The concept of a typical gait pattern is researched and documented fairly well and as therapists, that’s what we are using to assess how your child is walking. This gives us clues on what areas we want to work on to improve those gait mechanics to make walking easier or more independent for your child.
We look for repeatability, symmetry, and the “ease” of the movement. Basically, both sides should look even in regard to how the legs and arms move as well as symmetry in foot placement. Also, in book terms, it should be “energy efficient” which just means that it should feel and look easy and should be able to be maintained for long periods of time.
While there’s one “typical” version of gait, there are a bunch of different types of “abnormal” gait patterns; however, I’ll focus on the three most common ones that we tend to see here at NAPA.
Ataxic gait is where our kids have difficulty with coordination and balance and tends to be caused by a neurological disorder. Think about how difficult it would be for you to walk across a boat that is rocking in the water and that’s how these children walk on a flat surface.
Ultimately, there are difficulties in their dynamic balance and motor coordination that then impacts their attempts and ability to walk by themselves.
Trendelenburg gait is primarily due to weakness in a child’s gluteal (or bottom) muscles, which can be from a variety of reasons, and can be concurrent with another type of atypical gait pattern, or can be by itself.
Physical therapists identify trendelenburg gait when a child demonstrates a “hip drop”. If you were to freeze frame a child walking when they are on one leg and the other is in the air, the hip of the leg that is lifted would be lower than the hip of the standing leg. While this is primarily due to a weakness in the muscle, it could also relate to some difficulties in balance as well as coordination.
A scissoring gait pattern is when the child is placing the next leg in front, it is crossing over the “midline” or center of their body. Usually this is due to a child having hypertonicity or spasticity that affects their muscle length and alignment, primarily on the inside of their legs.
Additionally, since their base of support is typically fairly narrow, these children usually have some difficulties with their balance and usually prefer to hold onto either an adult or furniture for stability.
Now, while your little one may be a quick mover, physical therapists are trained to quickly and efficiently pick up on these various gait deviations to be able to determine the best course of action to help your little one achieve their goals! So, if you ever see us stand back for a moment to observe your child, know that this is what we are observing. Should you want tips on what you can do at home to help your child on top of what your physical therapist has already prescribed, head over to see our blog post on “Physical Therapy Exercises for Gait and Balance”.
Kayla Darnbrough received her DPT from USC and is based at the NAPA Center in Los Angeles. She’s always had a heart for working with kids and loves figuring out the best way to motivate the little ones! When not at the clinic, she is either reading a book, snuggling with her cats, or trying a new cooking recipe with her fiancée.
At NAPA, we take an individualized approach to therapy because we understand that each child is unique with very specific needs. For this reason, no two therapeutic programs are alike. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.
