Gait analysis methods in rehabilitation

Baker, RJ

Abstract

Introduction: Brand's four reasons for clinical tests and his analysis of the characteristics of valid
biomechanical tests for use in orthopaedics are taken as a basis for determining what
methodologies are required for gait analysis in a clinical rehabilitation context.
Measurement methods in clinical gait analysis: The state of the art of optical systems capable
of measuring the positions of retro-reflective markers placed on the skin is sufficiently advanced
that they are probably no longer a significant source of error in clinical gait analysis. Determining
the anthropometry of the subject and compensating for soft tissue movement in relation to the
under-lying bones are now the principal problems. Techniques for using functional tests to
determine joint centres and axes of rotation are starting to be used successfully. Probably the last
great challenge for optical systems is in using computational techniques to compensate for soft
tissue measurements. In the long term future it is possible that direct imaging of bones and joints
in three dimensions (using MRI or fluoroscopy) may replace marker based systems.
Methods for interpreting gait analysis data: There is still not an accepted general theory of
why we walk the way we do. In the absence of this, many explanations of walking address the
mechanisms by which specific movements are achieved by particular muscles. A whole new
methodology is developing to determine the functions of individual muscles. This needs further
development and validation. A particular requirement is for subject specific models incorporating
3-dimensional imaging data of the musculo-skeletal anatomy with kinematic and kinetic data.
Methods for understanding the effects of intervention: Clinical gait analysis is extremely
limited if it does not allow clinicians to choose between alternative possible interventions or to
predict outcomes. This can be achieved either by rigorously planned clinical trials or using
theoretical models. The evidence base is generally poor partly because of the limited number of
prospective clinical trials that have been completed and more such studies are essential. Very
recent work has started to show the potential of using models of the mechanisms by which people
with pathology walk in order to simulate different potential interventions. The development of
these models offers considerable promise for new clinical applications of gait analysis.

Citation

Baker, R. (2006). Gait analysis methods in rehabilitation. Journal of NeuroEngineering and Rehabilitation, 3(1), 4. https://doi.org/10.1186/1743-0003-3-4

• Journal Article Type: Article
• Publication Date: Mar 1, 2006
• Deposit Date: Jul 4, 2011
• Publicly Available Date: Apr 5, 2016
• Journal: Journal of NeuroEngineering and Rehabilitation
• Print ISSN: 1743-0003
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 1
• Pages: 4
• DOI: https://doi.org/10.1186/1743-0003-3-4
• Publisher URL: http://dx.doi.org/10.1186/1743-0003-3-4
• Related Public URLs: http://www.jneuroengrehab.com/content/3/1/4