Albesher Reem A, McGinley Jennifer L, Dobson Fiona L, Mentiplay Benjamin F, FitzGerald Tara L, Cameron Kate L, Cheong Jeanie L Y, Spittle Alicia J
Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia.
Department of Physiotherapy, University of Melbourne, Melbourne 3010, Australia.
Children (Basel). 2025 Sep 19;12(9):1261. doi: 10.3390/children12091261.
BACKGROUND/OBJECTIVE: The gait pattern of children born very preterm shows gait decrements compared to their full-term peers in dual-task walking. It is essential to identify children at a higher risk for these gait deficits. The aim of this study was to compare spatiotemporal gait variables in preschool-age children born very preterm at risk for developmental coordination disorder (DCD) with those not at risk.
Preschool-age children born < 30 weeks' gestation. Risk for DCD was defined as (i) ≤16th percentile on the Movement Assessment Battery for Children-Second Edition, (ii) ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, and (iii) without cerebral palsy. Spatiotemporal gait variables and variability were assessed using GAITRite during preferred speed, cognitive and motor dual-task, and tandem conditions. Variables included speed (cm/s), step time (s), cadence (steps/min), step length (cm), base of support (BOS; cm), and single and double support time (%gait cycle).
Of 111 children who were assessed, 26 children were classified as at risk for DCD. Most gait variables were similar between groups at preferred speed walking. Children at risk for DCD had wider BOS and shorter single support time in motor dual-tasking (mean difference [MD] = 0.86 cm, 95% confidence interval [CI] 0.10, 1.61; MD = -1.77%, 95% CI -3.36, -0.19) compared to those not at risk. Similarly, wider BOS and higher cadence were found when tandem walking (MD = 0.63 cm, 95% CI 0.07, 1.20; MD = 0.63 steps/min, 95% CI 0.07, 1.20).
Children born very preterm at risk for DCD had poorer walking performance than those not at risk for DCD at preschool age, especially during dual-task situations. Clinicians may incorporate complex gait assessments into early evaluations to detect subtle impairments in children. Future research is needed to investigate the impact of gait variability on children's daily lives and participation in sports activities.
背景/目的：与足月儿同龄人相比，极早产儿在双任务行走时的步态模式存在缺陷。识别这些步态缺陷风险较高的儿童至关重要。本研究的目的是比较有发育协调障碍（DCD）风险的极早产学龄前儿童与无此风险儿童的时空步态变量。
孕龄小于30周的学龄前儿童。DCD风险定义为：（i）在《儿童运动评估量表第二版》中处于≤第16百分位；（ii）在《韦氏学龄前及初小儿童智力量表第四版》中≥80分；（iii）无脑瘫。使用GAITRite在偏好速度、认知和运动双任务以及串联条件下评估时空步态变量和变异性。变量包括速度（厘米/秒）、步时（秒）、步频（步/分钟）、步长（厘米）、支撑面（BOS；厘米）以及单支撑和双支撑时间（%步态周期）。
在接受评估的111名儿童中，26名儿童被归类为有DCD风险。在偏好速度行走时，两组之间的大多数步态变量相似。与无风险儿童相比，有DCD风险的儿童在运动双任务中支撑面更宽，单支撑时间更短（平均差[MD]=0.86厘米，95%置信区间[CI]0.10，1.61；MD=-1.77%，95%CI-3.36，-0.19）。同样，在串联行走时也发现支撑面更宽且步频更高（MD=0.63厘米，95%CI0.07，1.20；MD=0.63步/分钟，95%CI0.07，1.20）。
有DCD风险的极早产儿童在学龄前的行走表现比无DCD风险的儿童差，尤其是在双任务情况下。临床医生可将复杂的步态评估纳入早期评估，以检测儿童的细微损伤。未来需要研究步态变异性对儿童日常生活和参与体育活动的影响。
