Development of postural adjustment during gait initiation: kinematic and EMG analysis.

The authors studied the development of postural adjustments associated with the initiation of gait in children by using kinematic and electromyographic (EMG) analysis. Participants (N = 28) included infants with 1-4 and 9-17 months of walking experience, children 4-5 years of age, and adults. Anticipatory postural adjustments (APA) were present in the youngest age groups, including a clear anticipatory lateral tilt of the pelvis and the stance leg, which enabled the child to unload the opposite leg shortly before its swing phase. An anticipatory activation of the hip abductor of the leg in stance phase prior to heel-off was found, suggesting pelvis stabilization. APA did not appear consistently until 4-5 years of age. A decrease in segmental oscillations occurred across the ages, indicating better control of intersegmental coordination in the frontal and sagittal planes during the postural phase of gait initiation. Young walkers presented APA involving movements of both the upper and the lower parts of the body, whereas, like adults, 4- to 5-year-olds were able to laterally shift only the pelvis and the stance leg. The oldest children and the adults also showed lower activation levels of hip and knee muscles but higher activation at the ankle level. Those kinematic and EMG results taken together suggest a clear developmental sequence from an en bloc operation of the body through an articulated operation with maturation, walking experience, or both.