application of gait analysis

8/7/2019 Application of Gait Analysis

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Application of Gait Analysis


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Introduction

Gait Analysis

Clinical gait assessment Gait research

How can gait analysis be used, particularly in aclinical setting??


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Clinical gait assessment aims to help

individual patients directly.

Gait research aims to improve our

understanding of gait either as an end to

itself or in order to improve medical

diagnosis or treatment in the future.

There is obviously some overlap.


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The technical requirements

Requirement for accuracy of the data. The time spend in collecting the data

Ability of the system to cope with various

types of pathological gait.

There is no use using complicated and

expensive measurement system unless it

provides information which is useful and

which cannot be obtained in an easierway.


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Gait research

Clinical Fundamental Clinical: concentrates on disesase processes

and methods of treatment.

Fundamental: methods of measurement and theadvancement of knowledge in biomechanics,

human performance and physiology.


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Clinical gait assessment

Gait analysis: data gathering.

Gait assessment: omtegrationm of thisinformation with that from other ources for

the purposes of clinical decision making.

Rose (1983)


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Gait analysis is a special investigation.

Interchangeable with gait evaluation.

Gait assessment can be informal and formal. It

is performed for:

- basis of clinical decision making.

- it may help with the diagnosis of an abnormalgait

- used to document patients condition


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Clinical decision making

This has 3 clear steps:

1. Gait assessment

2. Hypothesis formation

3. Hypothesis testing


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Gait assesment

1. Joint angle: at a particular phase of gait cycle.

2. Joint moment: is the internal moment

flexor/extensor?

3. Joint power: is power generation/absorption

taking place?

4. EMG- is the muscle activity consistent with the

kinematic data?


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A hypothesis is formed as to the detailed cause

of any abnormalities present.

Treatment is decided. May involve assessment

under anaesthesia prior to surgery.

Post treatment after a suitable recovery period a

further gait assessment is done to determine

success of the treatment, or to decide on furthercourse of treatment.


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Critical review of the original

diagnosis and the treatment. To find out if correct decisions were made.

If recognise the error if any and to learn from it to

prevent it from happening again and to correct it.

No change in EMG post-op

Main criteria for review:

- general gait parameters

- joint rotations

- estimated external work of walking.


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Total body energy consumption is the best

measure of the success of treatment.

Gage

3 criteria to gauge success:

- walking speed

- energy consumption

- cosmesis

Perry


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Diagnosis of abnormal gait

Detailed diagnosis relating to exact joints and

muscles.

To detect abnormal gait habits and differentiate

them from pathological gait.

Differential diagnosis.


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Documentation of patients

condition To quantify disability

Series of gait assessment for monitoring of the

progress/deterioration

To decide on treatment.

Making the patient and relatives recognise the

progress/deterioration


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Objective monitoring to avoid error of judgementin the investigators.

Early detection in deterioration of gait

Identifying clinical signs

Shape of GRF used empirically to detectingprogress in rehab.


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Litigation

Claims for damage

Litigations against medical negligence


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Conditions benefiting from gait

assessment Gait in elderly: to improve quality of life and toreduce risk of falls and fractures.

Causes of aletered gait in elderly:

- neurological- psychological

- orthopedic

- endocrinological

- general drugs- senile gait and associated conditions

Cunha


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Other conditions

Cerebral palsy

Multiple joint diseases

Knee pain

Hemiplegia

Muscular dystrophy


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The use of gait analysis gives a better insight

into the exact nature of the deficit and the way in

which the patient is able to compensate for it.

This applies to where moments and powers

have been measured.

It may lead to a better understanding of the

pathological condition itself and may also

suggest improved methods of treatment.


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Prosthetic and orthotic management

Alignment and adjustment of the prosthetic limbs

may be improved using objective management

of gait.

Provides an insight into the functioning of

orthosis and to compare different designs and

also permit improvements in existing designs


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Future developments

Exact knowledge of forces in the different

structures in and around the joints.


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Conclusion

Wide acceptance of gait assessment

Walking is not the only thing done analysis

of various other movements:- sit-to-stand

- stair climbing

- starting and stopping walking- stair climbing and descending

application of gait analysis

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