Walking Development in Children

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 (

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.

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.

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.

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).

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.

By 3 years By four years of age, By seven 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.

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.

3. Cadence 4. Velocity 5. Base of support decreases with age. 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.

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.

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

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.

Development of Normal Posture

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.

Neonate: