Anticipatory locomotor control for obstacle avoidance in mid-childhood aged children

Differences in gait parameters when crossing real versus projected everyday life obstacles in healthy children and adolescents

Practicing complex everyday life walking activities is challenging in paediatric neurorehabilitation, although it would prepare patients more comprehensively for the requirements of daily life. Floor projections allow simulation and training of such situations in therapy. Twenty healthy youths aged 6-18 years stepped over a tree trunk and balanced over kerbstones in a real and projected condition. Spatiotemporal and kinematic parameters of the two conditions were compared by equivalence analysis, using the medians of the differences between the two conditions with their bootstrapped 95% confidence intervals. Velocity, step and stride length, step width, and single support time were generally equivalent between the two conditions. Knee and hip joint angles and toe clearance decreased substantially during the execution phase of the projected tree trunk condition. The largest differences were found at the end of the execution phase in both tasks for the ankle joints. As spatiotemporal parameters were equivalent between the conditions, floor projections seem suitable to train precise foot placement. However, differences in knee and hip joint kinematics and toe clearance revealed that floor projections are not applicable for obstacles with a vertical extension. Therefore, exercises aiming at knee and hip flexion improvement should favourably be trained with real objects.

Locomotor patterns during obstacle avoidance in children with cerebral palsy

Previous studies mainly evaluated the neuromuscular pattern generation in cerebral palsy (CP) during unobstructed gait. Here we characterized impairments in the obstacle task performance associated with a limited adaptation of the task-relevant muscle module timed to the foot lift during obstacle crossing. Impaired task performance in children with CP may reflect basic developmental deficits in the adaptable control of gait when the locomotor task is superimposed with the voluntary movement.

Manipulating sensory information: obstacle crossing strategies between typically developing children and young adults

Individuals constantly adapt their locomotion to navigate through complex environments. However, little known about anticipatory strategies used by children during adaptive locomotion. The purpose of this study was to compare the effects of manipulating visual and somatosensory information during a multiple obstacle crossing task between children and adults. It was hypothesized that compared to young adults, children would have difficulty with anticipatory motor planning and online control during a multiple obstacle crossing task when sensory information was manipulated. Children (N = 16, [Formula: see text] = 9 ± 1.07 years) and young adults (N = 16, [Formula: see text] = 22 ± 0.96 years) walked along a 7 m pathway towards a goal while avoiding stepping on one, or two virtual obstacles placed 5 m from the start. Visual information regarding the number of obstacles was either presented at the start of steady-state locomotion, or two steps prior to the first obstacle. Each participant completed 36 trials, 18 on flat ground and 18 on foam terrain. Results indicated that in comparison to young adults, children's foot positions were significantly closer to the first obstacle when visual information about the obstacle was delayed. On flat ground, children demonstrated similar Trail foot positions relative to the first and second obstacles, suggesting children planned for the avoidance of the obstacles separately. On foam terrain, children performed similar to young adults, such that their Trail foot position relative to the first obstacle was significantly closer to the obstacle compared to their Trial foot position relative to the second obstacle. The results suggest that children plan for the avoidance of multiple obstacles differently compared to young adults. When stability is challenged, maintaining forward progression of locomotion overrides the planning of obstacle crossing, such that children perform similar to young adults. Therefore, it appears that children have difficulties with online control and anticipatory motor strategies during a multiple obstacle crossing task.

Transitioning from the level surface to stairs in children with and without Down syndrome: Motor strategy and anticipatory locomotor adjustments

BACKGROUND

Children with Down syndrome (DS) show underdeveloped motor strategy and anticipatory locomotor adjustments (ALA) before crossing an obstacle. Stairs presents another important setting to study environment navigation and motor adaptation. Inclusion of external ankle load is often used to perturb the stability of a system and observe the emergence of new patterns.

RESEARCH QUESTION

How do stair height and external ankle load affect motor strategy and ALA in 5-to-11-year-old children with typical development (TD) and with DS when approaching the stairs?

METHODS

Fourteen children with DS and 14 age- and sex-matched children with TD participated in the study. They walked along a 5-meter walkway and ascended 3-step staircases. There were three staircases (low, moderate, and high heights) and 2 loading conditions (no load and ankle load). A 3D motion capture system was used to collect data. Motor strategy was coded for each trial. Step length, width, time, and velocity, minimum toe clearance, and horizontal toe velocity were calculated for the last four steps before stair ascent. Mixed ANOVAs with repeated measures were conducted for statistical analysis.

RESULTS

The TD group walked up all the stairs, while the DS group displayed a strategy shift from walking to crawling when the stairs became higher. While the TD group maintained the values of most spatiotemporal variables, the DS group continuously decreased step length and velocity but not step width over the last four approaching steps. Ankle load decreased step length, step velocity, minimum toe clearance, and horizontal toe velocity in the DS group, to a greater extent, than in the TD group.

SIGNIFICANCE

Children with DS show underdeveloped motor strategy and ALA when approaching the stairs, and external ankle load further disrupts these patterns. Stair negotiation appears to be an effective assessment tool for evaluating motor adaptation in children with DS.

Effects of Practice on the Control of Whole-Body Momentum in Active Children and Adults

The purpose of this study was to determine the effects of practice on performance of a running task requiring maximal speed and accurate termination. Physically active pre-pubertal boys and men ran as fast as possible and stopped at a pre-determined target location. Twenty-five trials were collected and comparisons made between first five (early) and last five (late) trials. Approach velocity, normalized approach velocity (percent of maximal sprint velocity, %Vmax), stopping distance from target, and success rate were calculated. Self-efficacy for task performance and fatigue reports were collected prior to trials. Children ran more slowly than adults in absolute terms but performed at higher relative velocity. Both groups displayed similar accuracy and percentages of successful trials across early and late practice. Adults increased approach velocity and %Vmax from early to late; children, already higher in relative maximal velocity, did not change. Self-efficacy paralleled performance findings and correlated with %Vmax and success rate; both groups reported higher self-efficacy for late compared with early. With practice, adults increased approach velocity and children did not; however, children appeared to be performing at a higher relative level from the beginning, perhaps reflecting their more substantial recent histories of similar physical activity and limiting further effects of practice.

Different neural substrates for precision stepping and fast online step adjustments in youth

Humans can navigate through challenging environments (e.g., cluttered or uneven terrains) by modifying their preferred gait pattern (e.g., step length, step width, or speed). Growing behavioral and neuroimaging evidence suggests that the ability to modify preferred step patterns requires the recruitment of cognitive resources. In children, it is argued that prolonged development of complex gait is related to the ongoing development of involved brain regions, but this has not been directly investigated yet. Here, we aimed to elucidate the relationship between structural brain properties and complex gait in youth aged 9–18 years. We used volumetric analyses of cortical grey matter (GM) and whole-brain voxelwise statistical analyses of white matter (WM), and utilized a treadmill-based precision stepping task to investigate complex gait. Moreover, precision stepping was performed on step targets which were either unperturbed or perturbed (i.e., unexpectedly shifting to a new location). Our main findings revealed that larger unperturbed precision step error was associated with decreased WM microstructural organization of tracts that are particularly associated with attentional and visual processing functions. These results strengthen the hypothesis that precision stepping on unperturbed step targets is driven by cortical processes. In contrast, no significant correlations were found between perturbed precision stepping and cortical structures, indicating that other (neural) mechanisms may be more important for this type of stepping.

Executive dysfunction following a mild traumatic brain injury revealed in early adolescence with locomotor-cognitive dual-tasks

OBJECTIVE

To compare gait parameters between children in early adolescence (EA) with and without a mild traumatic brain injury (mTBI) during dual-task walking (DTW).

METHODS

Children in EA with mTBI (n = 14; six girls) were compared to those without (n = 13; five girls) while walking in different combinations of obstacle avoidance and cognitive dual-tasks. Gait speed and fluidity and their related dual-task costs (DTC) were analysed along with foot clearance and proximity to the obstacle.

RESULTS

No group effects were found for gait speed, proximity or clearance, but were found for fluidity DTC, specifically during the dual Stroop task and when crossing the deeper obstacle. There were also group differences for fluidity during the planning of obstacle avoidance for the narrow obstacle combined with the verbal fluency task and the deep obstacle with no cognitive task. Finally, gait fluidity showed group differences across unobstructed dual-task situations.

CONCLUSIONS

Gait fluidity may be a more sensitive variable than gait speed for revealing executive dysfunction following mTBI in EA. Assessing DTW in level walking also seems to show a potential to reveal executive dysfunctions in this age group. These results provide direction for future research on clinical assessment using DTW post-mTBI in adolescents.

Obstacle crossing in 7-9-year-old children with Down syndrome

This study aimed to investigate obstacle crossing in 7-9-year-old children with Down syndrome (DS). Fifteen children with DS, age- and gender-matched with 15 typically developing (TD) children, were recruited to walk and cross obstacles with heights of 10%, 20% and 30% of their leg lengths. End-point and kinematic variables of obstacle crossing were obtained using a three-dimensional motion analysis system. The results showed that children with DS tend to adopt a lower speed and larger step width when they perceive instability. Moreover, unlike TD children, children with DS adopt a pelvic strategy (i.e., greater pelvic leading-side listing and forward rotation) to achieve a higher leading toe clearance with a longer step length, presumably for safety reasons. This pelvic strategy increased the frontal plane motion of the whole leg and trunk, and thus possibly stability, during obstacle crossing. However, this strategy may be inefficient. Trailing toe clearance did not differ significantly between two groups. The results of this study suggest that children with DS tend to use inefficient and conservative strategies for obstacle crossing. Knowledge of both end-point and kinematic control of obstacle crossing in children with DS is useful for understanding the mechanisms of obstacle-related falls. Moreover, obstacle crossing can be used as a task-oriented rehabilitation program for children with DS.

Slow maturation of planning in obstacle avoidance in humans

Complex gait (e.g., obstacle avoidance) requires a higher cognitive load than simple steady-state gait, which is a more automated movement. The higher levels of the central nervous system, responsible for adjusting motor plans to complex gait, develop throughout childhood into adulthood. Therefore, we hypothesize that gait strategies in complex gait are likely to mature until adulthood as well. However, little is known about the maturation of complex gait from childhood into adolescence and adulthood. To address this issue, we investigated obstacle avoidance in forty-four 8- to 18-yr-old participants who walked at preferred speed along a 6-m walkway on which a planar obstacle (150% of step length, 1 m wide) was projected. Participants avoided the obstacle by stepping over this projection, while lower body kinematics were recorded. Results showed that step length and speed adjustments during successful obstacle avoidance were similar across all ages, even though younger children modified step width to a greater extent. Additionally, the younger children used larger maximal toe elevations and take-off distances than older children. Moreover, during unsuccessful trials, younger children deployed exaggerated take-off distances, which resulted in obstacle contact upon the consecutive heel strike. These results indicate that obstacle avoidance is not fully matured in younger children, and that the inability to plan precise foot placements is an important factor contributing to failures in obstacle avoidance.

Dynamic stability during running gait termination: Differences in strategies between children and adults to control forward momentum

Rapid deceleration during running is key for successful participation in most childhood activities and sports; this requires modulation of body momentum and consequent challenges to postural equilibrium. The purpose of this study was to investigate the strategies employed by adults and children to control forward momentum and terminate running gait. Sixteen young adults and 15 pre-pubertal children completed two tasks as fast as possible: an unobstructed run (RUN) and a run and stop (STOP) at a pre-determined location. For STOP, center of mass (COM) approach velocity and momentum prior to deceleration and spatiotemporal characteristics and COM position during deceleration were compared between groups. Position and velocity variables were normalized to height and maximum velocity during RUN, respectively. Children used fewer steps with relatively longer step length to decelerate over a relatively longer distance and longer time than adults. Children approached at higher relative velocity than adults, but adults approached with greater momentum. Adults positioned their COM lower and more posterior than children throughout deceleration. Our results suggest that pre-pubertal children and young adults employ different strategies to modulate body momentum, with adults exhibiting mechanics characteristic of a more stable strategy. Despite less stable mechanics, children and adults achieved similar success.

Direction of single obstacle circumvention in middle-aged children

When required to walk around a stationary object, adults use the location of the goal to set up their locomotor axis and obstacles presented along the locomotor axis will repel the individual towards the side that affords more space [1]. Research has yet to examine whether children can identify the locomotor axis and choose their paths accordingly. Therefore, the current study examined the factors that influence the direction in which children choose to deviate around a single obstacle and whether the presence or absence of a goal influences path selection and trajectory. Ten children (age: 7.1 years±0.8) walked along a 9 m path and avoided a single obstacle that was located in one of three locations (midline, 15 cm to the right or 15 cm to the left). On half the trials, an end-goal was visible from the start of the path while the other half of the trials had no visible goal. The results demonstrate that: (1) children are able to perceive and move towards more open space but are more variable when the end-goal is not visible; (2) children are capable of maintaining an elliptical-shaped protective envelope when avoiding a single obstacle regardless of whether or not the locomotor axis is established; and (3) although children are capable of choosing paths that afford the most space, the manner in which they arrive at their goal is not driven by factors similar to adults.

Development of postural control during gait in typically developing children: the effects of dual-task conditions

The purpose of this study was to investigate the typical development of postural control in younger (5-6 yrs) and older (7-16 yrs) children (YTD and OTD) during two gait tasks, including level walking and obstacle-crossing, using a dual-task paradigm, and to compare the results of the children's performance with that of healthy young adults (HYA). Our findings revealed that gait control in typical children requires attentional resources to maintain stability. Moreover, dual-task interference was less in HYA compared to YTD and OTD. Gait performance decrements in the dual-task context were greater in YTD compared to OTD, whereas cognitive performance decrements in YTD and OTD were similar. In addition, dual-tasking affected cognitive performance more in YTD when gait task difficulty was increased. Results suggest a developmental trend in attentional resources used to control gait in typical children. Postural control during gait under dual-task conditions was improved when children were more mature, as attentional resources increased with age.

Child temporal-spatial gait characteristics and variability during uphill and downhill walking

PURPOSE

Gait maturation, evidenced in, for example, the ability to walk over nonlevel surfaces, is an important indicator of typical development in children. Therefore, the purpose of this study was to compare the walking strategies used by children and adults during hill walking.

METHODS

Temporal-spatial gait parameters and trial-to-trial coefficient of variation of these parameters were compared between 30 children (aged 3.5-5.5 years) and 30 adults during level and 15° hill walking.

RESULTS

Compared with the adult group, the child group coefficient of variation was greater during all conditions. Furthermore, unique to the child group, there was a significant increase in variability during downhill walking.

CONCLUSION

It is evident from the current results that children aged 3.5 to 5.5 years do not yet exhibit a mature gait and that downhill walking may increase fall risk. Attention should be given to gait variability and nonlevel walking when investigating or training children's gait.

Locomotor behaviour of children while navigating through apertures

During everyday locomotion, we encounter a range of obstacles requiring specific motor responses; a narrow aperture which forces us to rotate our shoulders in order to pass through is one example. In adults, the decision to rotate their shoulders is body scaled (Warren and Whang in J Exp Psychol Hum Percept Perform 13:371-383, 1987), and the movement through is temporally and spatially tailored to the aperture size (Higuchi et al. in Exp Brain Res 175:50-59, 2006; Wilmut and Barnett in Hum Mov Sci 29:289-298, 2010). The aim of the current study was to determine how 8-to 10-year-old children make action judgements and movement adaptations while passing through a series of five aperture sizes which were scaled to body size (0.9, 1.1, 1.3, 1.5 and 1.7 times shoulder width). Spatial and temporal characteristics of movement speed and shoulder rotation were collected over the initial approach phase and while crossing the doorway threshold. In terms of making action judgements, results suggest that the decision to rotate the shoulders is not scaled in the same way as adults, with children showing a critical ratio of 1.61. Shoulder angle at the door could be predicted, for larger aperture ratios, by both shoulder angle variability and lateral trunk variability. This finding supports the dynamical scaling model (Snapp-Childs and Bingham in Exp Brain Res 198:527-533, 2009). In terms of movement adaptations, we have shown that children, like adults, spatially and temporally tailor their movements to aperture size.

Anticipatory postural adjustments in children with typical motor development

Anticipatory postural adjustments (APAs) play an important role in the performance of many activities requiring the maintenance of vertical posture. However, little is known about how children utilize APAs during self-induced postural perturbations. A group of children, aged 7-16 years, with typical motor development, performed various arm movements while standing on a force platform. APAs were measured by recording the electromyographic activity of six trunk and leg muscles on both sides of the body and displacement of center of pressure (COP). Anticipatory bursts of activity in the dorsal muscle groups of the trunk and legs and suppression in the ventral muscle groups as well as posterior COP displacement were found during the performance of bilateral shoulder flexion. Conversely, during bilateral shoulder extension, the COP displacement was anterior, and APAs were reversed showing bursts of activity in the ventral muscle groups and suppression in the dorsal muscles. During right and left reciprocal arm movements, COP displacement was minimal and APAs were generated in the dorsal muscle groups on the side of the forward moving arm and in the ventral muscle groups on the side of the arm moving into extension. However this pattern reversed for lower leg muscles, where APAs were generated in the ventral muscles on the side of forward moving arm and in the dorsal muscle on the side of the arm moving into extension. The results of this study indicate that children with typical motor development are able to generate APAs, produce task-specific sequencing of muscle activity and differentiate between perturbations in the sagittal and transverse planes. The results of this study indicate that by at least age 7, children who are typically developing demonstrate the ability to generate patterns of anticipatory muscle activation and suppression, along with center of pressure changes, similar to those reported in healthy adults.

Balance problems during obstacle crossing in children with Developmental Coordination Disorder

The present study investigated the visuomotor and balance limitations during obstacle crossing in typically developing (TD) children and those with Developmental Coordination Disorder (DCD) (7-9 years old; N=12 per group). Spatiotemporal gait parameters as well as range and velocity of the centre of mass (COM) were determined in three conditions: overground walking at a self-selected speed, crossing a low obstacle and crossing a high obstacle (5% or 30% of the leg length, respectively). Both groups walked more slowly during obstacle crossing than walking over level ground. In addition, both groups exhibited a significant decrease in the spatial variability of their foot placements as they approached the obstacle, which was then negotiated with a similar strategy. There were no differences in approach distance, length of lead and trail step, or lead and trail foot elevation. Compared to walking over level ground, obstacle crossing led to a longer swing phase of the lead and trail foot and increased maximal medio-lateral COM velocity. In children with DCD, however, medio-lateral COM velocity was higher and accompanied by significantly greater medio-lateral COM amplitude. In conclusion, the results indicate that while TD-children and those with DCD exhibit satisfactory anticipatory control and adequate visual guidance, the latter group have a reduced ability to control the momentum of the COM when crossing obstacles that impose increased balance demands.

Obstacle stepping in children: task acquisition and performance

The aim of this study was to investigate the locomotor capacity of children during the performance of different lower extremity tasks with increasing difficulty. Two subject groups of children (aged 6-8 and 9-12 years) and adult controls performed several motor tasks from the Zürich Neuromotor Assessment (ZNA) test, as well as a unilateral and bilateral obstacle stepping test during treadmill walking. Performance of ZNA items, changes in foot clearance, and obstacle hits were assessed. Correlations between children's age, ZNA and obstacle measures were calculated. Performance of all motor tasks improved with increasing age. All three groups improved foot clearance during unilateral obstacle stepping, while the younger children achieved a poorer performance level. During bilateral obstacle stepping, only the adult controls and the 9-12 years old children's group further improved foot clearance, while no further improvement occurred in the 6-8 years old children's group. A relationship between items of ZNA and bilateral obstacle stepping was found. It is concluded that children in the mid-childhood range are able to significantly improve performance of a high-precision locomotor task. However, children below 9 years of age have a poorer motor performance compared to older children and adults that becomes more pronounced with increasing complexity of the task. Finally, ZNA tests can improve the prediction of complex adaptive locomotor behaviour compared to calendar age alone.

Anticipatory postural adjustments associated with a forward leg raising in children: effects of age, segmental acceleration and sensory context

OBJECTIVE

The purpose of this study was to determine the influence of age, segmental acceleration and sensory context on anticipatory postural adjustments (APAs) in a forward leg raising task.

METHODS

Three groups of 11 children, aged 8, 10 and 12, and 12 adults, aged 20 to 26, were instructed to perform this movement at maximal (MAXIMAL) and sub-maximal segmental accelerations and in normal (CONTROL), no vision (NV) and perturbed proprioception conditions (VIB). The generation and calibration of APAs were examined through the centre of foot pressure displacements: The onset, duration and amplitude of APAs were particularly explored. The EMG activity of the tibialis anterior (TA(stance)) and gastrocnemius medialis (G(stance)) of the stance leg was also recorded.

RESULTS

Two phases were clearly identified on the ML axis: A thrust and an unloading phase. Effect of age: At 8 and 10, (1) the unloading duration was shorter, and (2) the onset of APAs on the ML axis appeared later than in 12-year-old children and in adults. Effect of the segmental acceleration: (1) a greater amplitude of the thrust and unloading phases, (2) a shorter unloading duration, and (3) a later onset of ML APAs and of the TA(stance) activity were observed at maximal acceleration in all groups. Effect of the sensory context: No difference was found between the CONTROL and NV conditions. When the proprioceptive feedback was altered, (1) the thrust and unloading durations increased, and (2) the onset of the APAs on the ML axis occurred earlier.

CONCLUSION

All children exhibited an anticipatory behaviour, but the adults' behaviour was reached at 12 only. Our results also indicated a change in the generation and calibration of APAs in the VIB condition, suggesting that proprioceptive information is essential for both dimensions of the APAs.

SIGNIFICANCE

The development of the APAs was not related to the segmental acceleration and to the sensory context of the forthcoming movement in children aged 8-12. It is very likely that the participants built up an internal representation of this movement.

Strategy adoption and locomotor adjustment in obstacle clearance of newly walking toddlers with Down syndrome after different treadmill interventions

This study investigated how newly walking toddlers with Down syndrome (DS), after different treadmill interventions, adopted clearance strategies and modified anticipatory locomotor adjustment patterns to negotiate an obstacle in their travel path. Thirty infants with DS (about 10 months of age) were recruited and randomly assigned to either a lower-intensity, generalized (LG) treadmill training group, or a higher-intensity, individualized (HI) treadmill training group. Thirteen in each group completed a one-year-gait follow-up after the treadmill intervention. Initially, both groups chose to either crawl or walk over an obstacle. However, walking over the obstacle became their preferred clearance strategy over the course of the gait follow-up even though the height of the obstacle increased from visit to visit. The HI group used the strategy of walking over the obstacle at a considerably higher percentage than the LG group within 6 months after the training. When approaching the obstacle, both groups started to show consistent anticipatory locomotor adjustments about 6 months after the training. Both groups decreased velocity, cadence and step length, and increased step width at the last three pre-obstacle steps. It was concluded that the retention of the HI training effects led the HI group to predominantly walk over an obstacle earlier than the LG group within 6 months after treadmill intervention, and the two groups produced similar anticipatory locomotor adjustments in the last three steps before negotiating the obstacle.

Stepping over obstacles of different heights: kinematic and kinetic strategies of leading limb in hemiplegic children

Twelve hemiplegic children (HC) and five normally developing children (NDC) were instructed to walk barefoot over a level surface and to cross obstacles of various heights (0%, 10%, 15% and 20% of their leg lengths). Kinematic and kinetic strategies of their leading limb were mainly examined. For the starting position of the trials HC was adjusted so that the affected limb was the leading one, while NDC step over the obstacle with their preferred selection of leading and trailing limb. The results demonstrated that the crossing speed was decreased and the crossing swing phase was increased in both groups. The toe vertical clearance augmented with the presence of the obstacle, but it remained constant with obstacle heights. The toe and heel horizontal distances of the leading limb remained constant with all obstacle heights. The toe horizontal distances of the trailing limb in HC increased with obstacle heights outlying a peculiar strategy. A comparison of joint angles and power variations revealed substantial differences in height changes between the two groups: HC exhibited a preferential modulation of pelvis and hip joints and a reduced modulation of knee and ankle joints. The knee flexor limitation in HC was accomplished by knee power variations near the toe-off. HC showed also an increased ankle involvement of the support limb, i.e. the almost normal limb. Collectively, the results provided insights into multijoint variations of locomotor act caused by visible obstacle in HC and indicate that a correct rehabilitation treatment should be focused on the use of dynamic constraints preferentially at the plegic knee.

Characteristics of single and double obstacle avoidance strategies: a comparison between adults and children

Activities of daily living often require us to negotiate several obstacles in the travel path. To date, there is little work investigating how adults accomplish such tasks, and there is even less known about multiple obstacle avoidance strategies used by children. The current work will expand our knowledge about the role of vision in adults and children when avoiding two obstacles placed in their travel path under altered ambient lighting. Healthy 7-year old children (n=10; aged 7.51+/-0.2 years) and adults (n=10; aged 22.76+/-1.7 years) were instrumented with infrared markers (Optotrak, NDI) placed on anatomical landmarks and asked to walk along a ten meter path under three conditions: unobstructed, single obstacle, or double obstacle. These trials were performed under two lighting conditions: Full (simulating standard office lighting) and Low (simulating a dark hallway lit by nightlights). Data analyses included lead and trail clearance values, step length, step width and step velocity, take-off distance and Horizontal toe Displacement at Apex (HDA) which was defined as the distance between the horizontal position of the toe to the leading edge of the obstacle when the toe reaches its peak height. Adults were able to maintain consistent behaviour regardless of the number of obstacles in the travel path. Children, however, adjusted their foot placement for the second obstacle. This indicates that having multiple obstacles in the travel path is a more challenging task for 7-year old, and suggests that children at this age may not have fully developed anticipatory locomotor strategies. Children had larger clearance values than adults for the lead foot crossing the obstacle under all obstacle and lighting conditions, and consistently used larger HDA values than adults. Together, these findings suggest that children adopt more cautious strategies than adults in complex environments. Additionally, children decreased walking velocity, increased step width and decreased their step length in a Low light environment. These changes are all indicators of a more careful avoidance strategy, which implies that children at this age rely heavily on visual information to guide foot placements in a complex environment.

Intersegmental dynamics during the swing phase of gait: a comparison of knee kinetics between 7 year-old children and adults

Existing literature suggests that kinetic patterns associated with children's gait may not be adult-like until after 7 years of age. The development of adult-like kinetic patterns, especially those involving non-muscular interaction moments, occurs with time and experience. We tested the hypothesis that compared to adults, 7 year-old children would demonstrate a relatively larger contribution of muscle moment and a smaller contribution of interaction moment to the net knee joint moment during the swing phase of gait was tested. Net knee joint moments and the contributions of muscle and interaction moments to the net moments were compared between 7 year-old children and adults. Knee kinematics and net joint moments were similar between the two groups. Also, the contributions of the muscle and interaction moments to the net joint moment were similar (P > 0.05), suggesting that the ability to employ interaction moments during the swing phase of gait did not differ between the two groups.

Children use different anticipatory control strategies than adults to circumvent an obstacle in the travel path

Carrying out the daily activities of work and play requires the ability to integrate available sensory information in order to navigate complex, potentially cluttered, environments. The expression of locomotor adjustment behaviour is still maturing during mid- to late-childhood (Grasso et al. in Neurosci Biobehav Rev 22(4): 533-539, 1998a; McFadyen et al. in Gait Posture 13:7-16, 2001), which raises the question, do children coordinate their body segments differently than adults when circumventing an obstacle in their travel path? Healthy young children (n=5; age 10.3+/-1.5 years) and adults (n=6; age 26.3+/-2.9 years) were asked to walk at their natural pace during unobstructed walking, as well as during the avoidance to the right or left of a cylindrical obstacle located in the travel path 3 m from the initial starting position. Fourteen infrared markers were fixed to participants and tracked using the Optotrak motion analysis system (60 Hz; Northern Digital Inc, Canada). Data analyses included center of mass (COM) clearance from the obstacle, gait speed, angular movement of the head and trunk (yaw, pitch and roll) and medial-lateral (M-L) COM displacement. Onset of change in these variables from unobstructed walking was also calculated as the time from OBS crossing. Although there were no differences in when adults or children altered their M-L COM trajectory, adults reoriented their head and trunk segments at the same time as their COM while children reoriented their head and trunk prior to changing COM direction. A comparison of foot placement data for this task indicated that while adults changed their gait patterns well in advance of obstacle crossing, children initiated M-L adjustments to gait patterns just prior to OBS crossing. Vallis and McFadyen (Exp Brain Res 152 (3):409-414, 2003) indicated that during circumvention of an obstacle, adults coordinate body segments for a single transient change in COM trajectory while maintaining the underlying travel direction. The present data suggest, however, that children partition obstacle avoidance into two tasks, initially steering with proactive movement of the head and trunk segments and finally making adjustments to their gait trajectory, via stride and step width changes, to ensure adequate obstacle clearance just prior to obstacle crossing. This study demonstrates different anticipatory control strategies used by children as compared to adults to circumvent obstacles in the travel path. The different head and trunk anticipatory segmental coordination suggests that children gather visual information differently when circumventing an obstacle in their travel path and are more dependent on visual input to guide their circumvention strategy.

Adaptations in bilateral mechanical power patterns during obstacle avoidance reveal distinct control strategies for limb elevation versus limb progression

The present study investigated the adaptations of specific power bursts during the combined contexts of the proximity (lead vs. trail limb) and height of an obstruction in relation to limb elevation versus progression. Ten young, adult, male subjects walked at their natural speed during unobstructed walking and the bilateral avoidance of moderate and high obstacles. Hip flexor generation power was unaffected by obstacle height for the leading limb and always delayed for the trailing limb. The knee extensor absorption power burst at toe-off was also eliminated for the trailing limb and was found to reappear in mid-swing. Few differences were seen for ankle push-off power. The results suggest that the hip joint is dedicated to limb advancement only, while the knee joint is directly involved in limb elevation and the control of multiarticular effects.

Stepping over obstacles: anticipatory modifications in children with and without Down syndrome

The purpose of this study was to explore the mechanism of anticipatory control of gait in relation to the perception of an obstacle. Typically developing (TD) children (4-7 years of age) and children with Down syndrome (5-6 years of age) walked and stepped over obstacles of two different heights-a "subtle" obstacle that was placed at a very low distance from the floor (1% of total body height) and an "obvious" obstacle that was placed at a much higher distance from the floor (15% of total body height). Spatial and temporal measures of the gait cycle were analyzed. TD children showed increased variability in pre-obstacle step lengths only in response to the higher obstacle. Children with DS showed a decrease in variability in response to the higher obstacle and marked qualitative changes in their gait cycle. Both groups of children were able to scale toe clearance with obstacle height. These results show that TD young children can make task-specific anticipatory adjustments by modulating step length and toe clearance. Children with DS show appropriate scaling of toe clearance and are beginning to show the emergence of anticipatory responses under specific environmental conditions.

Shoulder and elbow joint power differ as a general feature of vertical arm movements

Consistent patterns of joint power underlie coordinated lower extremity behaviors such as running and walking. Recent work found that shoulder and elbow power consistently differed during reaching movements in the horizontal plane. Moreover, joint power during horizontal reaching appears correlated with motor cortical activity. It is not known if the feature of differential joint power extends to vertical plane reaches or to reaches of different movement conditions. The purpose of this study was to test for differential shoulder and elbow power during the acceleratory and deceleratory phases of fast and normal speed vertical reaches in sitting and supine positions. Our results suggest that shoulder and elbow power typically differed both within and across conditions. First, shoulder power values were positive or negative dependent largely on movement direction and movement phase. That is, for each direction and phase, the shoulder either generated or absorbed energy independent of speed or body position. Second, and unexpectedly, reaches of certain condition combinations had similar shoulder power magnitudes across directions. In contrast, elbow power values for each direction varied between positive and negative values depending on phase, speed and position, and no two condition combinations overlapped across directions. Third, as target direction, movement phase and body position varied, shoulder power at fast and normal speeds were linearly correlated, as was shoulder power in sitting and in supine. In contrast, elbow power was linearly correlated only between speeds. These results join other studies to suggest that the neuromotor control of the shoulder may be less complex as compared to the elbow as a general feature of reaching movements. This differential control has important implications for the study of reaching impairments in neurorehabilitation populations, and provides a potentially important variable in the study of cortical firing patterns.