Sarah Curran of Cardiff Metropolitan University explains how technology is being used in the field of Clinical Gait analysis.
Human movement and the activity of walking and running intrigues many of us, and in particular those who are clinicians and researchers within the health and medical field. Getting from one point to the next in the most energy efficient manner predominates the aim of human movement, yet it is something we all take for granted until something goes wrong (i.e. injury, disease). Analysis of walking and other forms of human movement have evolved due to the inability of the human eye to capture events of our cyclic movement processes. Events that occur faster than 1/12 of a second cannot be picked up by the human eye and our memories that store the processes tend to fade out of context with time – which for clinicians can influence patient care and management outcomes.
Whilst there is no question that our understanding of human walking and running (human movement) has significantly increased, there are still gaps and the old problems remain – particularly within the clinical area. Arguably, true gait systems are perceived as expensive, occupy space, are not portable and require markers to be affixed to the individual you are recording. Whilst there are a number of markerless (to determine anatomical landmarks) systems available, the cost is still significant.
Many will be familiar with the use of Microsoft Kinect which uses 3D sensors which has portability, does not require markers and is inexpensive. Currently however, they lack accuracy but with the further development of technology such as that of ‘time of flight’ cameras are improving the precision and reliability.
Professor Jose Luis Pimentel do Rosário, PT, Ph.D (Department of Psychobiology, University of Sao Paulo, Brazil) is a strong adovator of this technology and has used this approach in a number of gait and postural alignment studies. Whilst there is still a little way to go in this development, it adds potential to clinical assessment and practice.
For gait systems that analyse walking and other forms of dynamic activities the choice of equipment should always be based on the preparation time for pre and post assessment, the availability of space within the clinical environment to house the equipment and the cost implications of installation and running the system. As the use of smartphone apps appear to dominate much of lives – many are using various apps to assess patients. Whilst this has potential for many clinicians, issues of reliability and validity (accuracy, precision) can be compromised.
There are approaches and basic rules which all clinicians should follow when collecting information for gait, posture and stance. In particular, a standardised approach to collecting the data (information) should be followed – this can involve for example, the distance of the camera to the invididual, lighting conditions, and the environment the information is collected in. Curran and Frossard (2012) discussed the use of camera systems within onsite environment in the 2008 Paralympics at Beijing and how it can contribute to not only performance analysis, but also pre and post injury analysis. This approach sets in context the demands placed on the body in environment where injuries can occur and performance matters. This is a contrast to the perhaps stale, sterile and protected environment offered within a clinical or laboratory setting. Many researchers and clinicians from across the world are adopting this approach (where they can) and it is likely that this approach will be the future of assessments for human movement, including walking and running.