Influence of speed variation and age on the asymmetry of ground reaction forces and stride parameters of normal gait in children.

The purpose of this study was to assess the influence of age and speed on the asymmetry of ground reaction forces (GRFs) and spatiotemporal parameters (STPs) during normal gait in 4- to 10-year-old children. Forty-seven children walked at three speeds on a treadmill dynamometer (ADAL; Tecmachine, Andrézieux Bouthéon, France). Thirty steps were recorded at each speed for each foot for each child. The GRF and stride parameters were normalized to body weight and to body height, respectively. A left-right symmetry index (SI) was calculated for each parameter. The influence of both age and speed on the different SI was examined with a two-way analysis of variance. GRF and STP were asymmetric (SI ranged from +/- 1.92% to +/- 45.05%). The SI of forces Fz1 and Fy1 are negative in children aged 4-6 years, indicating that left Fz1 and Fy1 are higher than right Fz1 and Fy1. The cross effect of age and speed on the asymmetries of gait parameters was not significant There was no significant effect of age on the asymmetries of vertical GRF and STP. The asymmetry of vertical propulsive force (Fz3) alone increased with the speed (P < 0.05). This study showed that the different tasks performed by the lower limbs could be responsible for the asymmetry of GRF and STP in children aged 4-6 years. It also shows that upper and lower limits of normal asymmetry of gait parameters are different. Therefore no single criterion value can be used to assess the symmetry of several gait parameters. The small values of upper and lower limits of symmetry indices of vertical forces and stride duration show that the symmetry indices of these variables are reliable measurements and should thus be used in symmetry analysis of gait in normal and disabled children.