What Are Gait Abnormalities?
Gait abnormalities refer to atypical patterns of ambulation resulting from neuromuscular, musculoskeletal, or developmental impairments.
Common pediatric gait deviations include:
- Toe-walking (equinus gait): Persistent forefoot walking.
- In-toeing (pigeon-toed): Medial rotation of the lower limb segments (e.g., femoral anteversion, tibial torsion).
- Out-toeing: Lateral rotation often due to femoral retroversion or external tibial torsion.
- Antalgic gait: Altered walking pattern due to pain or discomfort.
- Clubfoot (Talipes Equinovarus): Congenital deformity involving foot plantarflexion, inversion, and adduction.
What Does Difficulty In This Area Look Like?
- Altered Step Pattern
Asymmetry in step length, width, or timing, irregular foot placement or lack of heel strike. - Reduced Gait Efficiency
Increased energy expenditure during walking; quick fatigue or inability to keep up with peers. - Decreased Joint Range of Motion (ROM)
Limited ankle dorsiflexion (e.g., in toe-walking), hip rotation anomalies (e.g., in-toeing/out-toeing). - Muscle Imbalances
Tight or overactive gastrocnemius-soleus complex (toe-walking); weak hip abductors or external rotators. - Abnormal Postural Alignment
Pelvic tilt, knee valgus/varus, or foot pronation/supination contributing to compensatory gait patterns. - Delayed Gross Motor Skills
Difficulty with running, jumping, or stair negotiation secondary to inefficient gait mechanics.
How Can PT Help Build These Skills?
- Gait Training and Patterning
Use of neuromuscular re-education, pre-gait activities, visual/auditory cues, and manual facilitation to promote normalized gait cycles. - Stretching and Range of Motion Exercises
Targeted flexibility programs to address joint restrictions (e.g., Achilles tendon in toe-walking). - Strengthening Programs
Emphasis on lower limb and trunk muscles (e.g., dorsiflexors, hip external rotators) to support proper alignment and control. - Neuromuscular Re-education
Retrains appropriate muscle activation and timing during the gait cycle using functional tasks. - Orthotic and Assistive Device Recommendations
Prescribes ankle-foot orthoses (AFOs), shoe inserts, or supportive footwear as needed for alignment and stability. - Parent/Caregiver Education and Home Programs.
- Teaches exercises, stretches, and functional mobility strategies for consistent reinforcement outside of therapy sessions.