Gait Analysis Tools in the Clinic

Posted by PPL Biomechanics on

Analysing gait can provide critical information in both diagnosis and rehabilitation of injuries. Gait analysis measures the mechanical factors of joint loading, orientation, and neuromuscular function during walking/running. Assessing whole body mechanics during both walking and running can allow clinicians to identify the presence of abnormalities and asymmetries which may be affecting the patient. Gait analysis can range from a basic visual assessment of walking/running along a straight path or treadmill, to 3D kinematic and kinetic analysis using multiple cameras and force/pressure platforms.

3D Motion Capture

3D motion capture requires the use of retroreflective markers and a number of laser cameras (Vicon, MAC) to capture 3D body movements. This type of assessment is both expensive and time consuming and is more frequently used by researchers. However, should these facilities be available they would provide a much more detailed assessment, and may be crucial in the diagnosis and rehabilitation of injuries. Often used in conjunction with force plates to gather kinetic as well as kinematic data such as joint moments and power.

Force and Pressure Analysis

Force platforms (Kistler, AMTI) and pressure plate systems (Footwork Pro) can be used in conjunction with motion capture to include kinetic data capture. Force and pressure data is very different and should not be confused. Force platforms record ground reaction force (GRF) which is the equal and opposite force which the body applies to the ground (Newton’s 3rd Law). GRF data can be used to derive joint moments and forces through inverse dynamics which would help the practitioner in identifying asymmetries and weaknesses. Pressure platforms measure the force/area which can be useful in examining pressure, balance and postural sway. However, in terms of identifying foot types and shape, they have a very limited role. 

Video Analysis

Advanced video analysis software systems are available at reasonable rates to help you to provide a detailed gait assessment in the clinic (Templo, Quintic, Dartfish). These software packages facilitate motion capture from various angles which can be synchronised and analysed using a variety of tools such as angle finder, length measurements and drawing utilities. They also contain report writing templates which can be printed and/or emailed for the client. These are best used in conjuntion with a reversable treadmill which enables video capture from both frontal and sagital planes of motion. Our own personal choice of software package is the Templo system from Contemplas which we have found to be a very helpful aid in gait analysis. This type of analysis is frequently utilised in specialist footwear stores to assist with athletic shoe prescription.

Low Cost Video Analysis

As a result of significant advancements in technology within the past decade, video analysis has become more accessible and affordable to use in the clinic. The emergence of smartphone and tablet applications such as Ubersense, Dartfish and Coach’s Eye has provided low cost, highly accessible analysis systems. These low cost applications allow video capture, analysis and upload to online profiles for storage and sharing via social media and e-mail. As with the more expensive options these too facilitate utilities such as angle finder, free hand drawing and length measurements. All of this can be done within a matter of minutes and the patient can be sent away with a detailed online report.

PPL Opinion

Gait analysis, when used effectively, can be a very helpful tool in the clinic. However, the analysis is only as efficient as the analyser! Many systems on the market mislead the consumer by claiming the ability to diagnose injuries and create orthotics to solve the issue. The most expensive equipment is redundant without the knowledge to interpret the results and implement the necessary management protocol.

If you wish to bring an element of gait analysis into your clinic we would recommend initially setting yourself up with a basic system such as a smartphone/tablet with relevant apps (UbersenseDartfishCoach’s Eye). Realistically, a practitioner has just a few minutes in the clinic to perform dynamic assessments and cumbersome equipment can slow this process significantly. The ability to record from a handheld camera and instantly analyse the footage in slow motion is ample for most assessments. Secure storage of this analysis online is ideal for referral upon future appointments and could show significant changes upon repeat analysis. More advanced software could be acquired in future if more comprehensive assessments are required.

If you are interested in retraining gait through video assessment, a system such as Templo would be more applicable. This would enable you to display the analysis in real-time to the patient and provide audio/visual cues for them to alter their gait accordingly.

There is no single best method of gait analysis. What works for one practitioner may not suit all. We would suggest you practice using these software systems and become comfortable with what they are capable of. Once you are familiar with the technology the rest is up to you to derive the correct diagnosis!

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