From the Guidelines
This sideways forward motion during a child's gait is likely a normal developmental variation in walking patterns, and if the child is otherwise developing normally and has no pain, it usually requires no treatment. The motion occurs when the child swings one leg in a slight arc rather than bringing it straight forward, creating that sideways appearance. This pattern commonly develops as children learn to balance and coordinate their movements, particularly when transitioning from early walking stages. Children typically develop a mature walking pattern by age 7, so this movement often resolves naturally without intervention 1.
If the circumduction is pronounced, persists beyond age 7, appears asymmetrical (affecting only one side), or is accompanied by pain or other developmental concerns, consultation with a pediatrician or pediatric physical therapist is recommended. They can assess whether the pattern represents a normal developmental variation or indicates an underlying issue requiring attention, such as cerebral palsy, which is a clinical diagnosis based on a combination of clinical and neurological signs 1.
Some key points to consider when evaluating a child's gait include:
- The presence of other developmental delays or concerns
- The presence of pain or discomfort during walking
- The symmetry of the gait pattern
- The presence of other neurological signs, such as spasticity or weakness
- The child's overall developmental progress and medical history 1.
It is essential to prioritize the child's morbidity, mortality, and quality of life when evaluating and managing their gait pattern, and to consider referral to a pediatric specialist if there are concerns about the child's development or gait pattern 1.
From the Research
Gait Abnormalities in Children
- The described gait pattern of a child stepping forward with one foot, creating a slight sideways forward motion, may be indicative of an underlying condition such as cerebral palsy 2, 3.
- Cerebral palsy is a common disability in children, characterized by spasticity, which can affect gait patterns 2.
- Studies have shown that botulinum toxin injections can be effective in reducing spasticity and improving gait patterns in children with cerebral palsy 3, 4.
Assessment of Gait Abnormalities
- Observational gait assessment tools, such as the Edinburgh Visual Gait Score (EVGS), can be used to assess gait patterns in children with cerebral palsy 5.
- The EVGS has been found to have better reliability and validity than other observational gait tools, making it a useful tool for assessing gait patterns in children with cerebral palsy 5.
- Age-related gait standards, such as the GOS-ICH paediatric gait centiles, can also be used to assess gait patterns in healthy children and young people, and may be useful in identifying abnormalities in gait patterns 6.
Treatment of Gait Abnormalities
- Botulinum toxin injections, combined with physical and occupational therapy, and neuromuscular electrical stimulation, have been shown to be effective in improving gait patterns in children with cerebral palsy 4.
- The use of botulinum toxin injections, in particular, has been found to be effective in reducing spasticity and improving gait patterns in children with cerebral palsy 3.