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THE IMPORTANCE OF
CLINICAL GAIT ANALYSIS
THE CLINICAL IMPORTANCE OF
GAIT ANALYSIS
GERAINT DAVIES
SHEFFIELD CHILDREN’S HOSPITAL
WHAT IS CLINICAL GAIT
ANALYSIS?
Assembling the jigsaw:
• Clinical diagnosis
• Radiology
• Observational analysis
• Video
• Clinical examination
• Instrumented gait analysis: K;K;O2;EMG; etc
INSTRUMENTED GAIT ANALYSIS
• Measurement tool
• Natural history
• Feedback and assessment of
treatments
• Development of sophisticated models
• Improved understanding
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.
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
Objective measurement tools
• Kinematics
• Kinetics
• EMG
• Oxygen uptake
• Modelling
• Mapping
• Statistical power
• Measurement of
attributes/prerequisites
• Potential for predictive
treatment planning
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.
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
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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The importance of clinical gait analysis

  • 1. THE IMPORTANCE OF CLINICAL GAIT ANALYSIS THE CLINICAL IMPORTANCE OF GAIT ANALYSIS GERAINT DAVIES SHEFFIELD CHILDREN’S HOSPITAL
  • 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. INSTRUMENTED GAIT ANALYSIS • Measurement tool • Natural history • Feedback and assessment of treatments • Development of sophisticated models • Improved understanding
  • 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.
  • 6. 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
  • 7. Objective measurement tools • Kinematics • Kinetics • EMG • Oxygen uptake • Modelling • Mapping • Statistical power • Measurement of attributes/prerequisites • Potential for predictive treatment planning
  • 8. 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.
  • 9. 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
  • 10. 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.

Editor's Notes

  1. Count the black dots