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3D Revolutionizes Gait Analysis

Since Aristotle’s text, “On the Gait of Animals,” human beings have been preoccupied with locomotion. While the philosopher writes of watching people’s shadows against a wall to observe gait patterns, today’s experts rely on more technical methods.

With the advent of 3D technology, gait analysis took a leap forward. What’s more, the honing of these systems over the years may have finally made them available to Joe and Jane Runner. The accuracy of the 3D systems are supported by both scientific and anecdotal evidence, making them perhaps the next big thing when it comes to treating and preventing running injuries.

3D Technology for the Masses

The use of 3D technology for gait analysis dates back to 1990. At the University of Calgary, Assistant Professor Dr. Reed Ferber, also the founder of the Running Injury Clinic in Calgary, uses a 3D system with eight cameras to gather data and images while research participants run on the treadmill. “I’ll tell you the exact degree your foot is overpronating. We can see if your lower leg is rotating appropriately with your foot and how much torsional force is being created at your knee,” explains Ferber.

Dr. Irene Davis, professor of physical therapy at the University of Delaware, utilizes a similar six-camera system in her Motion Analysis Laboratory. “In the lab, we measure mechanics in 3D and provide the runner with real time feedback on those mechanics,” says Dr. Davis. She argues, however, that offering this technology in the clinical setting may not be realistic. “At the end of the day, clinics aren’t going to have the manpower or financial resources for these expensive systems,” she says.

Dr. Ferber contends that the cost of such equipment has dropped dramatically over the past few years and that his system is real-world ready. “With respect to training, our software is turn-key in its use. We’re trying to make it relatively easy for the clinician to use this sophisticated technology to understand the root cause of an injury,” he explains.

He began putting the system to the test this April at a clinic in downtown Calgary, offering it to the general public for the first time. With the use of the 3D gait analysis system, he can observe runners’ overall biomechanics and gather data on the their flexibility, strength and alignment. With those four points of reference, he runs the numbers against two-and-a-half years worth of biomechanical profiles in his lab’s database and prints off a report to show patients the potential root cause of their injuries and what they might do to remedy them.

Dr. Ferber also offers healthy patients information on how to prevent injuries. “Based on those four pieces of the puzzle, we can say: You have a 63 percent chance of getting injured.” Dr. Ferber’s job is to help the runner understand how to lower their injury risk score. “We want to change the way runners think about their bodies and how they can reduce their risk,” he says. “We are making scientific decisions about what a runner needs to work on; we’re not taking a shot in the dark, we’re not guessing.”

Both Dr. Davis and Dr. Ferber agree that for a highly trained biomechanist, 2D high-speed cameras can also be accurate. “There’s nothing that takes the place of experience,” says Dr. Davis. “As you see more patients, you gradually develop your evaluation skills. With time, you begin to see specific mechanics associated with particular injuries.” While Dr. Ferber concurs, he believes that many of the people doing gait analyses simply don’t have the knowledge to be able to be able to provide precise feedback. He says that the 3D gait analysis system can offer this regardless of the operator’s background.

Plan of Action

While the cutting-edge gait analysis system will be of interest to techies, runners simply want to know what they can do to get healthy and resume running. Upon completing a gait analysis, Dr. Ferber and Dr. Davis offer differing methods of rehabilitation and injury prevention. While Dr. Ferber tends to use strength and flexibility prescriptions for his patients, Dr. Davis is partial to gait retrainment.

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Burning at each end of the candle, both have found success in their approaches. “I’m going to change a runner’s mechanics by getting them stronger and more flexible. Within six weeks, 90 percent of my runners are injury free,” says Dr. Ferber (results will be published soon in the Journal of Athletic Training).

Dr. Davis explains her research: “Our data suggests that you can alter the gaits of runners who are at risk for injury.” To do this she uses a treadmill and a mirror, giving the runner visual feedback on form and cadence.

Regardless of the rehabilitation protocol, gait analysis is becoming an increasingly important part of preventing and treating running injuries. Having seen success in his Calgary Clinic, Dr. Ferber already has plans to bring 3D gait analysis to Alberta, British Columbia and beyond. There is much anticipation for how this technology will affect the way we diagnose and treat running injuries. Aristotle would surely have been impressed.

The Importance of Gait Analysis

The equipment and methodology used for gait analysis has progressed substantially in recent years. The advances in how a person’s gait is evaluated, and the tools used to correct and restore normal gait, allow those who have suffered an injury affecting their ability to walk or run to be diagnosed more efficiently and accurately. Once diagnosed, a treatment plan for gait problems is created—usually by an experienced clinician—and is specifically designed to focus on the affected limbs with the goal of returning the patient to his or her highest level of functioning in the shortest amount of time.

Hope for Patients

Long gone are the days in which observation was the main diagnostic tool used by clinicians, and outdated methods of treatment have been replaced with state-of-the-art technology that’s changing lives. Accident victims, injured athletes, and those with central nervous and musculoskeletal system diseases and ailments all benefit from gait analysis. Regardless of gender, age, or degree of functioning, patients all over the country are benefitting from these technological advances, and this is an exciting, hopeful time for physical therapists and patients.

If you’re a physical therapist, working with injured athletes, people who have suffered limb injuries in accidents, or people diagnosed with multiple sclerosis or some other debilitating disease that affects muscle movement and control is more rewarding than ever before thanks to advances in gait analysis.

Clinical Gait Analysis

The term “clinical gait analysis” is the process by which information is gathered to fully understand the cause of gait abnormalities and to create a treatment plan best suited for the patient’s individual limitations and mobility goals. A variety of technology and methods are used for gait analysis, including, but not limited to the following:

  • Comprehensive physical examination
  • Motion and muscle assessment
  • Computer-interfaced video cameras used to measure motion (equipped with motion-analysis software)
  • Electrodes placed on the skin to monitor muscle activity
  • Force platforms utilized to measure force and torque of the patient to the ground
  • AlterG® Anti-Gravity Treadmill™ with Stride Smart

Physical therapists are using advanced gait analysis systems and video motion software to treat deficiencies in patients’ limbs and other areas of the body.  After just a few minutes of walking or running on a specially designed treadmill equipped with high-speed cameras, physical therapists are able to capture a patient’s movement while walking or running; this provides real time data to the physical therapists, so they can assess and treat a variety of gait-related injuries, regardless of the severity of injury and lack of mobility of the patient.

The instant feedback of some gait analysis technology allows physical therapists to more quickly create a treatment program that will help restore limb function to their patients with the goal of a shorter recovery time and a faster return to normal (or even improved) functioning. By using data to analyze how our bodies react to the movements they make and by evaluating the limbs’ reaction to force placed on them, physical therapists are able to teach their patients how to properly walk and run and advise patients as to what they can do to avoid—or, at least, minimize the chances of future injuries.

When it comes to gait analysis and equipment that monitors a patient’s progress, the diagnostic tools available today far exceed those available even just a few years ago. Stay tuned to the AlterG blog for information about how video is used to analyze, monitor and improve a person’s gait. Recording someone walking or running provides documentation of movements which will allow a physical therapist the opportunity to assess the fluidity and smoothness of a patient’s gait. Video tapes allow for close-up views of specific motions while walking and running, and when video is put in slow motion, the patient’s walking pattern is greatly enhanced making it much easier for a physical therapist to evaluate the movement of a patient.