Onset Of Walking Research Articles

Baby steps towards linking calcaneal trabecular bone ontogeny and the development of bipedal human gait.

Trabecular bone structure in adulthood is a product of a process of modelling during ontogeny and remodelling throughout life. Insight into ontogeny is essential to understand the functional significance of trabecular bone structural variation observed in adults. The complex shape and loading of the human calcaneus provides a natural experiment to test the relationship between trabecular morphology and locomotor development. We investigated the relationship between calcaneal trabecular bone structure and predicted changes in loading related to development of gait and body size in growing children. We sampled three main trabecular regions of the calcanei using micro-computed tomography scans of 35 individuals aged between neonate to adult from the Norris Farms #36 site (1300 AD, USA) and from Cambridge (1200-1500AD, UK). Trabecular properties were calculated in volumes of interest placed beneath the calcaneocuboid joint, plantar ligaments, and posterior talar facet. At birth, thin trabecular struts are arranged in a dense and relatively isotropic structure. Bone volume fraction strongly decreases in the first year of life, whereas anisotropy and mean trabecular thickness increase. Dorsal compressive trabecular bands appear around the onset of bipedal walking, although plantar tensile bands develop prior to predicted propulsive toe-off. Bone volume fraction and anisotropy increase until the age of 8, when gait has largely matured. Connectivity density gradually reduces, whereas trabeculae gradually thicken from birth until adulthood. This study demonstrates that three different regions of the calcaneus develop into distinct adult morphologies through varying developmental trajectories. These results are similar to previous reports of ontogeny in human long bones and are suggestive of a relationship between the mechanical environment and trabecular bone architecture in the human calcaneus during growth. However, controlled experiments combined with more detailed biomechanical models of gait maturation are necessary to establish skeletal markers linking growth to loading. This has the potential to be a novel source of information for understanding loading levels, activity patterns, and perhaps life history in the fossil record.

Developmental cascades instigated by the onset of walking

Developmental cascades instigated by the onset of walking

Walking, pointing, talking - the predictive value of early walking and pointing behavior for later language skills.

Both walking abilities and pointing gestures in infants are associated with later language skills. Within this longitudinal study we investigate the relationship between walk onset and first observed index-finger points and their respectively predictive value for later language skills. We assume that pointing as a motor as well as a communicative skill is a stronger predictor of later language development than walk onset. Direct observations, parent questionnaires, and standardized tests were administered in 45 children at ages 1;0, 2;0, 3;0, and 4;0. Results show that both walk onset and early index-finger pointing predict language abilities at age 2;0, but only early index-finger pointing predicts language skills at ages 3;0 and 4;0. Walk onset seems to contribute to an initial increase in language acquisition without a sustained advantage. The predictive value of first observed index-finger points, however, is strong and lasts at least until age 4;0.

Point, walk, talk: Links between three early milestones, from observation and parental report.

Around their first birthdays, infants begin to point, walk, and talk. These abilities are appreciable both by researchers with strictly standardized criteria and caregivers with more relaxed notions of what each of these skills entails. Here, we compare the onsets of these skills and links among them across two data collection methods: observation and parental report. We examine pointing, walking, and talking in a sample of 44 infants studied longitudinally from 6 to 18 months. In this sample, links between pointing and vocabulary were tighter than those between walking and vocabulary, supporting a unified sociocommunicative growth account. Indeed, across several cross-sectional and longitudinal analyses, pointers had larger vocabularies than their nonpointing peers. In contrast to previous work, this did not hold for walkers' versus crawlers' vocabularies in our sample. Comparing across data sources, we find that reported and observed estimates of the growing vocabulary and of age of walk onset were closely correlated, while agreement between parents and researchers on pointing onset and talking onset was weaker. Taken together, these results support a developmental account in which gesture and language are intertwined aspects of early communication and symbolic thinking, whereas the shift from crawling to walking appears indistinct from age in its relation with language. We conclude that pointing, walking, and talking are on similar timelines yet distinct from one another, and discuss methodological and theoretical implications in the context of early development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Passive range of motion changes in young children with spastic diplegia. A study during the initial stages of independent walking.

To investigate how the onset of independent walking in children with Cerebral Palsy (CP) influences the Passive Range of Motion (PROM) of lower limb joints. Sixteen children with CP, GMFCS levels I and II, and 16 Typical Development (TD) children who had just begun independent walking participated in the study. The PROM of the hip abduction and external rotation, knee extension, popliteal angle, and ankle dorsiflexion was recorded with a goniometer at the onset of independent walking and 8months later. A repeated-measures two-way ANOVA was conducted to compare the main effects of "walking experience" and "group of children" and the interaction effect between them on PROM of lower extremities' joints. The effect of "group of children" in the PROM was significant; differences were observed between children with CP and TD children for all joints (p< 0.05). The effect of "walking experience" did not have a significant impact on PROM changes and the interaction effect of "group of children" and "walking experience" was also not significant for all the variables. The alternative gait pattern spontaneously adopted by children with CP does not significantly impact their PROM during the initial stages of walking development. The lower PROM in highly functional children with CP compared to TD children cannot be attributed to gait initiation with an "atypical" pattern, but possibly to other factors such as reduced voluntary movement and age.

Gait Characteristics of Children Born Preterm.

Walking is a central skill of daily living. A delay in the onset of walking can be a sign of abnormal motor development. Further, abnormalities in gait can also affect physical functioning. Children born preterm are at significant risk for neurodevelopmental impairments; however, little is known about how preterm birth affects walking. This review describes current evidence of walking in children born preterm with a focus on the age at onset of walking and comparisons of gait characteristics of children born preterm with those born full-term.

What Does Prone Skateboarding in the Newborn Tell Us About the Ontogeny of Human Locomotion?

The crawling behavior of sixty 2-day-old newborns was studied while they were supported prone on a mini skateboard and on a pediatric mattress without additional support. Analyses of the number and types of limb movements and their characteristics, the coactivation of limb pairs, and the displacement across the surface, revealed that newborns can crawl with locomotor patterns similar to those documented during quadrupedal locomotion in animals and human adults. This was particularly apparent on the skateboard. This discovery suggests that locomotor circuitry underlying quadrupedal locomotion develops during fetal life. Drawing upon other evidence for a quadrupedal organization underlying bipedal gait, we argue that early quadrupedal training may enhance interventions designed to hasten the onset of independent walking.

Gross motor skill performance in children with and without CHARGE syndrome: Research to practice

BackgroundCHARGE syndrome is a multifaceted syndrome of complex birth defects. The heterogeneous nature of children with CHARGE syndrome brings unique issues and challenges affecting the overall motor development of the child, often resulting in developmental delays including motor delays. AimsThe purpose of this research was to assess children with CHARGE Syndrome on locomotor and object control skills to better understand their motor development. This information is relevant to adapted physical education teachers, paraeducators, vision teachers, health care professionals (occupational therapists, physical therapists, and physicians) and parents and family members of children with CHARGE Syndrome. Methods and ProceduresThirty-seven children with CHARGE syndrome and thirty peers without disabilities participated in the study. Each participant was assessed on two object control and three locomotor skills with modifications, if necessary. In addition, the age of onset of independent walking was recorded for each participant. Outcome and resultsChildren with CHARGE syndrome performed significantly behind their same age peers in most gross motor skills with the biggest deficits found in the run and kick. Age of onset of walking was associated with performance in jumping, running, and throwing. Conclusions and implicationsEarly intervention services should focus on gross motor skills such as throwing, kicking, as well as walking at an early age.

Age for Onset of Walking May Predict Physical Activity in Childhood; The Norwegian Mother and Child Cohort-Study

Physical activity (PA) is associated with a wide range of health benefits in children and youth. Identifying factors that might influence activity level is important to aim future public health strategies. Cross-sectional studies have demonstrated an association between motor skills and PA in childhood, however few studies have examined whether early motor development in infancy is associated with PA in childhood. PURPOSE: To examine whether age for onset of walking predicts PA in 7 year olds. METHODS: We used data from the Norwegian Mother and Child Cohort Study (MoBa), which is an ongoing population-based birth cohort study. The mothers reported age for onset of walking (months) and PA at 7 years (frequency of participation per week in moderate-to- vigorous PA [MVPA]) through questionnaires. The PA-questionnaire's validity is tested against accelerometer assessed MVPA (spearman's rho=0.38). We used multiple regression analyses and adjusted the analyses for gestational age, sex and weight at 1 year and parental education as a marker for socio-economic status. A formal test showed no evidence of an interaction by sex. RESULTS: A total of 33013 participants are included in the analysis (49% girls), and the mean age (sd) were 7.1 (0.14) years at follow-up. The average age (sd) for onset of walking were 12.9 (1.86) months, and average participation rate (sd) were 4.3 (2.45) times/week in MVPA. We observed a negative association between age for onset of walking and participation in MVPA in childhood (B=-0.08, 95%CI=-0.10, -0.07) independent of confounding factors. CONCLUSION: This finding indicate that earlier age for onset of walking may predict PA in childhood. However, while the association may be considered week, i.e. each month earlier onset of walking is associated with 0.08 higher participation rate in MVPA (frequency per week), self-reported PA is likely prone to random measurement error attenuating the true association.

Independent Walking Onset of Children With Cerebral Palsy

Independent Walking Onset of Children With Cerebral Palsy

Anthropometric and Psychomotor Development Factors Linked to Foot Valgus in Children Aged 6 to 9 Years.

Planovalgus foot prevalence estimates vary widely (0.6%-77.9%). Among the many factors that may influence planovalgus foot development, much attention has been given to body mass index, especially that of children's feet; factors related to psychomotor development have been less studied. We sought to determine the presence of planovalgus foot in children and its association with anthropometric parameters and psychomotor development. A case-control study was conducted in Málaga, Spain, 2012-2013, of 104 schoolchildren (mean ± SD age, 7.55 ± 0.89 years; 45.2% were boys). Age, sex, body mass index, presence of valgus (valgus index, by pedigraphy), and personal history related to psychomotor development of the lower limbs (presence/absence of crawling, age at onset of crawling, age at onset of walking, use of mobility aids) were evaluated. Of the children with obesity, 53.7% had valgus deformity in the left hindfoot (odds ratio [OR], 6.94; 95% confidence interval [CI], 2.72-17.70; P < .0001). In the right foot, the corresponding values were 54.5% (OR, 9.08; 95% CI, 3.38-24.36; P < .0001). Multivariate logistic regression showed an increased risk of left planovalgus foot in boys, in children with overweight or obesity, and in those who began walking later. For the right foot, the same risk factors applied except age at onset of walking. These results corroborate data from previous studies, which report an association between overweight and obesity and the onset of planovalgus foot in children. In addition, we identify a new risk factor: age at onset of walking.

The onset and characteristics of walking in children born preterm compared with full term children

The onset and characteristics of walking in children born preterm compared with full term children

Association between age at onset of independent walking and objectively measured sedentary behavior is mediated by moderate-to-vigorous physical activity in primary school children

ObjectiveAge at onset of walking has been shown as an early predictor of physical activity in infants and children. However, little is known about whether age at onset of walking may predict sedentary behavior (SB). The aim of the present study was to examine the association between the timing of onset of walking and objectively measured SB, and whether this association is mediated by moderate-to-vigorous physical activity (MVPA) in children.MethodsThe subjects were 388 elementary school children aged 6–12 years. Current weight and height data were collected. Birth weight and the age in months the child first walked independently were reported based on the parents’ recall. Children’s SB and physical activity were objectively measured using a triaxial accelerometer (Active style Pro HJA-350IT, OMRON). The following summary outcome variables were derived from accelerometer data: Time (min/day) spent in SB (≤1.5 metabolic equivalents [METs]) and MVPA (≥3.0 METs).ResultsThe mean ± SD time (min/day) spent in sedentary was 376 ± 62 and MVPA was 67.6 ± 20.8. Multiple linear regression analyses revealed that a later age at independent walking was associated with increased time spent in SB (β = 0.15, P < 0.001) and decreased time spent in MVPA (β = -0. 18, P < 0.001) after adjusting for gender, birth weight, current age, body weight, schools, and time spent wearing the accelerometer. When MVPA was introduced as a covariate in the model predicting SB, the association between the age at independent walking and time spent in SB was completely attenuated (β = 0.04, P = 0.215), while MVPA was significantly associated with SB (β = -0.61, P < 0.001).ConclusionsOur results indicate that infants who walked at a later age spent more time in SB in childhood, and this association is mediated by MVPA. Appropriate interventions which focus on increasing MVPA and thereby reducing SB may be beneficial in infants who demonstrate a later age at onset of independent walking.

Superior Performance in Prone in Infants With Congenital Heart Disease Predicts an Earlier Onset of Walking.

Infants with congenital heart disease are at risk of impaired neurodevelopment, which frequently manifests as motor delay during their first years of life. This delay is multifactorial in origin and environmental factors, such as a limited experience in prone, may play a role. In this study, we evaluated the motor development of a prospective cohort of 71 infants (37 males) with congenital heart disease at 4 months of age using the Alberta Infant Motor Scales (AIMS). We used regression analyses to determine whether the 4-month AIMS scores predict the ability to walk by 18 months. The influence of demographic and clinical variables was also assessed. Fifty-one infants (71.8%) were able to maintain the prone prop position (AIMS score of ≥3 in prone) at 4 months. Of those, 47 (92.2%) were able to walk by 18 months compared to only 12/20 (60%) of those who did not maintain the position. Higher AIMS scores were predictive of a greater likelihood of walking by 18 months ( P < .001), with the scores in prone having a higher predictive ability compared to those in other positions (Exp(B) 15.2 vs 4.0). Shorter hospital stays and female gender were also associated with an earlier onset of walking. In conclusion, our study demonstrates that early ventral performance in infants with congenital heart disease impacts the age of acquisition of walking and could be used to guide referral to rehabilitation.

Social exchanges with objects across the transition from crawling to walking

ABSTRACTThe current study investigated infants’ spontaneous object interactions during naturalistic observation in a daycare centre in Japan. The researcher visited the class for 49 days, once a week, for one year (in the morning for about 1.5 h). Infants’ and caregivers’ interactions during free play time were videotaped. Of particular interest in this study was whether changes in infants’ locomotor status were functionally related to social exchanges with objects. During longitudinal one-year observation, all six infants gradually acquired locomotor skills: two infants became walkers from pre-crawlers, and another four became walkers from crawlers. Throughout the observations, the infants spent an impressive amount of time (i.e. about 50%) in contact with objects. As they acquired locomotor skills, they gained access to distal objects and carried objects frequently. Triggered by the onset of walking, infants’ carrying behaviour increased dramatically. Locomotor experiences were also related to qualitative changes in how they used objects in social interactions. These quantitative and qualitative changes in infants’ object experiences were not strongly connected with the infants’ age in months. Taken together, this study demonstrated that the onset of walking marks a critical developmental milestone that profoundly changes the way infants access, carry, and use objects to interact with others.

Biomechanical implications of the onset of walking

Changes in long bone strength associated with the onset of bipedal walking in humans have been previously documented in a longitudinal growth sample. However, it is unclear if this transition can be detected using archaeological, cross-sectional data, which likely encompass more cultural and biological variation than a single dataset of living children. Focusing on variation in cross-sectional polar second moment of area, we evaluate the ratios of femoral, tibial, and humeral strength in seven temporally diverse samples of individuals from birth to the age of eighteen years (n = 501), with subsequent comparisons to immature Late Pleistocene fossils. Using these samples, we determine whether changes related to the developmental onset of bipedality can be detected in a large, multi-population sample, test for differences in long bone strength ratios among Holocene groups that may indicate developmental differences in the onset of walking, and determine whether immature Late Pleistocene samples follow the same patterns as modern humans.Despite great variation within the Holocene sample, clear changes in these ratios are apparent around the age of the onset of walking. Humeral-to-femoral strength increases briefly prior to the age of one, with a sharp decline in relative humeral strength thereafter until age four. A similar pattern is apparent in the ratio of humeral/tibial and femoral/tibial strength. While the general pattern is consistent across all human groups sampled, these ratios vary by skeletal population, which seems to be closely related to variation in tibial length among samples. Although the extremely small fossil sample makes differences difficult to interpret, Neandertals also differ from both Late Pleistocene and Holocene modern humans in their strength ratios. Further research in this area may provide additional information about the skeletal impact of the onset of walking in the past and in additional fossil taxa.

Joint Laxity in Preschool Children Born Preterm

To evaluate the prevalence of joint laxity in children born preterm assessed in the first 2 years, the relationship between joint laxity and motor performance at preschool age, and possible changes over time in a subgroup of children followed longitudinally. The revised scale of Beighton Score was used to evaluate joint laxity in a population of 132 preschool children born preterm between 24 and 32 weeks of gestational age. All were assessed for joint laxity between 12 and 24 months of age. Children also performed the Movement Assessment Battery for Children-Second Edition between the age of 3 years and 6 months and 4 years; the age at onset of independent walking also was recorded. The total Beighton Score ranged between 0 and 8. Twenty percent of the cohort showed joint laxity. No differences related to sex or gestational age were observed. Children born preterm with joint laxity achieved later independent walking and achieved lower scores on Movement Assessment Battery for Children-Second Edition than those without joint laxity. In 76 children born preterm, an assessment for joint laxity was repeated once between 25 and 36 months and again after >36 months. No statistically significant difference was observed between the 3 assessments. The Beighton Score can be used to assess generalized joint laxity in children born preterm. As the presence of joint laxity influenced motor competences, the possibility to early identify these infants in the first 2 years is of interest to benefit from early intervention and potentially improve gross motor skills and coordination.

Dynamic stability during split-belt walking and the relationship with step length symmetry

IntroductionWalking instability is a contributor to falls and other undesired changes in walking performance. We investigated the effect of split-belt treadmill based perturbations on dynamic stability. Furthermore, we examined the relationships for dynamic stability and symmetry during unperturbed and perturbed walking. MethodTwenty healthy young adults completed unperturbed and perturbed walking conditions on a split-belt treadmill. The continuous perturbation involved moving the parallel belts at unequal speeds (1.5 m/s: 0.5 m/s). Margins of stability (MoS) and step length symmetry (SYM) were assessed. ResultsStability and symmetry measures each decreased at the onset of the split walking perturbation. Only anterior-posterior (AP) MoS and SYM exhibited adaptive changes. Associations were found primarily for AP MoS with immediate changes in SYM at the onset of split walking, and over the duration of the split walking condition. DiscussionOur findings suggest walking strategies were adapted to maintain dynamic stability when faced with a continuous perturbation. Additionally, dynamic stability was associated with symmetry during perturbed walking.

Can early physical therapy positively affect the onset of independent walking in infants with Down syndrome? A retrospective cohort study

The development of both gross and fine motor skills in a child with Down syndrome is generally delayed. The most seriously affected stage is the achievement of independent walking ability, which influences the onset of all following motor and cognitive skills. The study objectives were: 1) to assess the time taken to achieve independent walking ability in a cohort of children with Down syndrome; 2) to examine differences in walking onset by patient characteristics; and 3) to verify the effect of early physical therapy (neurodevelopmental treatment based on Bobath Concept practiced within the first months of life) in the achievement of that skill. A retrospective study was carried out on a cohort of 86 children with Down Syndrome. The knowledge of the exact age of walking onset and information about comorbidities and rehabilitation practiced since birth were the eligibility criteria. The average age at which walking began in the sample was 26 months (standard deviation=9.66). Some patient characteristics proved to be related negatively to the walking onset: gender male, trisomy 21, improved joint ligamentous laxity. When practiced, early physical therapy was able to contrast the delay in walking. NDT-Bobath is a well-known and valid instrument for a child with Down syndrome to attain his highest possible psychomotor functioning level. This study pointed out for the first time ever its capability to contrast the delay on walking onset, which can influence positively the development of the following motor and cognitive skills.

The use of an intraarticular catheter on fast-track primary knee arthroplasty, is it a step forward?

ObjectiveThis study compares the efficacy in post-operative pain control of the intraarticular catheter compared to the epidural catheter after primary total knee arthroplasty. Material and methodRandomised clinical trial consisting of two groups of patients. A control group with intradural anaesthesia and an intraoperative epidural catheter (ropivacaine) and an intervention group using the same anaesthetic technique and an intraarticular catheter with an elastomeric pump (ropivacaine+dexketoprofen). Data such as demographic, anaesthetic and surgical variables, pain intensity according to Verbal Rating Scale, opioid use and complications, joint balance, onset of walking and hospital stay were recorded. ResultsA lower incidence and severity on Verbal Rating Scale and a better control of postoperative pain (p<.0014) were observed in the intervention group. Joint balance also presented significant results in flexion and 74% of these patients started walking before the first 36h and the control group had not yet done so. Regarding patient satisfaction, 54.1% of the patients were “very satisfied” with the use of the catheter (p>.001). Finally, the hospital stay decreased significantly, with 33.3% of intervention group patients discharged within the first 48h compared to none of the control group. Discussion and conclusionsThe use of the intraarticular catheter as postoperative analgesia is a useful and safe alternative. It reduces the possibility of side effects. It helps in early improvement of joint balance, onset of walking and control of pain. All of which increase patient satisfaction and result in a shorter period of hospitalisation.