Normalisation of gait data in children

Stansfield, Ben; Hillman, Susan J.; Hazlewood, M. Elizabeth; Lawson, A.M.; Mann, A.M.; Loudon, I.R.; Robb, James

doi:10.1016/s0966-6362(02)00062-0

Cited by 109 publications

(78 citation statements)

References 6 publications

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“…Previous studies of normalized step length in infants relied on averaged data and reported values below 1.0 (e.g., Chang, Kubo, Buzzi, & Ulrich, 2006;Ivanenko, Dominici, Cappellini, & Lacquaniti, 2005;Scrutton, 1969). Normalized steps larger than leg length were deemed possible only in supported infant walking (Ivanenko et al, 2005) and in older children (Stansfield et al, 2003). Comparisons cannot be made with studies normalizing step length by height (e.g., Brenière & Bril, 1998) because the ratio of leg length to height varies across individuals (Stansfield et al, 2003).…”

Section: Resultsmentioning

confidence: 77%

“…Normalized steps larger than leg length were deemed possible only in supported infant walking (Ivanenko et al, 2005) and in older children (Stansfield et al, 2003). Comparisons cannot be made with studies normalizing step length by height (e.g., Brenière & Bril, 1998) because the ratio of leg length to height varies across individuals (Stansfield et al, 2003). The traditional reliance on averaged data overshadowed infants' potential to demonstrate performance requiring advanced balance control and strength.…”

Section: Resultsmentioning

confidence: 99%

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Beyond the average: Walking infants take steps longer than their leg length

Badaly

Adolph

2008

Infant Behavior and Development

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Traditionally, infant walking is characterized by small steps, attributed to limited balance control and strength. However, analyses of individual steps revealed that infants occasionally take large steps exceeding their leg length. These large steps provide evidence of advanced balance control and strength. KeywordsInfancy; Motor development; Locomotion; Walking; Step length; Individual differences For decades, researchers have used step length-the distance between consecutive steps-as a primary marker of developmental change in infant walking. Infants' footfalls have been recorded with simple, homely methods such as movies of foot pressure against a glass plate (McGraw & Breeze, 1941) and footprints obtained with graphite (Shirley, 1931), talcum powder (Scrutton, 1969), and ink-stained tabs (Adolph, Vereijken, & Shrout, 2003). Developmental changes in step length have likewise been documented with more sophisticated technologies such as high-speed film (Burnett & Johnson, 1971), pressure-sensitive mats (Garciaguirre, Adolph, & Shrout, 2007), and force plates (Bril & Brenière, 1992).Across generations of researchers and various methods of measuring gait, findings are remarkably consistent. New walkers characteristically display extremely short step lengths (~12 cm), shorter even than the lateral distance between their legs (~15 cm).Step length increases rapidly over the first few months of independent walking (~25 cm) and is accompanied by increases in velocity (from ~25 cm/s to ~80 cm/s). The standard explanation for poor performance in new walkers is that initially tiny steps reflect poor balance control and limited strength in the muscles used to support and stabilize the body. Increased step length is attributed to greater control of front-to-back disequilibrium and more efficient strategies for forward propulsion (e.g., Bril & Brenière, 1992). In other words, infants develop the ability to support the body and maintain balance on one leg while the other leg swings forward.The standard practice for reporting measures of walking skill is to average data over trials within each session for each infant. Although researchers typically collect multiple trials, each consisting of multiple steps, data for individual steps and trials are rarely reported. By averaging data, previous work ignored the range in individual ability. However, extremes in performance Daryaneh Badaly, 4 Washington Place, Room 415, Department of Psychology, New York University, New York, NY 10003, Phone (212) 998-3552, Fax (212) 995-4866, Email db121@nyu.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the jou...

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Section: Resultsmentioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Beyond the average: Walking infants take steps longer than their leg length

Badaly

Adolph

2008

Infant Behavior and Development

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“…First, measures related to growth and development were scaled to account for differences in age and physical body size in accordance with established nondimensional normalization principles. 18 Second, Pearson correlation coefficients were computed to examine associations between the 7 categories of standardized measures with QOL domains. Third, all measures identified as significantly associated with QOL domains were entered simultaneously into a stepwise multiple regression model that was reduced to a most parsimonious model to yield a set of variables that best predict (and can be regarded as independent determinants of) each outcome.…”

Section: 13mentioning

confidence: 99%

Determinants of reduced health-related quality of life in pediatric inherited neuropathies

Burns¹,

Ramchandren²,

Ryan³

et al. 2010

Neurology

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Objective:We have shown that health-related quality of life (QOL) in children with inherited neuropathies (Charcot-Marie-Tooth disease [CMT]) is significantly reduced compared to population norms, thus establishing its utility as an outcome measure in therapeutic trials. However, the Australian ascorbic acid trial in children with CMT type 1A (CMT1A) identified no change in QOL scores despite a trend toward improvement in nerve conduction velocities in the treated group. The objective of this study was to identify clinical, electrophysiologic, and functional correlates of QOL in children with CMT1A, to guide future investigations of strategies to improve QOL and reduce disability in these patients. Methods:In this cross-sectional study, a series of multivariate regression models were developed to determine whether QOL scores could be explained by demographic and symptom data, standardized measures of gross motor function, foot/ankle and hand/finger involvement, electrophysiology, and gait characteristics in 70 children aged 5-16 years with CMT1A.Results: Independent determinants of reduced QOL in children with CMT1A, from strongest to weakest, were leg cramps, hand tremor, short step length, reduced long jump distance, ankle inflexibility, poor agility and endurance, advancing age, and foot drop.

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“…This one-dimensional measure of walking performance is useful for classifying and evaluating gait performance in clinical practice; however, it does not explain the nature or source of atypical gait. In addition, comparison of gait variables with a reference population without controlling for stature (or leg length) and body weight might obscure deviations and lead to imprudent conclusions, since the walking pattern is highly dependent on anthropometrical characteristics (Hof, 1996;Stansfield et al, 2003). Therefore, to gain insight into the gait pattern of children with DCD, more detailed and quantitative data are needed.…”

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confidence: 99%

Differences in Gait between Children with and Without Developmental Coordination Disorder

Deconinck¹,

Clercq²,

Savelsbergh³

et al. 2006

Motor Control

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In the present study the walking pattern of 10 children with developmental coordination disorder (DCD) was investigated and compared to that of 10 typically developing, matched control children. All children walked at a similar velocity that was scaled to the length of the leg on a motor-driven treadmill. Three-dimensional kinematics were recorded with a motion capture digital camera system. The spatiotemporal parameters of the gait pattern revealed that children with DCD walked with shorter steps and at a higher frequency than the typically developing children. In addition, the children with DCD exhibited a body configuration that demonstrated increased trunk inclination during the entire gait cycle and enhanced during the entire gait cycle. At toe-off a less pronounced plantar flexion of the ankle was observed in children with DCD. In conclusion, it appeared that children with DCD make adaptations to their gait pattern on a treadmill to compensate for problems with neuromuscular and/or balance control. These adaptations seem to result in a safer walking strategy where the compromise between equilibrium and propulsion is different compared to typically developing children.

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Normalisation of gait data in children

Cited by 109 publications

References 6 publications

Beyond the average: Walking infants take steps longer than their leg length

Beyond the average: Walking infants take steps longer than their leg length

Determinants of reduced health-related quality of life in pediatric inherited neuropathies

Differences in Gait between Children with and Without Developmental Coordination Disorder

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