walking development in children
• Most children walk independently between 11 and
  15 months of age.
• Mature gait pattern appears by age three, through
  the interaction of changes in several systems
• Neurological (P.N.S C.N.S myelination(
• Biomechanical (changes in skeletal structure,
  including size and mass of body parts(
• Psychological (motor learning(
• Environmental (amount of handling,opportunities
  to walk (

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• Children begin walking, between 10 and 18 months.
• They stand and walk with a wide base of support.
• There is usually some bowing of the legs, which
  are a
• little externally rotated for stability .
• The feet are flat in appearance, Lumbar lordosis
• (arched back) is evident.
• The same pattern of posture is seen in both boys
  and
• girls.

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• Baby walkers
• Baby walkers are not recommended for infants
• because of the danger of childhood injury,
  but some parents still believe that their use
  will encourage the child to walk sooner.
• Walking is only achieved after the preliminary
  skills of
• sitting, crawling andsideways walking have been
• acquired.

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• By one-year old
• Less than 50 of children demonstrate heel strike
  oncommencement
• of walking. Instead, the child lands with a
  flat foot.
• Their cadence (steps per minute) is very high,
  with a slow walking speed and shortened step
  length, which is directly related to leg length
  and age.
• 95 of children can squat to play on the floor
  without support. The ability to perform this task
  is present from the onset of walking.

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• By 18 months,
• Heel strike is present in the majority of
  children. In this age group, the arms are
  outstretched for balance.
• 80 of children can run . The difference between
  walking and running is the presence of a period
  of "non-support", when neither foot is in contact
  with the ground. However, at this age the running
  child has little control over walking speed or
  change in direction and falls are frequent.
• By two years, 97 of children are able to run.
• The reciprocal arm swing of mature gait is not
  present (indicated by the leg and opposite arm
  moving forward in symmetry).

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• By 2 years
• 90 of children can 'walk on their tip-toes' .
• However, walking on heels' is a more difficult
  task. Only 60 are able to perform this activity
  by 2 years.
• Only 50 of children aged 2 years can stand on
  one leg 'for longer than six seconds'. However,
  by three years, the success rate is 95 .
• The ability to hop is slower to develop than
  single-leg standing, indicating this skill
  requires greater balance and co-ordination.

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• By 3 years
• 50 of children can hop for a distance of three
  metres.
• This increases to 92 by five years.
• By four years of age,
• The majority of children are able to walk on
  their heels.
• Most adult patterns of movement are present by
  the age of three to four years, with changes in
  velocity, step length and cadence, continuing to
  the age of seven.
• By seven years
• The child's gait and posture is nearly identical
  to that of an adult.
• The majority of children can hop on one leg or
  both.

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Determinants of mature gait

• 1.Duration of single limb stance
• increases from 32 at one year to mature pattern
  of 38 by 4
• years.
• 2. Step length
• increases not just with age but with increased
  leg length .
• Young children gradually use more of the
  available hip flexion range and take longer
  steps.
• The increase in step length produces an increase
  in the
• percentage of the gait cycle spent in single
  limb stance.

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• 3. Cadence
• decreases with age.
• 4. Velocity
• increase rapidly up to age of 3.5 yrs, then more
• slowly.
• 5. Base of support
• It is defined as distance between ankle joint
  centers.
• It becomes narrower until 4 years, but may be
• confounded early by wearing of diapers.

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• By 4 years the inter-relationships betwee the
  time/distance parameters are fixed,though stride
  length and walking
• velocity continue to increase with increasing
  leg
• length

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EMG patterns in immature walkers

• One-year olds show generally prolonged muscle
  firing, so that an-atagonistic muscle groups
  often co-contract. This immature firing pattern
  may be the kinetic correlate of the lack of
  proximal stability that children demonstrate in
  their early years.
• A more mature pattern is present by 4 years.

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• lack of myelination and slowness of both motor
  impulses and sensory feedback is responsible for
  prolongation of muscle activity in children.
• CNS myelination occurs in the following sequence
• roots before spinal cord tracts

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• cervical anterior roots (motor nerves).
• cervical posterior roots (sensory nerves).
• lumbar anterior roots (motor nerves).
• lumbar posterior roots (sensory nerves).
• This process is complete at about twelve months,
  the time when most children begin to walk
• independently.

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Development of Normal Posture
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• Baby walkers
• Baby walkers are not recommended for infants
  because of the danger of childhood injury, but
  some parents still believe that their use will
  encourage the child to walk sooner.
• Walking is only achieved after the preliminary
  skills of
• sitting, crawling andsideways walking have been
• acquired.

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Neonate
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