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