Developmental changes in compensatory responses to unexpected resistance of leg lift during gait initiation.

The development of the ability to integrate postural adjustments into the gait initiation process was investigated in children, using both kinematic and electromyographic (EMG) analysis. Subjects included children of 1 year of age (1-4 months' walking experience), 2-3 years of age (9-17 months' walking experience), 4-5 years of age (3-4 years' walking experience), and adults. We perturbed the balance of the children during gait initiation to determine the point at which infants begin to develop and finally master the ability to respond to external threats to balance during the gait initiation process. A magnet attached to the force platform on which the child stood was activated and served to resist the child's gait initiation (metal plaques on the soles of the shoes were attracted by the magnet) and thus served as an external perturbation during the gait initiation process. Kinematic and EMG analysis indicated that, while the ability to use preparatory postural adjustments in the gait initiation process emerges early in development, the ability to react efficiently to perturbations during gait initiation does not develop until after about 4-5 years of age. Though even the youngest age groups showed some response to the perturbation, it was highly variable, indicating its primitive form. The main response to the perturbation was a slight decrease in latency and increase in amplitude in the muscles used for push-off for gait initiation. Interestingly there was a shift in response pattern at 4-5 years of age, in both kinematic and EMG patterns. The amplitudes of the lateral and anteroposterior trunk and stance leg oscillations were significantly increased. In addition, the muscle response amplitudes (hamstrings and second quadriceps burst) of the swing leg were significantly increased and delayed (hamstring and gastrocnemius), with coactivation of agonist and antagonist muscles at the knee and ankle joint, concomitant with an exaggerated foot height of the first step.