Gait component changes observed during independent ambulation in young children.

The components of gait of the new independent ambulator can differ from that of the more experienced ambulator. The purposes of this review were to describe observable gait components exhibited at the onset of independent ambulation, the progression of changes in these components, and the time when a more mature pattern should be present consistently. Cross-sectional, longitudinal and single-recording studies, which analyzed children's gait at the onset of independent ambulation and followed changes in the components, were reviewed. Only components that can be observed by clinicians were included. The changes were reported as a function of time after independent ambulation onset or chronological age. The gait components evolved from (1) initial contact with toes, footflat or heel to consistent heel strike 1 y after independent ambulation onset or by 2.5 y of age, (2) a wide base of support to a narrower one 11 mo after independent ambulation onset or by 22 mo of age, and (3) upper extremities held in high guard position to reciprocal arm swing 11 mo after independent ambulation onset or by 3.5 y of age. Other components, such as the maintenance of squatted position and trunk flexion, were studied less extensively, but general descriptions are included. This review provides the length of time after independent ambulation onset or chronological age when the more mature form of a gait component should be present. The continued exhibition of a less mature form beyond these times may be indicative of a pathological gait pattern.