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Gait kinematics during walking in children with impaired binocular vision due to amblyopia or strabismus
Lauren E Hoare1, Krista R Kelly1
1School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada.
Insights
Children with amblyopia or strabismus exhibit variable and inaccurate walking patterns. This suggests an immaturity in gait development due to unbalanced visual input early in life.
Area of Science:
- Ophthalmology
- Neuroscience
- Biomechanics
Background:
- Impaired binocular vision from amblyopia or strabismus is linked to poorer motor ability scores.
- Standardized tests may not fully capture motor deficits, necessitating gait kinematic analysis.
Purpose of the Study:
- To investigate gait kinematics in children with amblyopia or strabismus.
- To compare gait patterns between children with visual impairments and controls.
Main Methods:
- Gait kinematics were analyzed using a GAITRite® walkway in children aged 7-13 with amblyogenic factors (amblyopia or strabismus group) and controls.
- Three walking conditions were tested: Straight Walk, Isolated Target Walk, and Distractor Target Walk.
- Gait parameters included velocity, cadence, step time, stance time, step length, step width, step accuracy, and variability (coefficient of variation).
Main Results:
- No significant differences in typical mean gait kinematics were observed between the amblyopia/strabismus and control groups.
- The amblyopia/strabismus group missed more targets and demonstrated increased gait variability (higher COV).
- Children with amblyopia or strabismus showed a lack of learning effects during target-based walking tasks compared to controls.
Conclusions:
- Unbalanced visual input in early life leads to variable and inaccurate walking patterns in children.
- Gait kinematic analysis reveals subtle motor deficits and an immaturity in gait development associated with amblyopia or strabismus.
Abstract:
Impaired binocular vision early in life from amblyopia or strabismus is related to lower scores than controls for walking on standardized tests of motor ability. However, standardized tests do not assess gait kinematics, which may provide a better understanding of motor deficits. This study investigated gait kinematics while walking in children with amblyopia or strabismus. Children ages 7-13 years with amblyogenic factors (13 anisometropia, 8 strabismus) were enrolled in the amblyopia or strabismus (AS) group (15/21 had current amblyopia). An age-similar group of 33 controls with normal vision were also enrolled. While viewing binocularly, children walked on a GAITRite® pressure-sensitive walkway and completed 3 conditions: 1) Straight Walk (SW): walk on mat, 2) Isolated Target Walk (IT): walk and step on two-dimensional targets, and 3) Distractor Target Walk (DT): walk and step on two-dimensional targets while avoiding two-dimensional distractors. Gait kinematics were mean normalized velocity, cadence, step time, stance time, step length, step width, and step accuracy (# targets missed, # distractors stepped on). Variability in gait kinematics was also examined using the coefficient of variation (COV). Typical mean gait kinematics did not differ between the AS and control groups. However, the AS group missed more targets, showed increased variability (higher COV), and lacked any learning effects compared to controls. Unbalanced visual input early in life from amblyopia or strabismus results in variable and inaccurate walking patterns, pointing to an immaturity of gait development.
