Part 1. Gait analysis in typically developed children: Differences in gait and balance characteristics during self paced gait between over ground VICON 3D motion capture system and the CAREN system.

Threedimensional gait analysis is routinely used in regular evaluation and
planning of treatment of children with mobility problems such as cerebral palsy
and spina bifida. It has been shown that children with CP have to deal with
high variability in trunk balance [34]. This variability in trunk balance
demands extra effort and energy consumption. Abnormal fatiguiing during walking
and falling is a major problem in these affected children. A stable gait
pattern is thus essential, as it provides an efficient energy consumption (less
fatigued) and it reduces the chance to fall.

The traditional gait analysis system (VICON 3D motion capture system) uses
selfpaced overground walking. Recently, a new system has become available at
MUMC+; Computer Assisted Rehabilitation Environment (CAREN), which combines the
VICON 3D motion capture system with a split belt treadmill and a virtual
reality environment. This system enables to analyse several successive steps.
In addition CAREN allows us to give real time feedback, providing and provides
various training possibilities (e.i. gaming), which makes it attractive for
children. For these reasons, we like to use CARENaren for gait analysis in
children with mobility problems.

Only few studies are done comparing both systems, showing small differences in
gait. However most of these studies focused on adults, and studies withon
children are scarce.

To compare gait and balance measured by the traditional 3D gait analysis system
(VICON) and by the new system including a treadmill and a virtual environment
(CAREN) during self- paced walking in typically developed children. In
addition, a reference database for gait and balance characteristics of
typically developed children of different age ranges is created for both
systems, which will be used to interpret deviations in gait of children with
cerebral pareses and spina bifida.

A comparative , cross- sectional propespective, single center pilot study on
typically developed children of different ages. The composed age groups are
based on known gait development phases throughout childhood. In each age group
(3-4 years, 5-6 years, 7-8 years, 9-10 years,11-12 years, 13 years and older)
10 children will be included. The choice for these age ranges and the amount
subjects relies on several assumptions: The walking speed increases in children
with 10% per 2 years. Literature shows that a sample size of 10 children per
age range provides reproducible outcomes. In addition, the number of
participants is matched with the availability of the VICON lab and the CAREN
lab.
Inclusion criteria: ambulatory, ability to walk without aid for 60 minutes and
age between 3-14 years.
Exclusion criteria: Acute and/or chronic muscular skeletal disorders,
interventions such as surgical treatment or botulinium toxin 6 months prior to
the assessment, severerious pes plano valgus, leg length difference > 1cm,
scoliosise with Cobbse angle >10°, parents or caregivers who are not proficient
in the Dutch language.

The risk of gait analysis is negligible. During the CAREN measurement, a safety
harness is worn which provides protectsion against falling. The safety harness
is secured with a life- line to the ceiling. The burden for the children is
minimal. There is however a time burden. From start till endThe whole analysis
will take approximately 2 hours. Parents will receive compensation for
travelling expenses. The children will receive a present (+/- 5 euros) for
participation.