# Age-Related Changes in Virtual Pivot Point Position and Variability During Pediatric Gait Development

## TL;DR

This study shows how the position and stability of a key point in walking mechanics, the virtual pivot point, change as children grow, offering insights into gait development.

## Contribution

The study reveals age-related changes in virtual pivot point (VPP) position and variability during pediatric gait development.

## Key findings

- GRFs are strongly focused toward a VPP in all age groups, with R2 values exceeding 0.95.
- Normalized vertical VPP position increases significantly from toddlers to adolescents.
- VPP variability decreases with age, indicating improved gait control and trunk stabilization.

## Abstract

What are the main findings?
Even in pediatric walking, ground reaction forces focus towards a virtual pivot point.VPP position and variability change with age, reflecting maturation of gait control.

Even in pediatric walking, ground reaction forces focus towards a virtual pivot point.

VPP position and variability change with age, reflecting maturation of gait control.

What are the implications of the main findings?
Age-related VPP changes indicate developmental shifts in trunk stabilization strategies.Understanding VPP development may support early identification of atypical gait patterns.

Age-related VPP changes indicate developmental shifts in trunk stabilization strategies.

Understanding VPP development may support early identification of atypical gait patterns.

Background/Objectives: During adult walking, ground reaction forces (GRFs) consistently intersect near a point above the center of mass (CoM), termed the virtual pivot point (VPP). The VPP is hypothesized to contribute to upper body stabilization. However, little is known about its presence and developmental trajectory during early childhood. This study investigated age-related differences in VPP position, variability, and GRF focusing during walking in typically developing children. Methods: Kinematic and kinetic data were collected from 29 children across three age groups: Group I (aged 1 year), Group II (aged 2–3 years), and Group III (aged 10–15 years) using markerless motion capture and force plates. VPP position relative to the CoM, its variability and GRF focusing (R2) were analyzed in sagittal plane during single support phases. Results: Across all age groups, GRFs were strongly focused toward a VPP (R2 > 0.95), with no significant age-related differences in GRF focusing. In contrast, significant age-related differences emerged in VPP position and variability. The normalized vertical VPP position increased progressively from Group I (7.58 cm) to Group III (14.79 cm). Notably, in several toddlers, the VPP was located at or below the CoM, contrasting with the consistent above-CoM position observed in adolescents. Conclusions: These findings demonstrate that while GRF focusing behavior is present in toddlers who can walk independently, VPP characteristics undergo substantial developmental changes. The shifting VPP position and the decrease in variability in toddlers likely reflect progressive changes in gait mechanics and trunk stabilization strategies during childhood.