4 - Pediatric Gait Analysis

What is "efficiency"?

the amount of useful energy that can be derived from a given energy supply

Define step length

measured from heel center of footprint to heel center of the footprint of opposite foot

Define stride length

measurement between the heel points of two footprints of the same foot

2x step length

ex. left foot to left foot

Define cadence

steps per minute

the total number of steps divided by ambulation time

Heel strike typically emerges by ____

2yrs

(18-24mo)

When will a child typically have the max amount of (normal) genu valgum?

3-3.5yrs ish

Around what time will a child's walking velocity begin to normalize with their height?

4-6yrs

List the five major attributes to typical walking

1 - stability in stance

2 - foot clearance in swing

3 - appropriate pre-positioning for initial contact

4 - adequate step length

5 - energy conservation

What types of interventions may be appropriate to address stance phase stability deficits?

SLS

trunk stability exercises

single and double leg balance

hip strengthening (esp ABDs)

What types of interventions may be appropriate to address deficits in foot clearance during the swing phase of gait?

walk w/ flippers

stepping over obstacles

walking on heels

stability exercises

At what age should children have adequate/full knee extension?

around 18-24mo

What kinds of interventions may be appropriate to address deficits in foot placement during initial contact?

stretching hams/PFs (for full knee ext)

strengthen quads/DFs

articulating or solid AFOs if necessary

What are some potential MSK causes of toe walking?

tight heel cords

weak posterior chain

What are some potential neurological causes of toe walking?

tone/spasticity

(common for individuals w/ CP)

What are some potential sensory causes of toe walking?

avoiding/seeking behaviors

What initial intervention would be appropriate for an individual who walks on their toes?

need adequate ROM first

stretching

serial casting

braces

What are some potential MSK causes of in-toeing?

hip restrictions

antetorsion

tibial torsion

forefoot adductus

What are some potential causes of foot drop / toe dragging in children?

weak DFs

sensory - dragging toes for sensory input

something neurologic