Effects of walking with bowed down head on gait and balance

Walking with looking down while the head bowed down is a gait adaptation seen in children with neuromuscular diseases and/or balance problems. Seventeen healthy children (mean age 12.59 ± 2.00) were included in our study to investigate the effects of changes in head posture on gait parameters and balance. The participants performed walking in two different head postures, 1. with their heads in neutral free posture and 2. with their heads in a posture with inclined painless maximum flexion degree. These walks were evaluated with the gait analysis system (ELITE2002 BTS, Milan, Italy). Head movements in the sagittal plane were tracked with the developed "Head Movement Sensor". The results of walking with the neutral head posture and bowed down head posture were compared statistically. There were many biomechanical changes in the head bowed down gait compared to the gait with the neutral head posture. It was determined that step length was shortened and cadence increased in children with head bowed down gait. When the kinematic parameters were evaluated, it was seen that most of the joint range of motion in sagittal, frontal and transverse planes decreased significantly in children who walked bowed down head posture. When the kinetic parameters were examined, it was seen that the range of motion of the body pressure centre was decreased; hip flexion, knee flexion and extension moments decreased, hip power generation increased and generated knee power decreased. In conclusion, it is thought that walking with the head bowed down posture can be an adaptive mechanism developed to improve stability during walking in children with stabilization problems. Therefore, the effects of head posture should be considered when evaluating the walking of such children in clinics. Besides, existing gait analysis protocols can be developed to avoid the effects of head posture change in gait analysis laboratories. The data we collected can be elaborated by comparing with the walking of children with sensory-motor and/or balance problems in future studies.