Elsevier

Gait & Posture

Volume 16, Issue 1, August 2002, Pages 69-77
Gait & Posture

Acquirement of stability and mobility in infant gait

https://doi.org/10.1016/S0966-6362(01)00205-3Get rights and content

Abstract

We examined gait development in a longitudinal and cross-sectional study in 35 infants, age range 7–70 months. We estimated walking stability from mediolateral motion of body segments and mobility from the angular displacement of joints. Motion at the shoulder, hip, knee and ankle decreased significantly over several months after the onset of walking and thereafter changed gradually. The remarkable decrease began distally. The trunk-thigh and thigh-shank angles changed significantly until 9 months after the onset of walking. These results indicate that lateral stability, which develops earlier than mobility, is the most important factor in gait development in infants.

Introduction

Studies of gait in infants from the 1960s and 1970s [1], [2], [3] have been used to identify abnormal gait in infants. These and subsequent studies, however, were qualitative rather than quantitative, and mostly cross-sectional analyses of walking in children of 3 years or older. Consequently, the mechanisms of the development walking were not clarified.

Most researchers did not describe the age of onset of independent walking or the period between its onset and the day of their examination. The normal onset of walking may lie between 9 and 17 months and so children of the same chronological age may have had a different period of walking experience. Moreover, a definition of the onset of walking was not given in most reports. The onset of walking may be defined as the moment at which infants can walk five steps independently although some researchers might define it at one or two steps. Even if the time since the onset of walking was reported, the period of walking experience could differ by a few months if different definitions were used.

Longitudinal studies are required to assess the individual because growth and development in children are characterized by large individual variation. Assaiante et al. [4], [5] and Ledebt et al. [6] performed both cross-sectional and longitudinal studies of walking of a few infants from the viewpoint of stability. Their results indicated that stability of the head and trunk developed later than that of the hip joint. Thus, the control of balance in walking might appear to develop from caudal to cranial.

The aim of this cross-sectional and longitudinal study was to examine how infant gait changed during walking development. We focused on lateral displacement of body and joint movement. Minimising lateral displacement of the trunk produces an efficient walking pattern that also lowers the potential for falling. Cadence, stride length and velocity, which are related to joint movement, are key factors in assuring walking efficiency as well. We analyzed walking stability from medio-lateral motions and mobility from the angular displacement of body segments.

Section snippets

Subjects

We studied 18 male and 17 female normal infants (age range 7–70 months). Ten males and five females were examined longitudinally every few months. More than 10 trials per session were recorded and the total number of sessions was 130. We defined the onset of walking as the moment when infants could walk five steps independently. The age at the onset of walking in all infants was recorded. Infants who could not walk independently were supported during walking. Their parents either held the

Qualitative analysis

Fig. 2 shows examples of medio-lateral motion in an infant at 12 months (15 days after the onset of walking) and 21 months of age (8 months after the onset of walking), and an adult. The amounts were not divided by stature in Fig. 2. The motions of the shoulder and hip display sine curves in both infant and adult walking. Whereas two motions in a 12-month infant were synchronized, those of the 20-month infant were discordant, showing the same pattern as the adult.

Knee motion was generally the

Discussion

From an energetic perspective, medio-lateral motion in walking is inefficient. Large medio-lateral motions in infants might be caused by a large step width. We did not measure the step width directly, but were able to estimate it by calculating the difference between the location of the shoulder and ankle. The ankles of younger infants lay outside the boundary of the shoulder whereas the ankles of older infants and of adults were always inside their shoulders. This indicated that the step

Acknowledgements

We are grateful to the children who participated in our study and to their parents. We also thank Dr Satoshi Nishizawa, Mr Masaki Fujita and Ms Mari Ogiue for their help in data collection, and Dr Ken Hashizume for his helpful comments as regards motor learning.

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