Gait kinematics during walking in children with impaired binocular vision due to amblyopia or strabismus

Impaired binocular vision early in life from amblyopia or strabismus is related to lower scores than controls for walking on standardized tests of motor ability. However, standardized tests do not assess gait kinematics, which may provide a better understanding of motor deficits. This study investigated gait kinematics while walking in children with amblyopia or strabismus. Children ages 7–13 years with amblyogenic factors (13 anisometropia, 8 strabismus) were enrolled in the amblyopia or strabismus (AS) group (15/21 had current amblyopia). An age-similar group of 33 controls with normal vision were also enrolled. While viewing binocularly, children walked on a GAITRite® pressure-sensitive walkway and completed 3 conditions: 1) Straight Walk (SW): walk on mat, 2) Isolated Target Walk (IT): walk and step on two-dimensional targets, and 3) Distractor Target Walk (DT): walk and step on two-dimensional targets while avoiding two-dimensional distractors. Gait kinematics were mean normalized velocity, cadence, step time, stance time, step length, step width, and step accuracy (# targets missed, # distractors stepped on). Variability in gait kinematics was also examined using the coefficient of variation (COV). Typical mean gait kinematics did not differ between the AS and control groups. However, the AS group missed more targets, showed increased variability (higher COV), and lacked any learning effects compared to controls. Unbalanced visual input early in life from amblyopia or strabismus results in variable and inaccurate walking patterns, pointing to an immaturity of gait development.