The effect of visual environmental distraction on gait performance in children

Purposes of this study were to identify the effect of visual distraction on gait parameters in children, describe the role of walking experience in the management of a visual distraction while walking, and explore the relationship between performance in standardized testing and management of visual distraction while walking. Gait parameters as measured by the GAITRite system included: velocity, step length, step width, and double limb support percentage (DLS%) of gait cycle. The standardized test used was the mobility domain of the functional scale of the Pediatric Evaluation of Disability Inventory (PEDI). Forty-two participants completed data collection; 24 males and 18 females, age range 16 to 90 months (mean=43.2 months, standard deviation=22.9 months) combined normative standard score mean for the mobility domain of the functional scale of the PEDI was=46.77, standard deviation=9.85; mean score confirms that participants were typically developing children. Participants were divided into three groups for data analysis according to their WE: early walkers (6-11 months of WE), pre-school walkers (12-37 months of WE), and experienced walkers (38-79 months of WE). A 3x2 multivariate analysis of variance (MANOVA) assessed differences between groups (effect of WE) and within groups (effect of condition) on gait. The interaction between group (effect of WE) and condition (effect of visual distraction) was not significant, F(74)=0.612, p=0.765. However, significant main effects of WE group F(74)=5.300, p≤0.001 and visual distraction condition F(36)=2.586, p=0.053 were found. A MANOVA was followed with univariate F-tests (ANOVAs) to further assess differences in main effect of group and WE. The results of this study show that visual environmental distraction significantly affected gait performance in children. Visual distraction decreased velocity from 110.04 cm/sec to 97.73 cm/sec (p=0.003), and increased DLS% of gait cycle from 18.29% to 20.39% (p=0.025) in all children. Results suggest physical therapists need to consider attentional requirements when assessing gait; even in children with more WE. If attention to task is a limiting factor for performance or learning of a motor task, physical therapists may need to address the limitations in attention to task more directly. Future studies should include children with special needs and with a variety diagnoses. Special consideration may be needed for children whose diagnosis includes specific attention to task limitations, such as attention deficit disorder and autism.