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Updated: May 1, 2026
Postural Organization of Gait Initiation for Biomechanical Analysis Using Force Platform Recordings
Published on: July 26, 2022
Gait initiation in children with Rett syndrome
Ioannis Ugo Isaias1, Mariangela Dipaola2, Marlies Michi3
1Department of Neurology, University Hospital Würzburg, Würzburg, Germany; Department of Pathophysiology and Transplantation, LAMB Pierfranco & Luisa Mariani, University of Milan, Milan, Italy.
Insights
Girls with Rett syndrome exhibit impaired gait initiation due to disrupted anticipatory postural adjustments. This neurodevelopmental condition affects motor control, impacting the feedforward control of gait.
Area of Science:
- Neuroscience
- Developmental Biology
- Biophysics
Background:
- Rett syndrome is an X-linked neurodevelopmental disorder.
- Gait abnormalities are a key characteristic of Rett syndrome.
- Gait initiation involves complex, centrally mediated motor programs.
Purpose of the Study:
- To investigate anticipatory postural adjustments during gait initiation in girls with Rett syndrome.
- To compare motor control strategies between individuals with Rett syndrome and healthy controls.
- To identify specific impairments in gait initiation related to Rett syndrome.
Main Methods:
- Electromyography of tibialis anterior and soleus muscles.
- Measurement of ground reaction forces.
- Analysis of body kinematics during gait initiation.
Main Results:
- Girls with Rett syndrome demonstrated impaired temporal organization of anticipatory postural adjustments.
- Deficits in temporal scaling led to reduced forward propulsion and altered first step parameters.
- Abnormal muscle activation patterns, including disrupted synergistic activity, were observed.
Conclusions:
- Girls with Rett syndrome exhibit significant impairments in the feedforward control of gait initiation.
- The findings highlight a lack of accurate tuning in motor control mechanisms.
- This study provides insights into the motor deficits associated with Rett syndrome.
Abstract:
Rett syndrome is an X-linked neurodevelopmental condition mainly characterized by loss of spoken language and a regression of purposeful hand use, with the development of distinctive hand stereotypies, and gait abnormalities. Gait initiation is the transition from quiet stance to steady-state condition of walking. The associated motor program seems to be centrally mediated and includes preparatory adjustments prior to any apparent voluntary movement of the lower limbs. Anticipatory postural adjustments contribute to postural stability and to create the propulsive forces necessary to reach steady-state gait at a predefined velocity and may be indicative of the effectiveness of the feedforward control of gait. In this study, we examined anticipatory postural adjustments associated with gait initiation in eleven girls with Rett syndrome and ten healthy subjects. Muscle activity (tibialis anterior and soleus muscles), ground reaction forces and body kinematic were recorded. Children with Rett syndrome showed a distinctive impairment in temporal organization of all phases of the anticipatory postural adjustments. The lack of appropriate temporal scaling resulted in a diminished impulse to move forward, documented by an impairment in several parameters describing the efficiency of gait start: length and velocity of the first step, magnitude and orientation of centre of pressure-centre of mass vector at the instant of (swing-)toe off. These findings were related to an abnormal muscular activation pattern mainly characterized by a disruption of the synergistic activity of antagonistic pairs of postural muscles. This study showed that girls with Rett syndrome lack accurate tuning of feedforward control of gait.
