a happy cerebellum = better learning

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We are not sure how many of these (little) guys you treat, but this article is germane.

4 hours per day, 5 days per week. It takes time to recannalize (or re create) new (or rejuvenate old) neurological pathways.

"After only two weeks, the children in the experimental group demonstrated a significant increase in locomotor and object control skills and in gross quotient (a composite measure of both skills categories). Participants’ locomotor improvements plateaued between weeks four and eight, and object control skills improved during the first two weeks but demonstrated nonsignificant changes between weeks two and four, four and six, and six and eight. A significant gain in locomotor skills also occurred between weeks four and eight."

...and don't forget about the "neurological windows" we are always talking about. Aggressive, early intervention is indicated

"Early childhood is a sensitive time in development, and motor researchers have an opportunity to improve motor skills very early—even as young as 2 years, said Ketcheson. Early intervention may give children with ASD the ability to play and interact in age-appropriate ways with their peers entering kindergarten. Early intense motor skills instruction within a CPRT framework can be a valuable addition to practitioners’ intervention strategies aimed at improving social success for children with ASD, she said."

Get them up, get them moving!

Lessons in Gait from Autistic Kids

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“Additionally, there is the potential for the cerebellum, which receives sensory information and regulates movements, to have a level of dysfunction as well. Viewed collectively, the potential key contributors for gait asymmetry originate in the brain and specifically, the motor-controlling functions of the brain.” 

“While there is still little known regarding gait impairments in children with ASD, our findings illustrate that gait descriptors may provide insight into furthering working knowledge of ASD and may even enable gait-related symptoms to be treatable through therapies and interventions” 

“Alternative hypotheses suggest that children with ASD exhibit dysfunctional segregation of the motor cortex, which may be the key to uncoordinated movements” 

We often say that "gait is a fingerprint". Gait symmetry is often considered a window to neurologic function. We like to think "normal" gait has minimal asymmetries, while pathological gait does not. 

These are two landmark studies of gait in children with autism spectrum disorder. There were significant kinetic and kinematic differences in gait patterns in the 3 cardinal planes (saggital, coronal and transverse)  in ankle, knee and hip mechanics: The "pattern" is that there is no pattern, only changes. If you have a little time, check out this free, full text article here.

What this article says to us is that

  • We should be looking more carefully at gait asymmetries realizing that
    • These asymmetries are most likely cortical/cerebellar phenomena implying
  • Gait dysfunction equals cortical/cerebellar dysfunction

As clinician's, we should be thinking of altered gait as a window to what is going on north of the feet, knees, hip and pelvis. We remember that the joint and muscle mechanoreceptors feedback to the cerebellum and cortex via the spinocerebellar and dorsal column pathways which feed forward to the lower extremities via the anterior spinous cerebellar pathway as well as cortical spinal, rubrospinal had vestibula spinal pathways. The cortex, particularly the motor portion, has the capacity to alter gait just as abnormal mechanoreception has the capacity to alter cortical and cerebellar function. The two are interrelated and inseparable. Changes over time will altered pathways due to neural plasticity and adaptations will occur.

We need to be prudent and examined people fully and be very careful as to the modalities and exercises that we utilize and prescribed as ultimately they will shape that patients neural architecture.

 

 

Eggleston JD, Harry JR, Hickman R, Dufek JS. Analysis of gait symmetry during overground walking in children with autism spectrum disorder. Gait Posture 2017;55:162-166. 

Dufek JS, Eggleston JD, Harry JR, Hickman R. A comparative evaluation of gait between children with autism and typically developing matched controls. Med Sci 2017;5:1.  link to free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635776/

 

Gait and the Autism issue.

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One more possible piece to the autism issue.
 

In this study, researchers discovered that between the first and 2 years of age, the brain networks linked to walking change. 
"At 12 months, stronger connections between the brain’s motor and default-mode networks were associated with better walking and gross motor skills. By 24 months, brain networks linked to attention and task control also had become engaged in walking and gross motor skills, the research shows."

Scientists have identified brain networks involved in a baby's locomotion systems, and they feel this discovery may help predict autism risks. As this study indicates, building on prior research showing those infants who show skill development delays in coordination and movement are more likely to indicate risk for autism spectrum disorder. The researchers believe they have discovered a root cause in the "default-mode network", a network thought to be very involved in developing one’s own sense of self. The researchers feel it is possible that the brains of children who go on to develop autism are not as adept at making those network connections and processing that data.

“Walking is a huge gross motor milestone, and it’s associated with a child’s understanding of his or her own body in relation to the environment,” said first author Natasha Marrus, an assistant professor of child psychiatry at Washington University School of Medicine in St. Louis.

“Understanding the early development of functional brain networks underlying walking and motor function in infancy adds critically important information to our understanding not only of typical development but also of a key deficit that appears early in the development of a number of neurodevelopmental disorders, such as autism,” says Joseph Piven.

“When a child first learns to walk, a big breakthrough involves just putting one foot in front of the other and learning to control one’s limbs,” Marrus says. “As walking improves, it’s possible the child may begin to think, ‘Where, exactly, do I want to put my foot?’ Or, ‘Do I need to adjust my position?’ And by becoming more or less active, the default-mode network, along with other networks, may help process that information."

Read the original source article here,
http://www.futurity.org/learning-to-walk-autism-1626792-2/

Podcast 48: Running Tech, Cadence and Running Shoes

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Podcast 48 is live !  Topics: new gait and running technologies, general gait and running talk, generation slow-poke, cadence and barefoot, mixing up your running shoes, a case of hallux rigidus and more !  Join us for another podcast here on The Gait Guys !

A. Link to our server:

http://thegaitguys.libsyn.com/podcast-48-running-tech-cadence-and-running-shoes

B. iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

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* Today’s show notes:

Neuroscience piece
 
1. The Sproutling: Why A Fitbit For Babies Might Be Brilliant
http://www.fastcodesign.com/3019806/the-sproutling-why-a-fitbit-for-babies-might-be-brilliant?partner=rss

2.Coming Soon: Workout Gear That Monitors Your Muscles
 
3. Micromovements hold hidden information about severity of autism
http://www.sciencedaily.com/releases/2013/12/131202171813.htm
4 Gait Factoid:
Q: Why do the two of us focus on gait so much ?  
A: Because it is such a deeply primary motor pattern that it is all encompassing.  
5. in the media this week:
Generation slowpoke? Kids don’t run as fast as parents once did, study finds - TODAY.com
http://www.today.com/moms/generation-slowpoke-kids-dont-run-fast-parents-once-did-study-2D11603599
6. CADENCE and BAREFOOT
7. In the media:
Can mixing up the running shoes prevent overuse running injury? | Running Research Junkie
 
9. From a Blog reader:
Hello the gait guys. I have over pronated rigid cavus along with hallux rigidus on my feet (also had one failed surgery for hallux rigidus on right foot). Having really hard time to be on my feet as well as find shoes and use orthotics. Due to the rigidity of my feet orthotics I’’ve been given create pain I can’t bear and mostly push medial side of my feet. Also without orthotics it is not much better - getting constant pain in my feet and knees. What would be your advise in my situation?Thanks
Disclaimer 
10. From a blog reader
Question: when my feet point straight my knees point outward from my body. I’ve heard it called external femoral torsion. Is this correct? Also is there any type of PT/stretching I can do to correct this? Would love to get things straightened out (no pun intended).
11 . National Shoe Fit Program