Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Value of gait analysis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by admin, Oct 28, 2007.

  1. admin

    admin Administrator Staff Member

    Members do not see these Ads. Sign Up.
    Ian Linane started the thread on Stable or unstable or ? . I have split of one of his points into this thread, so we can have a seperate discussion:
  2. Gait analysis, ie. the analysis of the kinetics, kinematics, and physiologic functions during gait are quintessential to our understanding of locomotion. Is this really questionable?
  3. Bruce Williams

    Bruce Williams Well-Known Member

    I have to agree with Simon here. Is it cold in here or just me?! :pigs:

    Seeing the potential changes in digital video analysis is beneficial. It depends on what you are looking for and how you measure the changes. 2D kinematics is questionable in it's repeatibility and measurability. 3D is better but expensive and very time consuming.

    In-shoe pressure analysis is great for tracking changes in the orthotic prescriptions, ie Force vs Time curves. You can also track the Center of Pressure as it moves along, comparing each foot side by side to compare accelerations.

    There is so much you can do both clinically and for research. If you really want to understand what your foot orthoses do, nothing is better than utilizing some regular type of gait analysis to track those changes for better or worse.
  4. Asher

    Asher Well-Known Member

    Simon and Bruce,

    What do you think of the value of basic visual gait analysis, that is, no mod cons?

  5. Craig Payne

    Craig Payne Moderator

    The point I tried to make at conference and where Kevin and I disagree is based on just why do we do a gait analysis for? .... there can only be two reasons:
    1. Is there any evidence of pathomechanical dysfunction that could be causing the patients symptoms
    2. Derive an orthotic prescription.
    Maybe: 3. Evaluate effects of interventions

    For (2) most of what I see in a gait analysis is not useful information for an orthotic prescription (what I see may be useful for other things, but then again is it?)

    For every clinical test we do, we need to ask, what useful information am I gaining from this test? What am I going to potentially change as a result of this clinical test (eg gait analysis)
  6. Bruce Williams

    Bruce Williams Well-Known Member

    were you referring to only visual gait analysis or computerized gait analysis or both?
    I do see some useful things with a visual gait analysis that will help me in devising a prescription for an orthosis. It is much more difficult to see if the inprovements worked visually after orthotic modification. that is why I prefer computerized gait analysis for step by step testing and evaluation. That helps to eliminate my subjectivity and provide much more objectivity.
  7. Craig:

    There are more than just two or three reasons to do a gait examination. Here are some other reasons to add to your short list:

    1. Find evidence of muscle weakness.
    2. Find evidence of central nervous dysfunction.
    3. Determine biomechanical effects of gait in different shoegear vs barefoot.
    4. Determine mechanical efficiency of gait.

    It must be remembered, that without analyzing the dynamics of gait, the clinician is trying to determine dynamic gait function from static measures only....an impossible task!
  8. Craig Payne

    Craig Payne Moderator

    Primarily visual, but the same principle applies to the comuterized systems, or any sort of clinical testing .... I guess it comes from teaching students .... I simply keep saying what are you going to do with the information from that test/observation? If the information gained does not have the potential to change your intervention, then why are you doing it?
  9. Craig Payne

    Craig Payne Moderator

    Kevin, I am not disagreeing. The point I am trying to make is that what do you do with the information? How does it change your treatment?

    For eg; what if you observe an asymmetrical arm swing during a visual gait analysis. What are you going to do differently to the orthotic because of that observation? The asymmetry in the arm swing may be due to a leg length difference. The decision re adding a heel lift (ie the intervention) is not based on observing the asymmetry in the arm swing, but on some clinical test of leg length. It does not mean the gait analysis is not important; its does not mean the asymmetrical arm swing is not important; I just want peple to think about what of our tests/observations are used to make the clinical decisions with.
  10. CraigT

    CraigT Well-Known Member

    You could look at many components of a biomechanical examination on their own and question their value. However these components all add small pieces of information to the big picture.
    I have had many instances where a NWB examination and static examination showed very little until the subject walked for me. On occasions walking showed little of interest, but running revealed something.
    On the flip side, I don't think you can do a true assessment of someone simply by viewing their gait. You must also examine the subject to get a true representation of the mechanics.
    I am preaching to the converted in this forum, however I have seen many instances where more value is given to what is seen on video, without actually assessing the patient.
    Example- I recently assessed an elite middle distance runner who has had chronic achilles issues. I performed my standard assessment of lower limb posture, ROM, strength etc. There was a limb length difference (symptomatic side long). He was mildy pronated, but nothing of glaring significance. Walking was also pretty unremarkable.
    I was then handed a report from a lab in Germany who had video taped him running- with the report that there was significant unilateral pronation (on the asymptomatic side).
    When I observed him running, he did actually appear to do just as the report said- there was significant medial upper deviation as we all have seen in heavy pronators.
    This was actually a case of what I call a 'false pronator' where the subjects heel sits medially in the shoe due to having a varus rearfoot. I have seen this many times in people who have cavus feet yet distort the medial upper of the shoe because the heel does not sit in the middle of the shoe.
    This type of case would be completely missed (and was in this case) if you live only by the video analysis.
  11. Bruce Williams

    Bruce Williams Well-Known Member


    great example! I will file that for future reference!

  12. I understand your point better now, Craig. In all of medicine, not all tests that clinicians perform result in a change in treatment. However, if the clinician hasn't performed the test, how are they to know that the test results are normal so that they can move their attention elsewhere in search of a proper diagnosis/treatment plan? In much the same way, the visual gait analysis is simply another medical test that may or may not give us valuable information to help us better understand the medical condition of a patient. I don't see why a podiatrist, who is hopefully better trained at visual gait analysis than any other health professional, would not perform a gait analysis (i.e. watch a person walk) for the benefit of every new patient to give them information on whether one of the patient's most important locomotor activities are occurring normally or not.

Share This Page