The process of walking combines complex interactions between muscles, tendons, ligaments, bones and neurons in the body. Pain free motion can sometimes be taken for granted but can also be jeopardised and indeed lost as a consequence of inactivity, accident or illness. As the population ages, the loss of pain free motion is fast becoming a significant factor in the quality of life of individuals and therefore is of high medical and social importance.
Clinical gait analysis facilitates a fast and easily practicable method which integrates well with the daily clinical routine in:
1. Diagnostics
2. Therapy
3. Documentation
Simple set up and short analysis times are key in clinical analysis and our software develops quantitative data pertaining to movement, and provides direct feedback to both therapist and patient. This gives it an important role in gait analysis.
The conventional terminology for gait analysis is based upon the phase model of Perry and defines physiological gait in 8 phases. In her work, Perry defines muscle activation, joint movement and ground reaction force as critical factors under consideration. Norm data are researched for these meaning that deviances can now be observed and as a consequence, a well-grounded approach has been formed for diagnostics and therapy in gait.
The ultimate goal of gait analysis is to identify a primary cause and this is done through detailed observation and critique. Subjects with gait problems often present a number of gait irregularities as a result of different body parts endeavouring to compensate for a primary fault. It is only when the cause of the problem has been identified and treated, that problematic compensatory actions can also be resolved. Compensatory movements and impairments are however often more obvious to the eye and this is why computer analysis methods have to be used, so that a more exact and decisive foundation can be obtained, upon which diagnoses can be based (Perry, 1992).
Systematic gait analysis includes the structuring of information, observation of a strict pre-assigned procedure, and a plan for data interpretation. In examinations, the following factors must be taken into account:
- Kinematics- define the exact joint movement in space. The hip, knee, and ankle joints are often the focus of investigation in both the sagital and frontal plane.
- Kinetics- provide information about ground reaction forces, and forces which are translated through the body and joints. Moments about joints which occur as a result of body weight can often provide vital information.
- Dynamic electromyography (EMG)- provides information about the activation and intensity of muscle contractions.
In clinical gait analysis it must be possible to attain reliable, quantitative data, which can provide quick and simple results for therapeutic feedback on a day to day basis.
Aktysis offers an immediate indication of joint angles or other parameter on the video live-stream allowing quick feedback to patients. Instantaneous results are a significant feature of this software as Aktisys delivers real-time results. It is both easy to operate and affordable.
Gait Analysis Protocol- Sagittal
Protocol sagittal gait analysis requires the use of 5 markers; these are placed on the fore foot, under the ankle joint and on the knee joint, trochanter and shoulder. The recording functions fully automatically and determines values for dorsal and plantar flexion at the ankle, extension and flexion at the knee and hip, and upper body angle to the horizontal.
In the review with the patient, therapists can demonstrate the different phases of gait, as described by Rancho Los Angeles. Without need for further input from the analyst, a report is produced which shows the amplitudes of joint angles, step length and the duration of the stand and swing phases as the video image and corresponding joint angles with standard reference values for every phase. Normalized angle-time graphs with reference data for the entire gait cycle are shown as well.
Through the use of this analysis software, clinical gait analyses can be conducted simply and quickly, allowing practitioners to provide their clients with visual feedback.
Analysis Protocol- Frontal
When analysing in the frontal plane, 5 markers are also used. These are placed anteriorly on the ankle joint, the origin of the patella ligament, on both the left and right anterior superior iliac crests and in line with the height of the T6 vertebrae. This allows for the measurement of valgus and varus movement at the knee, lateral hip tilt, and deviations of the upper-body from the midline. Information regarding initial contact, maximum knee flexion and toe off can also be calculated when reviewing results with the patient. The report automatically shows joint angles as well as the respective video image for key time points. Angle/time graphs can also be generated for each joint, which provide an overview of joint movement and the opportunity to determine joint angles at any stage of the cycle.
Tests such as frontal gait analysis, frontal running analysis, step down tests, leg axis stability tests and many more can be conducted automatically for immediate patient feedback. Aktisys is a good software for physical therapists for rehabilitation and return to sports assessments.
In clinical gait analysis it must be possible to attain reliable, quantitative data, which can provide quick and simple results for therapeutic feedback on a day to day basis.
Simi Motion 2D with force vector and EMG feedback is characterised by its ability to provide instant data for diagnostic and training, showing both ground reaction force with magnitude, point of origin and direction as EMG data in unison. As a result, diagnostic based on these data is possible and the patient receives biofeedback at a level which they themselves will be able to understand. All data can be viewed, analysed and stored with the relative video recording and kinematic data.
Simple to use: Live feedback is perfect for enhancing diagnostic possibilities and therapy.
Information about resultant ground reaction forces and the direction in which they act is of great importance in clinical analysis. Through knowing these values, it is possible to calculate the moments which act upon the joint and therefore determine what level of muscle activation is required. The vector is also able to show which forces and levers act upon the joint. As a result, it is possible to establish which movements and strains the joint should be able to withstand, but also those which cannot viably be sustained in the long term.
With the use of force plates and EMG measurements, both ground reaction forces and muscle activation data can be included in the analysis and therapy process. The data is directly synchronised with cameras as the measurement takes place, allowing direct biofeedback during training.
Ground reaction forces can be viewed in real time in the form of a force vector with direction, point of origin and magnitude which allows information about resultant moments and their levers. It is therefore possible to infer values for the work done by muscles, and the forces travelling through the joint. This information can be measured and evaluated with kinematic and EMG data simultaneously using Simi Motion as well as high speed videos.
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