Acquisition of upper body stability during walking in toddlers

The development of gait and mobility: Form and function in infant locomotion

The development of locomotion can be described by its form (i.e., gait) and its function (i.e., mobility). Both aspects of locomotion improve with experience. Traditional treatises on infant locomotion focus on form by describing an orderly progression of postural and locomotor milestones en route to characteristic patterns of crawling and walking gait. We provide a traditional treatment of gait by describing developmental antecedents of and improvements in characteristic gait patterns, but we highlight important misconceptions inherent in the notion of "milestones". Most critically, we argue that the prevailing focus on gait and milestones fails to capture the true essence of locomotion-functional mobility to engage with the world. Thus, we also describe the development of mobility, including the use of mobility aids for support and propulsion. We illustrate how infants find individual solutions for mobility and how the ability to move cascades into other domains of development. Finally, we show how an integration of gait and mobility provides insights into the psychological processes that make locomotion functional. This article is categorized under: Psychology > Motor Skill and Performance Psychology > Development and Aging.

Development of bipedal walking in olive baboons, Papio anubis: A kinematic analysis

OBJECTIVE

Although extant nonhuman primates are not habitual bipeds, they are able to walk bipedally from an early age. In humans, children improve their walking skills through developmental processes and learning experience. In nonhuman primates, infants do not routinely experience bipedalism and their musculoskeletal system gradually specializes for other locomotor modes. The aim of this study is to explore the development of occasional bipedal walking in olive baboon and to test whether the postural adjustments change with age.

MATERIALS AND METHODS

We collected kinematics and spatiotemporal parameters of bipedal gait in an ontogenetic sample of 24 baboons. Data were collected at the primatology station of the CNRS (France) and a total of 47 bipedal strides were extracted for the present analysis.

RESULTS

Adults and adolescents walk bipedally in the same way, and the average kinematic pattern is similar across the age-classes. Infants walk bipedally with longer duty factor, they present larger movement amplitude of the thigh and the amplitude of the knee joint decreases with speed. In contrast, older baboons increase the amplitude of the knee and ankle joints with speed.

DISCUSSION

In a non-adapted biped, the postural adjustments of bipedal walking vary with age. In infant baboons, the balance requirements are likely to be higher and these are solved by adopting a "blocking strategy". In older baboons, the postural adjustments are focused on the lower limb and the movements increase with speed. These results may echo, in some respects, the developmental sequence of the intersegmental coordination described in the ontogeny of human locomotion.

Biomechanical Characteristics of the Typically Developing Toddler Gait: A Narrative Review

Independent ambulation is one of the most important motor skills in typically developing toddlers. Gait analysis is a key evaluation method in basic and clinical research. A narrative review on the literature of toddler gait development was conducted following inclusion criteria, explicitly including the factors of English article, age range, no external intervention during the experimental process of studies involved, the non-symptomatic toddler, and no pathological gait. Studies about toddlers' morphological, physiological, and biomechanical aspects at this developmental stage were identified. Remarkable gait characteristics and specific development rules of toddlers at different ages were reported. Changes in gait biomechanics are age and walking experience-dependent. Gait patterns are related to the maturation of the neuro and musculoskeletal systems. This review thus provides critical and theoretical information and the nature of toddler walking development for clinicians and other scientific researchers. Future studies may systematically recruit subjects with more explicit criteria with larger samples for longitudinal studies. A particular design could be conducted to analyze empirically before practical application. Additionally, the influence of external interventions on the development of toddler gait may need consideration for gait development in the toddler cohort.

The Impact of Different Periods of Walking Experience on Kinematic Gait Parameters in Toddlers

This study aimed to analyse the kinematic differences in gait between three groups of toddlers who differed in their weeks of independent walking (IW) experience, but not in anthropometrical characteristics, to determine the relationship between walking experience without the side effect of morphological differences on gait parameters. Twenty-six toddlers participated in this study. Depending on the week of their IW, toddlers were divided into three groups: Group 1 (1-5 weeks of IW), Group 2 (6-10 weeks of IW), and Group 3 (11-15 weeks of IW). Each toddler walked barefooted over a 2-m long pathway, and 3D kinematic data were obtained. A decrease in the upper limb position, hip flexion, and step width, i.e., changes towards the adult gait pattern, were observed in Group 3. Less experienced walkers exhibited a wider step width despite no statistically significant difference in body mass and height between groups. Results of this study show no statistically significant difference in step length between groups, suggesting that step length is more related to height than to the walking experience. The increased step length in more experienced walkers reported in previous studies may therefore be a result of different heights and not walking experience.

A time series analysis of the relation between motor skill acquisition and sleep in infancy

To systematically examine the relation between motor milestone onset and disruption of night sleep in infancy, three families kept microgenetic, prospective, daily checklist diaries of their infants' motor behavior and sleep (197-313 observation days; 19,000 diary entries). Process control and interrupted time series analyses examined whether deviations from the moving average for night wakings and evening sleep duration were temporally linked to motor skill onset and tested for meaningful differences in individual sleep patterns before and after skill onset. Model assumptions defined skill onset as first day of occurrence or as mastery and moving average windows as 3, 7, or 14 days. Changes in infants' sleep patterns were associated with changing expertise for motor milestones. The temporal relation varied depending on infant and sleep parameter. Intensive longitudinal data collection may increase our understanding of micro-events in infant development.

Practice and proficiency: Factors that facilitate infant walking skill

Infant walking skill improves with practice-crudely estimated by elapsed time since walk onset. However, despite the robust relation between elapsed time (months walking) and skill, practice is likely constrained and facilitated by infants' home environments, sociodemographic influences, and spontaneous activity. Individual pathways are tremendously diverse in the timing of walk onset and the trajectory of improvement, and presumably, in the amount and type of practice. So, what factors affect the development of walking skill? We examined the role of months walking, walk onset age, spontaneous locomotor activity, body dimensions, and environmental factors on the development of walking skill in two sociodemographically distinct samples (ns = 38 and 44) of 13-, 15-, and 19-month-old infants. Months walking best predicted how well infants walked, but environmental factors and spontaneous activity explained additional variance in walking skill. Specifically, less crowded homes, a larger percentage of time in spontaneous walking, and a smaller percentage of short walking bouts predicted more mature walking. Walk onset age differed by sample but did not affect walking skill. Findings indicate that elapsed time since walk onset remains a robust predictor of walking skill, but environmental factors and spontaneous activity also contribute to infants' practice, thereby affecting walking skill.

Effect of wearing diapers on toddler's gait

Gait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant’s motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers’ gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.

Head and eyes: Looking behavior in 12- to 24-month-old infants

This study demonstrates evidence for a foundational process underlying active vision in older infants during object play. Using head-mounted eye-tracking and motion capture, looks to an object are shown to be tightly linked to and synchronous with a stilled head, regardless of the duration of gaze, for infants 12 to 24 months of age. Despite being a developmental period of rapid and marked changes in motor abilities, the dynamic coordination of head stabilization and sustained gaze to a visual target is developmentally invariant during the examined age range. The findings indicate that looking with an aligned head and eyes is a fundamental property of human vision and highlights the importance of studying looking behavior in freely moving perceivers in everyday contexts, opening new questions about the role of body movement in both typical and atypical development of visual attention.

Inter-intra observer reliability and validity of the Turkish version of Trunk Control Measurement Scale in children with cerebral palsy

Objective

The aim of this study was to demonstrate the inter and intra rater reliability and validity of the Turkish version of the Trunk Control Measurement Scale (TCMS) for children with CP.

Methods

Fifty children (21 girls and 29 boys; mean age 6.6 ± 2.3 years) with spastic, dyskinetic and ataxic types of CP were participated in the study. Children with Level I–II and III according to Gross Motor Function Classification System (GMFCS) were included into the study. All children were evaluated separately by two physiotherapists for interrater reliability and they re-evaluated for intra rater reliability. Gross Motor Function Measurement total score and B part were used for construct validity.

Results

The intraclass correlation coefficient (ICC) value of the inter-rater reliability for the Turkish TCMS was 95% CI (0.823–886), and the intra-rater reliability was 95% CI (0.986–0.992). The Spearman rank correlation coefficient between the Turkish TCMS and the Gross Motor Function Measure total score r: 0.827; p < 0.05 Part B was r: 0.863; p < 0.05.

Conclusion

The results of the study support that the Turkish TCMS has a high inter and intra rater reliability and validity similar to the original version. Thus, the Turkish TCMS appears to be a suitable evaluation tool to assess the qualitative performance of trunk control and sitting balance for children with CP and it gives opportunity to use clinically and research purposes.

Level of Evidence

Level III, Diagnostic Study.

Infants' Age and Walking Experience Shapes Perception-Action Coupling When Crossing Obstacles

This study examined the effects of age and walking experience on infants' ability to step over an obstacle. We videotaped 30 infants with one (mean [ M] age = 12.6 months), three ( M age = 14.7 months), and six months ( M age = 17.7 months) of walking experience walking on a pathway with and without an obstacle. We found a shorter stride and slower velocity for infants with one month of walking experience and for the walking condition with an obstacle than for other experience groups or for walking without an obstacle. Across all groups, the horizontal distance between an infant's foot and the obstacle was larger for the trailing leg than for the leading leg. The vertical distance for both legs was similar among 1-month walkers, increased for 3-month walkers, and was similar for the trailing leg of the 6-month walker group. The percentage of the interlimb coordination relative phase for the leading limb was smaller for 3- and 6-month walker groups. In conclusion, age and walking experience contribute to improving coupling between sensory information and motor action and to organization for stepping over an obstacle in infants.

The Influence of a Constraint and Bimanual Training Program Using a Variety of Modalities, on Upper Extremity Functions and Gait Parameters Among Children with Hemiparetic Cerebral Palsy: A Case Series

AIM

To assess the influence of an intensive combined constraint and bimanual upper extremity (UE) training program using a variety of modalities including the fitness room and pool, on UE functions as well as the effects of the program on gait parameters among children with hemiparetic cerebral palsy.

METHODS

Ten children ages 6-10 years participated in the program for 2 weeks, 5 days per week for 6 hr each day. Data from the Assisting Hand Assessment (AHA) for bimanual function , the Jebsen-Taylor Test of Hand Function (JTTHF) for unimanual function, the six-minute walk test (6MWT), and the temporal-spatial aspects of gait using the GAITRite walkway were collected prior to, immediately post and 3-months post-intervention.

RESULTS

A significant improvement was noted in both unimanual as well as bimanual UE performance; A significant improvement in the 6MWT was noted, from a median of 442 meter [range: 294-558] at baseline to 466 [432-592] post intervention and 528 [425-609] after 3 months (p = .03).

CONCLUSION

Combining intensive practice in a variety of modalities, although targeting to the UE is associated with substantial improvement both in the upper as well as in the lower extremity function.

Bipedality from locomotor autonomy to adulthood in captive olive baboon (Papio anubis): Cross-sectional follow-up and first insight into the impact of body mass distribution

OBJECTIVE

Despite that the biomechanics of standing and walking bipedally has been extensively studied in nonhuman primates, the morphological features that may constrain, or facilitate, the control of balance and thus of the spontaneous occurrence of bipedal behavior are poorly known. We aim to test the relationship between body mass distribution and bipedal behavior using a nonhuman primate species, the olive baboon, Papio anubis, raised in captivity.

MATERIALS AND METHODS

We collected quantitative data on the frequency and duration of bipedalism together with morphometrics on a sample of 22 individuals. We used ontogenetic changes as a natural experiment that provides insights into the impact of morphology. Specifically we focus on 1) quantifying how body mass distribution changes from infancy to adulthood in baboons; and 2) whether the different patterns of mass distribution influence the behavioral variables, i.e., a) the frequency and b) the duration of bouts of bipedal behavior realized in different activity contexts.

RESULTS

With regard to assisted bipedal behaviors, the duration and frequency of bouts of standing, contrary to walking, are significantly related to age. With regard to unassisted bipedal behaviors, no correlation to age is observed; the bout duration of walking is strongly correlated to body mass and mass distribution, contrary to the frequency of walking as well as the bout duration and frequency of bipedal standing.

DISCUSSION

Our results suggest a close relationship between the pattern of mass distribution and the mechanism of balance control in the spontaneous bipedal walking of baboons. The mechanical effects of the pattern of mass distribution on the ability to perform bipedally in extant nonhuman primates are discussed in the context of the evolution toward habitual bipedalism.

Evaluation of toddler different strategies during the first six-months of independent walking: a longitudinal study

Twenty infants (age 10-16 month) were analyzed using inertial sensors over a 6-month period after the onset of independent walking. Changes in gait temporal parameters, coordination and gait strategies were evaluated. Gait temporal parameters showed a developmental shift at 2 months of walking experience: after this period, a change in the developmental trend was present in most of the analyzed parameters. Cadence results showed that the increased velocity is more due to an increase in step length than to an increase in cadence, after the first two months of independent walking. Different gait strategies were identified during the first month of independent gait based on collected data; after one month, characteristics of the pendulum mechanism were present in each examined toddler.

Identification of gait patterns in individuals with cerebral palsy using multiple correspondence analysis

Great importance has been placed on the development of gait classification in cerebral palsy (CP) to assist clinicians. Nevertheless, gait classification is challenging within this group because the data is characterized by a high-dimensionality and a high-variability. Thus, the aim of this study was to analyze without a priori, a database of clinical gait analysis (CGA) of CP patients, using multiple correspondence analysis (MCA). A retrospective search, including biomechanical and clinical parameters was done between 2006 and 2012. One hundred and twenty two CP patients were included in this study (51 females and 71 males, mean age ± SD: 14.2 ± 7.5 years). Sixteen biomechanical spatio-temporal and kinematic parameters were included in the analysis. This data was transformed by a fuzzy window coding based on the distribution of each parameter in three modalities: low, average and high. Afterward, a MCA was used to associate parameters and to define classes. From this, seven most explicative gait parameters used to characterize gait of CP patients were identified: maximal hip extension, hip range, knee range, maximal knee flexion at initial contact, time of peak knee flexion, and maximal ankle dorsiflexion in stance phase and in swing phase. Moreover, four main profiles of CP patients have been defined from the multivariate approach: an apparent equinus gait group (the most similar of the control group with diplegic and hemiplegic patients with a GMFCS 1), a true equinus gait group (the youngest group with diplegic and some hemiplegic patients with a GMFCS 1), a crouch gait group (the oldest group with a majority of diplegic and rare hemiplegic patients with a GMFCS 2) and a jump knee gait group (the greatest level of global spasticity of the lower limbs with a majority of diplegic and rare hemiplegic patients with a GMFCS 2). Thus, this study showed the feasibility of the MCA in order to characterize and classify a large database of CP patients.

Three-dimensional head and trunk movement characteristics during gait in children with spastic diplegia

This study uses a recently developed trunk model to determine which head and trunk kinematic parameters differentiate children with spastic diplegia from typically developing (TD) children while walking. Differences in head and trunk parameters in relation to the severity of the motor involvement (GMFCS levels) were additionally examined. The trunk model consisted of five segments (pelvis, thorax, head, shoulder line, spine). Discrete kinematic parameters (ROM, mean position) and angular waveforms were compared between 20 children with spastic diplegia (age 9.8 years±2.9 years; GMFCS I: n=10, GMFCS II: n=10) and 20 individually age-matched TD children (9.7 years±3 years). A new measure for overall trunk pathology, the trunk profile score (TPS), was proposed and included in the comparative analysis. Compared to TD children, children with GMFCS II showed a significantly higher TPS and increased ROM for pelvis tilt, for thorax and head in nearly all planes, and the angle of kyphosis. In children with GMFCS I, only ROM of thorax lateral bending was significantly increased. Sagittal ROM differentiated best between GMFCS levels, with higher ROM found in children with GMFCS II. Current results provide new insights into head and trunk kinematics during gait in children with spastic diplegia.

Reliability and validity of the Trunk Impairment Scale in children and adolescents with cerebral palsy

Standardized clinical tools are useful for treatment planning and evaluation, however clinical tools to assess quality in trunk movements in children with cerebral palsy (CP) are sparse. We have recently reported good intra- and inter-observer reliability of the Trunk Impairment Scale (TIS) in 5-12 year old children with CP. The aim of this study was to assess reliability in adolescents (13-19 years old), and to assess the construct validity in children and adolescents in the whole age spectrum from 5 to 19 years. Video recordings of 17 children with CP with Gross Motor Function Classification (GMFCS) level I-IV were analyzed by three observers on two occasions. For construct validity the TIS was compared with Gross Motor Function Measure (GMFM), in 37 children with GMFCS levels I-IV. Intraclass correlation coefficients varied between 0.82 and 0.98, and 86% of the kappa values varied between 0.61 and 1.00, suggesting high inter- and intra-observer reliability. The smallest detectable difference (SDD) of the TIS (scale range 0-23) varied between 2.55 and 3.82 for intra- and 4.07-8.23 for inter-observer observations. The high inter-observer SDD was partly due to consistently lower TIS scores by one observer. The correlation between the TIS total score and the dimension scores of the GMFM was high (Spearman's rho: 0.80-0.87), while decreasing GMFCS levels were associated with increasing total TIS score; both findings indicating good construct validity of the TIS. This study suggests that the TIS is a reliable and valid measure of trunk control for both children and adolescents with cerebral palsy.

Gait component changes observed during independent ambulation in young children

The components of gait of the new independent ambulator can differ from that of the more experienced ambulator. The purposes of this review were to describe observable gait components exhibited at the onset of independent ambulation, the progression of changes in these components, and the time when a more mature pattern should be present consistently. Cross-sectional, longitudinal and single-recording studies, which analyzed children's gait at the onset of independent ambulation and followed changes in the components, were reviewed. Only components that can be observed by clinicians were included. The changes were reported as a function of time after independent ambulation onset or chronological age. The gait components evolved from (1) initial contact with toes, footflat or heel to consistent heel strike 1 y after independent ambulation onset or by 2.5 y of age, (2) a wide base of support to a narrower one 11 mo after independent ambulation onset or by 22 mo of age, and (3) upper extremities held in high guard position to reciprocal arm swing 11 mo after independent ambulation onset or by 3.5 y of age. Other components, such as the maintenance of squatted position and trunk flexion, were studied less extensively, but general descriptions are included. This review provides the length of time after independent ambulation onset or chronological age when the more mature form of a gait component should be present. The continued exhibition of a less mature form beyond these times may be indicative of a pathological gait pattern.

Full body gait analysis may improve diagnostic discrimination between hereditary spastic paraplegia and spastic diplegia: a preliminary study

Hereditary spastic paraplegia (HSP) and spastic diplegia (SD) patients share a strong clinical resemblance. Thus, HSP patients are frequently misdiagnosed with a mild form of SD. Clinical gait analysis (CGA) has been highlighted as a possible tool to support the differential diagnosis of HSP and SD. Previous analysis has focused on the lower-body but not the upper-body, where numerous compensations during walking occur. The aim of this study was to compare the full-body movements of HSP and SD groups and, in particular, the movement of the upper limbs. Ten HSP and 12 SD patients were evaluated through a CGA (VICON 460 and Mx3+; ViconPeak(®), Oxford, UK) between 2008 and 2012. The kinematic parameters were computed using the ViconPeak(®) software (Plug-In-Gait). In addition, the mean amplitude of normalised (by the patient's height) arm swing was calculated. All patients were asked to walk at a self-selected speed along a 10-m walkway. The mean kinematic parameters for the two populations were analysed with Mann-Whitney comparison tests, with a significant P-value set at 0.05. The results demonstrated that HSP patients used more spine movement to compensate for lower limb movement alterations, whereas SD patients used their arms for compensation. SD patients had increased shoulder movements in the sagittal plane (Flexion/extension angle) and frontal plane (elevation angle) compared to HSP patients. These arm postures are similar to the description of the guard position that toddlers exhibit during the first weeks of walking. To increase speed, SD patients have larger arm swings in the sagittal, frontal and transversal planes. Upper-body kinematics, and more specifically arm movements and spine movements, may support the differential diagnosis of HSP and SD.

The dynamics of walking acquisition: a tutorial

Tracking for developmental changes is at the heart of developmental psychology. The qualitative features of the variation of the center of mass (CoM) acceleration during a sequence of steps are revealed by first return maps, a tool taken from differential dynamics. The focus is put on the acceleration of the CoM along the antero-posterior and medio-lateral axes. Application is shown on data recorded from one infant followed up repeatedly during the first year of learning to walk. At a given experience in walking, the gait dynamics is exhaustively characterized by a specific enchainment of pendula and quasi-equilibria. The developmental process is revealed by the succession of dynamical structures, each determined at each walking experience. It shows a drift toward increasingly regular gait patterns, together with a clear asymmetry between an impulse foot and a regulatory foot.

A cross-sectional study about the relationship between morphology and kinematic parameters in children between 15 and 36 months

Morphology and kinematic parameters were recorded for 31 children between 15 and 36 months to investigate the relation between morphology and the walking pattern. A full 3D gait analysis using a VICON motion system was performed to gather kinematic data. Next, the differences in kinematic parameters between four morphological classes were assigned with a multiple analysis of variance, with a correction for walking experience. Also stepwise linear regressions were performed, to examine the relation between detailed morphological measurements and kinematic parameters. The regression models showed relationships between kinematic parameters of the ankle, hip, thorax and morphology. All results indicated that the upper body played an important role in the coordination of the walking pattern, especially in the frontal plane.

The complexity of childhood development: variability in perspective

The complexity of childhood development is exemplified in the variability of development that is seen across tasks and individuals. Furthermore, variability in performance is omnipresent within individuals across repetitions of a task and across individuals performing the same task. Previously, this variability was thought to reflect error of measurement or error of execution. On this account, variability reflects noise that should be filtered or averaged out of the data in order to reveal the "true" underlying characteristics of the performance. Although errors of measurement and execution indeed contribute to variability in movements, research in the last 2 decades has revealed characteristics of variability that are far more interesting than just noise. These characteristics can be deeply informative about underlying control processes and point to directions for clinical practice. This perspective article reviews different ways of characterizing variability, illustrates changes in variability as a result of development and learning, and discusses different theoretical perspectives on the role of variability that give clues about how to understand changes in variability and how to deal with variability in clinical settings.

A cross-sectional study about the relationship between morphology and step-time parameters in children between 15 and 36 months

Morphology and step-time parameters were recorded in 100 children between 15 and 36 months to investigate the relation between morphology and the walking pattern. A footfall method was used to register step-time parameters. Next, the differences in step-time parameters between four morphological classes were assigned with a multiple analysis of variance. We also performed stepwise linear regressions with a correction for walking experience, to examine the relation between detailed morphological measurements and step-time parameters. The results of these regressions show a significant relation between pelvis span/ankle spread ratio and the relative radii of gyration in the frontal plane of head and pelvis. It is hypothesized that the morphology of the head and pelvis plays a role in the coordination of the walking pattern.

Developmental trajectory of dynamic resource utilization during walking: toddlers with and without Down syndrome

After years of walking practice 8-10-year-old children with typical development (TD) and those with Down syndrome (DS) show uniquely different but efficient use of dynamic resources to walk overground and on a treadmill [Ulrich, B.D., Haehl, V., Buzzi, U., Kubo, M., & Holt, K.G. (2004). Modeling dynamic resource utilization in populations with unique constraints: Preadolescents with and without Down syndrome. Human Movement Science, 23, 133-156]. Here we examined the use of global stiffness and angular impulse when walking emerged and across the ensuing months of practice in eight toddlers with TD and eight with DS. Participants visited our lab when first able to walk four to six steps, and at one, three, four, and six months of walking experience. For all visits, toddlers walked overground at their preferred speeds and for the last two visits on a treadmill. Toddlers with TD and DS demonstrated clear and similar developmental trajectories over this period with more similarities than differences between groups. At six months stiffness and impulse values were higher than previously observed for 8-10-year-old children. Stiffness values increased significantly throughout this period, though rate of change slowed for the TD group by three months of experience. Impulse values rose sharply initially and slowed to plateau during the latter months. Treadmill data illustrated toddlers' capacity to adapt dynamic resource use to imposed changes in speed, particularly well after six months of practice. Consistent with our studies of preadolescents and older adults, toddlers with DS produced significantly wider normalized step width than their TD peers. We propose that the challenge of upright bipedal locomotion constrains toddlers with TD and DS to generate similar, necessary and sufficient stiffness and impulse values to walk as they gain control and adapt to playful and self-imposed perturbations of gait over the first six months. The plateau in impulse and slow-down of stiffness increases over the latter months may be the first signs of a downward trend to the lower values produced by older children with several years of walking experience.

The development of infant upright posture: sway less or sway differently?

Postural control is an important factor for early motor development; however, compared with adults, little is known about how infants control their unperturbed upright posture. This lack of knowledge, particularly with respect to spatial and temporal characteristics of infants' unperturbed independent standing, represents a significant gap in the understanding of human postural control and its development. Therefore, our first analysis offers a thorough longitudinal characterization of infants' quiet stance through the 9 months following the onset of independent walking. Second, we examined the influence of sensory-mechanical context, light touch contact, on infants' postural control. Nine typically developing infants were tested monthly as they stood on a small pedestal either independently or with the right hand lightly touching a stationary contact surface. In addition to the longitudinal study design, an age-constant sample was analyzed to verify the influence of walking experience in infant postural development without the confounding effect of chronological age. Center of pressure excursions were recorded and characterized by distance-related, velocity, and frequency domain measures. The results indicated that, with increasing experience in the upright, as indexed by walk age, infants' postural sway exhibited shifts in rate-related characteristics toward lower frequency and slower, less variable velocity oscillations without changing the spatial characteristics of sway. Additional touch contact stabilized infants' postural sway as revealed by decrease in sway position variance, amplitude, and area as well as lower frequency and velocity. These results were confirmed by the age-constant analysis. Taken together, our findings suggest that instead of progressively reducing the sway magnitude, infants sway differently with increasing upright experience or with additional somatosensory information. These differences suggest that early development of upright stance, particularly as it relates to increasing postural and locomotor experience, involves a refinement of sensorimotor dynamics that enhances estimation of self-motion for controlling upright stance.

Development of energy and time parameters in the walking of healthy human infants

Sixteen infants were analyzed longitudinally from the onset of independent walking to 3 years of age using time parameters, speed and energy recovery. Considerable variation and irregularities were observed in many parameters of infant walking, especially until 13 months of age when infants had difficulty in walking steadily step by step. Infant walking until 3 years of age was characterized by a small braking duration, caused mainly by the forward inclination of the trunk, a large relative stance phase duration, which maintained static balance, short stride length, due to the small range of the lower limb joint angle, and a small recovery of external energy. These characteristics were also predominantly evident until 13 months of age. The small recovery characteristic of infants was caused by flexed lower limb joints, pronounced irregularities in energy output, and in younger infants, slow speed. The maximum recovery up until 2 years of age, though smaller than in adults, appeared at about 0.45 dimensionless speed, which is about the same speed that adults in particular naturally and at which their maximum recovery appeared. The forward inclination of the trunk and the lower limb joint angle, influenced the development of many characteristics of bipedal walking.

Age-related changes in upper body adaptation to walking speed in human locomotion

Assessments of changes in gait stability due to aging and disease are predominantly based on lower extremity kinematic and kinetic data. These gait changes are also often based on comparisons at preferred speed only. The purpose of this experiment was to: (1) examine age-related changes in range of motion and coordination of segments of the upper body during locomotion; and (2) investigate the effects of a systematic walking velocity manipulation on rotational motion and coordination. Participants (n=30) walked on a motor driven treadmill at speeds ranging from 0.2 to 1.8m/s and were divided into three groups with mean ages of 23.3, 49.3 and 72.6 years, respectively. Seven high-speed infrared cameras were used to record three-dimensional kinematics of the pelvis, trunk and head. Dependent variables were amplitude of segmental and joint rotations, as well as relative phase to assess coordination between segments. Although no differences in stride parameters were found between the groups, age-related changes in movement amplitude in response to speed manipulations were observed for all segments and joints. Pelvic rotations in sagittal, frontal and transverse planes of motion were systematically reduced with age. Older individuals showed reduced trunk flexion-extension in the sagittal plane and increased trunk axial rotation in the transverse plane. Coordination analysis showed reduced compensatory movement between pelvis and trunk in older individuals. These findings support the importance of systematic manipulation of walking velocity and three-dimensional upper body kinematics in assessing age-related changes in locomotor stability and adaptability.

Kinematics in Newly Walking Toddlers Does Not Depend Upon Postural Stability

When a toddler starts to walk without support, gait kinematics and electromyographic (EMG) activity differ from those of older children and the body displays considerable oscillations due to poor equilibrium. Postural instability clearly affects motor patterns in adults, but does instability explain why toddlers walk with a different gait? Here we addressed this question by comparing kinematics and EMGs in toddlers performing their first independent steps with or without hand or trunk support. Hand support significantly improved postural stability and some general gait parameters, reducing percent of falls, step width, lateral hip deviations and trunk oscillations. However, the kinematic and EMG patterns were unaffected by increased postural stability. In particular, the co-variance of the angular motion of the lower limb segments, the pattern of bilateral coordination of the vertical movement of the two hip joints, high variability of the foot path, the elliptic or single peak trajectory of the foot in the swing phase, and characteristic EMG bursts at foot contact remained idiosyncratic of toddler locomotion. Instead the toddler pattern shared fundamental features with adult stepping in place, suggesting that toddlers implement a mixed locomotor strategy, combining forward progression with elements of stepping in place. Furthermore, gait kinematics remained basically unchanged until the occurrence of the first unsupported steps and rapidly matured thereafter. We conclude that idiosyncratic features in newly walking toddlers do not simply result from undeveloped balance control but may represent an innate kinematic template of stepping.

Kinematics in Newly Walking Toddlers Does Not Depend Upon Postural Stability

When a toddler starts to walk without support, gait kinematics and electromyographic (EMG) activity differ from those of older children and the body displays considerable oscillations due to poor equilibrium. Postural instability clearly affects motor patterns in adults, but does instability explain why toddlers walk with a different gait? Here we addressed this question by comparing kinematics and EMGs in toddlers performing their first independent steps with or without hand or trunk support. Hand support significantly improved postural stability and some general gait parameters, reducing percent of falls, step width, lateral hip deviations and trunk oscillations. However, the kinematic and EMG patterns were unaffected by increased postural stability. In particular, the co-variance of the angular motion of the lower limb segments, the pattern of bilateral coordination of the vertical movement of the two hip joints, high variability of the foot path, the elliptic or single peak trajectory of the foot in the swing phase, and characteristic EMG bursts at foot contact remained idiosyncratic of toddler locomotion. Instead the toddler pattern shared fundamental features with adult stepping in place, suggesting that toddlers implement a mixed locomotor strategy, combining forward progression with elements of stepping in place. Furthermore, gait kinematics remained basically unchanged until the occurrence of the first unsupported steps and rapidly matured thereafter. We conclude that idiosyncratic features in newly walking toddlers do not simply result from undeveloped balance control but may represent an innate kinematic template of stepping.

The temporal organization of posture changes during the first year of independent walking

Although the development of upright posture has received considerable attention, the quiet stance of infants in their first months of learning this fundamental behavior has not been well studied. The purpose of the present study was to characterize the time evolutionary properties, or temporal organization, of these infants' unperturbed upright stance as well as to elucidate how somatosensory information influences that organization. Six healthy, full-term infants were tested monthly from walk onset until 9 months of independent walking experience while standing either independently or touching a static surface. The structure of sway was assessed through stabilogram-diffusion analysis using an exponential Ornstein-Uhlenbeck characterization. The results of this analysis revealed two new insights into postural development. First, the developmental changes in quiet stance involved a decreased rate at which sway decays to maximal variance, rather than an attenuation of the magnitude of that variance. Specifically, measures indexing amount of sway variance were significantly reduced when touching a static surface as compared with an independent stance condition, but revealed no change with increased walking experience. Further, a reduction in the average rate constant of decay indicated an increased influence of long time-scale sway corrections on the overall sway trajectory. Second, it was shown that, at early walk ages, the use of touch both reduced the amount of variance and shifted the rate constant of sway towards longer time-scale displacements. Taken in the context of previous research, these results support our conclusion that early postural development embodies the dual tasks of calibrating sensorimotor relations for estimation of self-motion as well as identification and tuning of control system properties.

Regulation of arm and leg movement during human locomotion

Walking can be a very automated process, and it is likely that central pattern generators (CPGs) play a role in the coordination of the limbs. Recent evidence suggests that both the arms and legs are regulated by CPGs and that sensory feedback also regulates the CPG activity and assists in mediating interlimb coordination. Although the strength of coupling between the legs is stronger than that between the arms, arm and leg movements are similarly regulated by CPG activity and sensory feedback (e.g., reflex control) during locomotion.