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Gait Assessment and Management


Normal development of walking in the developing child is varied, however follows a typical pattern:

  9 months: Stands holding on  
  10 months: Pulls to standing       
  12 months: Walks with assistance. Concern if not walking by 18 months.
  15 months: Walks unaided.
  18 months: Runs.

2 years: Goes up and down stairs without assistance.

  2.5 years: Jumps. Walks on tip toes. Concern if cannot jump by school age.
  3 years: Stands on one foot (few seconds). Goes up stairs 1 foot per step, comes down 2 feet per step. 
  4 years: Hops. Goes up and down stairs like an adult. Heel and tiptoe walk.
  5 years: Skips.
  7 years: Balance on one foot for 20 seconds.

When babies first learn to walk they walk with legs far apart and arms up in the air. As they continue to practice their legs comes closer together and their arms come down. Babies fall many, many times when first learning to walk and they also walk a lot. Typical 12- to 19-month-olds averaged 2368 steps and fell 17 times/hour.

Children sometimes walk with toes turned in or out and may trip and fall often. There are many reasons as to why this is happening from muscle weakness to a torsion/twist of the bone or just part of normal gait development.

A thorough knowledge of typical and atypical gait patterns is needed to assess a child’s gait and any potential for red flags. We perform Gait Assessments for children with neuromuscular impairments such as Cerebral Palsy. We use videotaping of the child walking with and without orthotics and walking aides. Then we analyze their gait pattern frame by frame. Measurements are taken and a plan of action recommended. Making adjustments to the orthotics and shoes have a tremendous impact to how the child walks.

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