Relationship between newborn stepping and later walking: a new interpretation.

The relationship between newborn stepping and later walking was examined by means of new kinematic and electromyographic data. Stepping movements of a group of 18 normal infants were compared at one and two months of age, at one and two months before the first independent steps, and at the month when these first steps occurred. Stepping in the first month was characterized by tight synchronization of hip, knee and ankle movements, but as early as two months the ankle-joint began to move out of phase with the hip and knee. Before independent walking a more adult-like pattern continued to emerge, with the knee leading the hip in flexion. However, with the onset of walking, primitive characteristics of newborn stepping remained, including ankle hyperextension at the end of the step, hyperflexion of the hip and knee and excessive muscle activation. These results suggest that mature walking may evolve from the newborn stereotyped movement pattern. It is suggested that these gradual changes in the organization of the step are evoked by the dynamic functional demands of upright locomotion, in addition to balance, postural control and strength development in the first year of life.