Elsevier

Gait & Posture

Volume 33, Issue 1, January 2011, Pages 29-35
Gait & Posture

Basic gait and symmetry measures for primary school-aged children and young adults. II: Walking at slow, free and fast speed

https://doi.org/10.1016/j.gaitpost.2010.09.017Get rights and content

Abstract

This study recorded basic gait data from 656 healthy primary school-aged children (5–13 years) and 81 young adults (18–27 years) whilst walking over-ground across a level walkway at varying speed. It investigated the effect of gait speed and re-examined the issue of gait maturation. Participants completed 6–8 walks at self-selected slow, free and fast speed along a GAITRite walkway whilst wearing athletic shoes. Outcome measures (non-normalized and normalized) were gait speed, cadence, step and stride length, step and stride time, support base, single and double support (%), stance duration (%), foot angle and associated symmetry measures. Compared to free speed, participants walked 24% slower for the slow speed and 30% faster for the fast speed (p < 0.0001). Both normalized and non-normalized measures of cadence, step and stride length increased with speed (p < 0.001) whereas step and stride time reduced (p < 0.001). As a percentage of the gait cycle, single support and stance duration increased with speed (p < 0.001) whereas double support reduced (p < 0.001). Foot angle was significantly less (less toe-out) for the fast speed than the free and slow speeds (p < 0.001) whereas support base was unaffected by speed. Symmetry measures were unaffected by age or speed. Step and stride symmetry differentials (combining conditions) fell around 0.8 cm, whereas symmetry differentials for step and stance time, single and double support fell around 0.7%. This information can be used by clinicians and researchers to assess the gait of children.

Introduction

There is limited knowledge about the basic spatiotemporal gait parameters (i.e. step length, cadence, etc.) of healthy school-aged children when walking over a range of gait speeds. In general, most studies of children involving large samples have used self-selected or free walking speeds to record basic gait parameters [1], [2], [3]. Moreover, little is known about the effect of walking speed on the symmetry of a child's gait pattern. This information is important since it can be used by clinicians and researchers to assess gait. This investigation recorded normative or reference gait data, including measures of symmetry, from a large sample of healthy primary school-aged children whilst walking over-ground across a level walkway with shoes at varying speed (slow, free and fast). It also re-examined the issue of gait maturation by comparing the children's gait to young adults.

The majority of gait studies involving large samples of children have generally used a free or self-selected walking speed to investigate the basic parameters of gait. For example, Sutherland et al. [2] recorded the gait of 309 children aged 1–7 years, Dusing and Thorpe [3] recorded the gait of 438 children aged 1–10 years, and more recently Lythgo et al. [1] recorded the gait of 898 children aged 5–13 years whilst walking at self-selected speeds. Holm et al. [4] did record the gait of 360 children aged 7–10 years for a range of walking speeds classified as “slow”, “a little faster”, faster, but not as fast as you can” and “as fast as you can, without running” but only reported a few basic gait parameters for speeds ranging between 1.4 and 1.6 m/s. This speed range is well above the speeds of 1.1 m/s (SD = 0.2 m/s) and 1.26 m/s (95% CI = 2.9 m/s) reported by Sutherland et al. [2] and Lythgo et al. [1], respectively, for children aged 7 years. In a recent significant study, Schwartz et al. [5] recorded the gait patterns (including 3D angular kinematics, kinetics and EMG) of 83 typically developing children and adolescents (aged 4–17 years) whilst walking at a range of speeds classified as “very slow”, “slow”, “free”, “fast” and “very fast” (dimensionless speed range: 0.039–0.915). This study, however, only reported a limited number of basic gait parameters.

In general, most studies of normative gait in children have not reported measures of gait symmetry. Our group [1] found the gait symmetry of children to be remarkably invariant when walking over-ground across a level walkway at self-selected or free speed (barefoot and shod). Step and stride differentials fell around 0.7 cm and temporal differentials fell around 0.6%. Other work by Rosengren et al. [6] has shown that children (age: 7.4 ± 0.86 years, n = 10) with conditions such as Developmental Coordination Disorder (DCD) exhibit significant asymmetry when walking on a treadmill at around 0.85 m/s. It is important therefore, to further investigate measures of gait symmetry across a range of speeds, particularly for over-ground walking, in a large group of healthy children. This information can be used by clinicians and researchers to assess the gait of children with pathology.

Sutherland et al. [2] found mature gait patterns to be well established by the age of 3 years. More recent work [1], [3], [4] suggests normalized basic gait parameters (e.g. step length, gait speed) stabilize from 5 to 13 years with little change from the age of seven. Other research, however, suggests it is not fully developed or mature by the age of 7 years. Ganley and Powers [7] reported that 7-year-old children (n = 15) may lack the neuromuscular maturity to generate a mature or adult-like gait pattern. More recently, we found children [1], when compared to young adults (age: 19.6 ± 1.6 years; n = 82), spend less time in single support (normalized to the gait cycle) but more time in double support and stance (p < 0.0001).

The aim of this investigation was twofold. First, to record normative or reference gait data, including measures of symmetry, from a large sample of healthy school-aged children whilst walking over-ground across a level walkway at slow, free and fast walking speeds. Second, to use this database to further investigate gait development by comparing the children's gait characteristics to those of a young adult population.

Section snippets

Participants

A sample of 737 healthy able-bodied children and young adults from Australia participated in this study in 2006–2007. Participant demographics are listed in Table 1 as well as the average step count for each age group. The latter data indicates the average step count or number of steps from which gait data were extracted. The children were recruited from schools located in the North, East, South and Western Metropolitan Regions of a major Australian city. Twenty-three percent of the children

Results

On average, participants took 31.4 steps in the slow speed condition, 28.5 in the free speed condition, and 26.4 steps in the fast speed condition (Table 1). For the children, no significant gender differences were found for height, mass or leg length, whereas significant gender differences were found in the young adult group (p < 0.05); mean (SD), height (male: 178.5 (8.1) cm; female: 164.2 (6.6) cm), mass (male: 72.5 (9.6) kg; female: 59.4 (8.2) kg) and leg length (male: 93.3 (5.4) cm; female: 85.3 (5.6) 

Discussion

Reference or normative gait data are important to assess gait dysfunction and development in children. Information about the typical walking speeds of children is also important for the regulation of pedestrian crossing times on signalized road crossings by road traffic authorities. The specific aims of this investigation were to record normative or reference gait data from a large sample of healthy primary school-aged children whilst walking over-ground across a level walkway at slow, free and

Conclusion

This study investigated the gait patterns, including symmetry, of a large sample of healthy primary school-aged children and young adults whilst walking over-ground at varying speed. It provides descriptive statistics for basic gait parameters commonly used to assess gait. This information is valuable to clinicians and researchers since it provides a normative or reference gait data set that can be used for comparison purposes.

Conflict of interest

The authors have no financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work.

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Funding for this project was granted by the Early Career Researchers Grant Scheme funded by the Faculty of Medicine, Health Sciences and Dentistry, University of Melbourne.

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