presented by Kathy Martin
In order to understand how to appropriately plan interventions for children with gross motor delays, physical therapists must first understand typical development. Peer reviewed data regarding the maturation of typical gait will be discussed. Contemporary motor learning theory related to skill practice will be discussed as a framework for consideration of interventions to improve gait maturation in children with gross motor delays. Several intervention activities will be demonstrated that may improve gait skill.
Dr. Martin received a BA in Athletic Training from Purdue University in 1987, an MS in Physical Therapy from the University of Indianapolis in 1990, and a Doctor of Health Science from the University of Indianapolis in 2003. She joined the faculty of the Krannert School of Physical Therapy at the University of Indianapolis in 2000, and is currently a Professor. Her clinical background includes early intervention and inpatient pediatric general acute care. Dr. Martin teaches the pediatric portion of the DPT curriculum, and her research efforts have been focused on orthotic effectiveness, and children with Down syndrome. Dr. Martin is currently the Chair of the Education Committee for the Academy of Pediatric Physical Therapy and has been actively involved in identifying best practices in pediatric physical therapy professional education. She is also the 2008 winner of the Indiana Chapter of the APTA Frances Ekstam Award for outstanding contribution to the physical therapy profession.
This chapter will review gait lab data on the characteristics of gait in toddlers and young children. Key differences from adult (mature) gait will be described. General time lines for maturation of gait will also be reviewed.
This chapter will review the key differences between immature toddler gait and mature adult gait. This will include gait lab data on spatial temporal characteristics and EMG data for muscular activities. Sutherland et al's statistical analysis of the characteristics of mature gait will also be discussed.
This chapter will review several theories on motor development and motor learning and apply them to the development and maturation of independent gait. The work of Dr. Karen Adolph (with typically developing children) will be reviewed for context on the role of practice for development of gait.
The first 3 chapters discussed typical development of independent gait, and in this chapter that information will be applied to clinical practice. Intervention activities will be suggested for children who are delayed in achieving independent gait.