Mobile Gait Analysis

- A Low Cost Solution to Providing a Specialised Service Locally

Mike Walsh MISCP MMedSc

Manager of Gait Laboratory, CRC

What is Gait Analysis

Pictures GraphsVideo

Identification of Need

Client demand/locationReferrer demand/locationDatabase study/prevalence figures Concerns over representative dataCRC Strategic PlanGovernment Health Policies

Identification of ability – “Eureka Moment”

Processes used

Planning phase Technology testing Stakeholder meetings/contacts - Informal Financing – Cost/benefit analysis Project Management Strategy Risk assessment Training

Implementation phase Stakeholders - Formal Pilot PR strategy – Local/National Media, People First. Workshops/Information sessions QA testing and development

Stakeholders

ClientsReferring cliniciansCRC BoardGait Lab TeamManufacturersHSE

Impact/Outcomes

Local service in Mid West and South East (70 clients/yr, ~ 25%) Impact on families – 100% Satisfaction, ↓travel time, cost, stress,

service contact time, ↑ quality of care Impact on referrers – ↑ 20% new referrers, education/knowledge,

↑interaction/working trust with gait lab staff, ↑ quality of care, ↑referral numbers from those regions Research/Publications ↑ Gait lab profile nationally and internationally HSE Innovations award Impact on gait lab staff Technology Used in other areas/departments Temporary mobile lab ↑ Academic links

Measurements and Continuous Improvement Processes

Review phaseClient survey (interviews/questionnaire)Referrer survey (interviews/workshops)Gait lab staff survey (continual review)Service review with local managers Cost/output/operational efficiency analysisPeer reviewManufacturer’s reviewClinical Movement Analysis Society (CMAS) audit Independent risk assessment

Strategy plan for service expansion

Changes Based on Review

Achieved Environmental / equipment changes Clinic model / transport Experience of client Communication processes Education Technical protocols / QA / support procedures

Planned North/West/Southern service ↑ Staffing resource ↑ Gait Course/Education Modules ↑ Academic Links ↑ PR

Key Learning Points for the Organisation

Innovative work practice improved experience of client and filled a service gap

Potential of telemedicine Hunger/need for education/knowledge Communications infrastructure Benefits of partnership ? Formal project management training / support /

infrastructure for all heads of departments Strategy for increasing staffing resource for national

services

Learning transferred/use for NFPBA member organisations

Working model of mobile gait lab may provide solution in other areas of specialised clinical practice

Flexibility is key Potential of telemedicine/communications infrastructure Value of a partnership approach to provision of local services

(maximisation of resources) Hunger/market for knowledge/education (link it with service

provision) Strategy for resourcing service development early in a project Methodology for supporting HSE’s Primary, Community and

Continuing Care Directorate plans

Research/Publications

“Mobile gait analysis – A low-cost solution to provision of this specialised service to a large geographical area” M Walsh BPhysio MMedSc, R O’Sullivan BPhysio MSc, D Bennett BAI PhD, A Jenkinson BPhysio MSc, C Dunlevy BSc PhD, T O’Brien MCh FRCSI, O Hensey BSc FRCPI. Developmental Medicine & Child Neurology. Supplement No. 103 November 2005. Vol 47.

“Mobile Gait Analysis – A Low Cost Solution to Provision of this Specialised Service to a Large Geographical Area” Walsh Mike BPhysio MMedSc, Bennett D BAI PhD, O’Sullivan R BPhysio MSc, Jenkinson A BPhysio MSc, Dunlevy C BSc PhD, O’Brien T MCh FRCSI. JEGM Proceedings 2006, Amsterdam.

“The characteristics of gait in Charcot-Marie-Tooth disease type I and II”. Christopher J. Newman, Mike Walsh, Rory O’Sullivan, Ann Jenkinson, Bryan Lynch, Timothy O’Brien. Gait & Posture 2007;26(1):120-127.

“The gait of young people with Charcot-Marie-Tooth Disease”. Christopher J. Newman, Mike Walsh, Rory O’Sullivan, Ann Jenkinson, Bryan Lynch, Timothy O’Brien, Owen Hensey. Developmental Medicine & Child Neurology. Supplement No. 102 September 2005 Vol 47. Page 19.