Strategy adoption and lomocotor adjustment in obstacle negotiation in toddlers with typical development and at risk for cerebral palsy.

This study investigated the development of adaptive gait of toddlers in obstacle negotiation. Three groups were studied: toddlers with typical development (TD, N = 9), toddlers at risk for cerebral palsy without treadmill training (RC, N = 5), and toddlers at risk for CP who received treadmill training (RE, N = 5). Infants at risk for CP were recruited at about 9 months of age and randomly assigned to either RC or RE group. A home-based treadmill training was provided for the RE group until the child walked 3 steps independently (walking onset). Then, at about 1 and months after walking onset, all three groups were brought into our lab to collect gait data. A 5-cm-high obstacle was placed perpendicular to the travel path on the floor at Visits 1 and 2, and was also raised to 10% of the child's leg length at Visit 2. All the trials were recorded with a video camera. A GaitRite mat was used to record footprints and to calculate spatiotemporal gait variables (step length, step width, and step time). Results showed that all three groups preferably walked over the obstacle starting at Visit 1. However, in terms of the second preferred strategy at Visit 1, the TD group tried to step over the obstacle but failed, whereas both RC and RE groups equally crawled or fell over the obstacle. Also at Visit 2, all three groups decreased step length sequentially in the three steps prior to the obstacle, and then increased step length and step time for the leading foot crossing the obstacle (all p 0.05). However, such locomotor adjustment patterns were observed only in TD and RE groups at Visit 1. These preliminary results suggest that all three groups are able to predominately walk over the obstacle at 1 month after walking onset, and produce locomotor adjustment while negotiating an obstacle at 4 months after walking onset. Furthermore, treadmill training appears to facilitate earlier development of locomotor adjustment in obstacle negotiation in infants at risk for CP. [ABSTRACT FROM AUTHOR]