The importance of clinical gait analysis

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  • The importance of clinical gait analysis

    1. 1. THE IMPORTANCE OF CLINICAL GAIT ANALYSIS THE CLINICAL IMPORTANCE OF GAIT ANALYSIS GERAINT DAVIES SHEFFIELD CHILDREN’S HOSPITAL
    2. 2. WHAT IS CLINICAL GAIT ANALYSIS? Assembling the jigsaw: • Clinical diagnosis • Radiology • Observational analysis • Video • Clinical examination • Instrumented gait analysis: K;K;O2;EMG; etc
    3. 3. INSTRUMENTED GAIT ANALYSIS • Measurement tool • Natural history • Feedback and assessment of treatments • Development of sophisticated models • Improved understanding
    4. 4. GAIT ANALYSIS AND PERCEPTION • One must learn to see • One sees only what one has learned to see • Seeing is not perception • Perception is not understanding Prof Gregory, Bristol Café Wall Illusion. Eye & Brain.
    5. 5. VISUAL GAIT ANALYSIS • Perception in real time is difficult • Analysis of events at the hip is suspect • Edinburgh Visual Gait Score • Slow motion/freeze frame video • Pattern recognition
    6. 6. Objective measurement tools • Kinematics • Kinetics • EMG • Oxygen uptake • Modelling • Mapping • Statistical power • Measurement of attributes/prerequisites • Potential for predictive treatment planning
    7. 7. IS GAIT ANALYSIS OF BENEFIT? CONCERNS WITH ACCURACY •Skaggs 1999. Data of 7 patients to 12 institutions. •Noonan 2003. Inter observer variability of gait analysis in CP. 11 patients to 4 centres.
    8. 8. IS GAIT ANALYSIS OF BENEFIT? • More powerful than visual analysis • Outcomes improved in GA group • Improvement correlates with adoption of recommendations • Allows statistical retrospective analysis
    9. 9. SUMMARY • A tool for better assessment • An opportunity for objective reflection • A means to critically evaluate treatments • A means to improve one’s imperfect knowledge.

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