Physiological changes of walking rotation during development

Abstract

Background: Feet rotation during walking is a frequent worrying motive. Most of the time, it corresponds to physiological conditions and variations within the normal range. 

Objective: Evaluate the factors involved in walking on healthy children, according to physical examination performed by Staheli method and its correlation with symptoms. 

Method: Evaluation of 610 healthy children at Santiago - Chile; 10 cases were excluded due to previous orthopedic pathology. A questionnaire was applied, which included perinatal factors, previous pathologies and lower limb related symptoms. An anthropometric evaluation and specific physical examination of lower limb rotations was also performed. The data was statistically analysed. 

Results: 58% of cases presented neutral walking, 23% of children had convergent walking and 19% presented divergent walking. There is a direct relationship between age and type of walking, being convergent walking most frequent at lower ages, due to bigger hip anteversion and greater internal tibial torsion. The plane foot and metatarsus adductus do not influence lower limb rotation. Obese children presented divergent walking most frequently. There are no significant differences in terms of lower limb pain and walking alterations. 

Conclusions: Walking has a known natural history, with a wide normality range and most of the time, it solves spontaneously without the need of specific therapy.