Less to see, more to feel? Gait with reduced visual field and proprioception in children with UMN lesions

Background Dynamic movement control during walking relies on vision and the somatosensory system. It is known that proprioception can be impaired in children with upper motor neuron (UMN) lesions, but it is unclear to what extent it affects motor function. Therefore, we investigated the relationship between lower limb proprioception and differences in speed and stride length when walking with normal vision and a reduced visual field in typically developing children (TDC) and children with UMN lesions.

Methods Forty-one children with UMN lesions and 49 TDC, aged 5 to 19 years, completed lower limb proprioception tests and the 10-metre walk test (10MWT) with normal vision and wearing adapted goggles that obstructed their lower visual field. We divided the walking time and step length performed with reduced vision by the normal vision values and expressed this as a percentage. We compared these percentages between the groups and calculated Spearman correlations (ρ) with the proprioception tests.

Results Children with UMN lesions were significantly (p < 0.001) more affected by reducing the visual field than TDC. Correlations between proprioceptive function and the percentages for time and step length were fair for the whole group (ρ = 0.27–0.37), poor to fair for children with UMN (ρ = 0.07–0.32), and poor for the control group (ρ = 0.03–0.18).

Conclusions Visual restriction affected gait speed and stride length significantly stronger in children with UMN lesions. Poor to fair relationships with proprioception show that individual factors influence gait parameters, especially in children with UMN lesions.

Clinical relevance People with lived experience are interested in how they perceive the movement and position of their limbs. In situations where the visual feedback is reduced, such as in the dark or evening, we need to know if children with UMN lesions can rely on their somatosensory function. Identifying the difficulties can support clinical reasoning in finding a solution to train the gait efficiency of these children.

Publication History

Article published online:
23 October 2025