Related Experiment Video
Updated: Jul 2, 2026
Sit-to-stand-and-walk from 120% Knee Height: A Novel Approach to Assess Dynamic Postural Control Independent of Lead-limb
Published on: August 30, 2016
The relationship between step variability, muscle strength and functional walking performance in children with
Michal Katz-Leurer1, Hemda Rotem, Ofer Keren
1Alyn Children's Orthopedic Hospital and Rehabilitation Center, Jerusalem, Israel. michalkz@post.tau.ac.il
Insights
Children with traumatic brain injury (TBI) show greater step variability and lower muscle strength than typically developed peers. These factors impact walking performance differently in TBI survivors versus typically developed children.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Biomechanics
Background:
- Traumatic brain injury (TBI) in children can lead to long-term motor deficits.
- Understanding gait variability and muscle strength is crucial for assessing functional recovery post-TBI.
Purpose of the Study:
- To examine the relationship between step variability, muscle strength, and walking performance in children with TBI compared to typically developed (TD) children.
- To identify differences in these associations between the two groups.
Main Methods:
- Cross-sectional study comparing 16 children post-TBI with 16 age- and sex-matched TD children.
- Utilized an electronic walkway for step variability measures (step length and time).
- Assessed lower-extremity muscle strength with a hand-held dynamometer and functional walking with the 2-minute walk test.
Main Results:
- Children post-TBI exhibited significantly greater step time and length variability and poorer 2-minute walk test performance compared to TD children.
- TD children demonstrated higher muscle strength in knee extensors and hip abductors.
- Inverse correlation between 2-minute walk test and step variability was found only in children post-TBI, while positive correlation with muscle strength was observed only in TD children.
Conclusions:
- Gait variability and muscle strength are significantly affected by TBI in children.
- The relationship between gait parameters, muscle strength, and walking performance differs between children post-TBI and TD children, highlighting the need for tailored rehabilitation strategies.
Abstract:
The objective of this study was to investigate the association between step variability, muscle strength and functional walking performance in children post-traumatic brain injury (TBI) and typically developed (TD) children. A convenience sample of 16 children post-TBI and 16 TD age and sex matched controls participated in this cross sectional study. The main outcome measures included step length and step time variability, measured with an electronic walkway, strength of four lower-extremity muscle groups, tested bilaterally with a hand held dynamometer, walking performance as assessed by the 2-min walk test, energy expenditure index (EEI) and rating of perceived exertion (OMNI scale). Significant differences were found in walking parameters between the groups (e.g., 2-min walk test: TBI 109+/-31 compared to TD 168+/-19 m). Children post-TBI had significantly greater variability in step time and step length in comparison to TD controls (e.g., step length variability: TBI 16.3+/-13.6 compared to TD 4.9+/-2.0). TD children had significantly higher mean strength values than children post-TBI in the knee extensor and hip abductor muscle groups (p<0.05). The 2-min walk test correlated inversely with the step time and length variability only among children post-TBI while muscle strength values correlated positively with the 2-min walk test only in TD children. This study found that step time and length variability and lower-extremity muscle strength correlated differently to distance covered during the 2-min walk test among children post-TBI and among TD children.
