RESEARCH REPORT PLATFORM PRESENTATION

DEVELOPMENTAL TRENDS IN TEMPORAL AND SPATIAL PARAMETERS RECORDED BY THE GAITRITE IN CHILDREN 4-14 YEARS. Alderson L^1,2, Watson T¹, Eleanor M^2,3; ¹University of Hertfordshire, Hatfield, UK. ²Physiotherapy Department, Great Ormond Street Hospital, London, UK. ³Institute of Child Health, University College London, UK

PURPOSE: Temporal and spatial measurements of gait in children have the potential to quantify important clinical changes associated with recovery or therapy. However, measurements in the clinical environment rely on a clear understanding of normal developmental gait changes during growth. Recent advances in electronic walkways such as the GAITRite provide an accessible way for physiotherapists to measure gait in a clinical setting. The purpose of this study was to investigate developmental trends in velocity, cadence, step length, and single and double support in children between 4-14 years. RELEVANCE: There are currently no widely used, acceptable and accurate measures of gait in a paediatric clinical setting. While there is some normative data in children from sophisticated gait laboratory equipment, normative paediatric data for the GAITRite walkway is sparse. PARTICIPANTS: 137 children aged 4-14 years with no neurological or musculoskeletal conditions were recruited from local schools (59% boys). The first ten children in each school year group who returned signed parental consent were included. METHODS: The children walked across the GAITRite walkway (5mx1m) three times at each of three speeds: preferred, fast and slow. One practice trial was permitted. Preferred speed was always recorded first to ensure children had established a reference speed. Footfalls were automatically recorded by GAITRite software and edited following the prescribed protocol in the handbook. ANALYSIS: Gender and left-right differences were assessed using t-tests and paired t-tests respectively. Children were stratified into five age groups (4-5yrs n=29; 6-7yrs n=22; 8-9yrs n=32; 10-11yrs n=28; 12-14yrs n=26). A one-way ANOVA was used to explore age group effects on velocity, step length, cadence, single and double support. Planned contrasts were completed to evaluate differences between specific age groups. RESULTS: Velocity and step length increased significantly with age (p < 0.001) at all three speeds. Cadence reduced significantly with age at preferred and fast speeds only (p < 0.001); with the most significant changes occurring in the youngest three groups (4-9 years) at preferred speed, and the oldest three groups (8-14 years) at fast speed. Double and single support (percent of gait cycle) showed no significant age effects except for left single support at slow speed (p = 0.05), which was significantly shorter than the right (p = 0.05). There were no significant gender differences. CONCLUSIONS: The increase in velocity and step length can be explained by an increase in leg length with growth. However both cadence and normalised velocity (divided by leg length) decrease with age, demonstrating that walking in older children is made more efficient by an increase in stride length and fewer steps per minute. This study shows that between 8-11 years cadence approaches adult norms with inter-subject variation continuing to reduce up to 14 years. Walking speeds had different effects on both cadence and single support, which reinforces the importance of using more than one speed in gait assessment. IMPLICATIONS: This study demonstrates that the GAITRite is an accurate yet relatively inexpensive way to measure temporal and spatial gait changes associated with development. Understanding these changes will facilitate the assessment of therapeutic efficacy and natural recovery in children with walking and balance difficulties. KEYWORDS: Walking, Measurement, Child development. FUNDING ACKNOWLEDGEMENTS: This study was completed as part of a PhD, which was funded by the Health Foundation and Great Ormond Street Hospital. CONTACT: alderl@gosh.nhs.uk

ETHICS COMMITTEE: Barnet and Enfield Research and Ethics Committee, London