Gait Laboratory at Newington Children's Hospital

SYLVIA OUNPUU, MS


The gait analysis laboratory is a computerized center designed to study human locomotion in a clinical setting. The laboratory is staffed by orthopedic surgeons, a kinesiologist, physical therapists, and biomedical and computer engineers. The group provides a multidisciplined approach which is critical to the success of the laboratory.

The major function of gait analysis is to provide objective data that is both descriptive in nature and identifies the causes of gait abnormalities. Information can then be used first to help design a treatment program, such as deciding on appropriate surgery, and second to allow for objective evaluation of the treatment through before and after comparisons.

A typical gait analysis is comprised Of four tests: 1) simultaneous videotaping from the front and right and left sides which provides a qualitative view of the patient and is useful as a check for motion data. 2) Static clinical examination includes assessment of range of motion and strength. 3) Motion analysis is completed to obtain threedimensional kinematics and kinetics of the lower limb and trunk. Kinematics (joint angles) provides descriptive data regarding the patient's gait patterns. Through the collection of force plate data and kinematics, joint kinetics (joint moments and powers) are calculated to provide information relating to the cause of the deformity. Data is collected with the patient barefoot as well as with orthoses or prostheses to evaluate function during gait objectively. 4) Dynamic muscle function is assessed through the use of electromyography. Phasic activity of specific muscles is examined and compared to data from nondisabled persons.

Once data is collected and processed, review and interpretation are completed and the treatment program can be established. Success of the treatment program is also assessed with a postoperative gait analysis one year after surgery.

The gait laboratory has an extensive data base containing information from recordings of more than a thousand patients. This provides the opportunity to study post hoc the effectiveness of treatment strategies by comparing pre- and post-treatment data. Research into specific questions involving gait is also conducted. For instance, studies are presently being conducted to evaluate various modifications to orthotic and prosthetic designs.

Most children seen at the gait laboratory have neuromuscular disorders, such as cerebral palsy, traumatic brain injury, or cerebrovascular accident. With the advent of gait analysis, major progress has been made in understanding the cause of the children's locomotor difficulties and, as a result, more rational treatment is being prescribed.

Newington Children's Hospital, 181 East Cedar Street, Newington, CT 0611