Gait Analysis:

Techniques and
Recognition of
Abnormal Gait

Fabian E. Pollo, Ph.D.
April 30, 2007
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Gait analysis in
modern terms
implies that
some type of
quantification
will take place.


Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
1. Temporal / Spatial velocity, cadence, step
length, etc.

2. Kinematics - the movement of the body in
space without any reference to forces.

3. Kinetics - the forces involved in producing
these movements.

4. Dynamic Electromyography - the study of
muscular activity patterns during walking.
Gait analysis involves the measurement of:
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Temporal-Spatial Parameters
1. Stop watch and marks
on the floor

2. Gait Pressure Mat
Gait Pressure Mat
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Kinematics can be recorded using a
variety of systems and methodologies
Passive Marker Systems use
reflective markers and multiple
cameras (typically 6 to 8 cameras
simultaneously). The cameras send
out infra red light signals and detect
the reflection from the markers
placed on the body. Based on the
reflected signals from at least 2
cameras - triangulation of the
marker in space is possible.
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Kinematics can be recorded using a
variety of systems and methodologies
Active Marker Systems are similar
to the passive marker system but
use "active" markers. The markers
are triggered to illuminate. This
signal is used to triangulate the
location of the marker. The
advantage is that individual markers
work at predefined frequencies and
therefore, have their own "identity".
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Kinematics can be recorded using a
variety of systems and methodologies
Electromagnetic Systems track the
position (X, Y, and Z Cartesian
coordinates) and orientation
(azimuth, elevation, and roll) of
small sensors attached to various
segments of the body as they move
through space.
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Vicon Motion Analysis System
Twelve MX-40 Cameras
4 Megapixel Resolution
5 Hz 2,000 Hz
Passive Marker System
Near Infra-Red Ring LEDs
Camera/Computer
Baylor Motion & Sports Performance Center
Force Platforms
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Camera Positioning (Think Volume)
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
X
Y
Z
L- Frame designates lab origin and orientation (Global Coordinate System)
Calibration: L-Frame
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Wand defines camera positions in relation to each other in 3D space and
corrects for any lens distortion
Calibration: Wand
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Various Markers Sets and
Gait Models dependent on
application
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Direct Linear Transformation
Camera 1 Camera 2
Camera 3 Camera 12
3D Image
DLT
Take all
12 Raw Video
Camera Views
Identified Markers
3D Image
Virtual Hip Joint Centers
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Kinematics
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Force Platform
The reaction force
produced by the ground is
called the Ground
Reaction Force (GRF),
which is basically the
reaction to the force the
body exerts on the
ground.
Kinetics
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Use Inverse Dynamics
to compute Joint Forces,
Joint Torques
(Moments) and Joint
Power.
Kinetics
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Electromyography
25 Gauge Needle
0.051mm, insulated, hooked wires
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Raw EMG Signal
Rectified EMG Signal
Enveloped EMG Signal
Processing
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Recognition of Abnormal Gait
Question is not whether a gait pattern is abnormal
what is primary cause.

Requires formal gait analysis

Many primary causes are fairly easy to diagnose
(i.e. bunions and peroneal nerve dysfunction)

Many secondary causes that are not so clear
(chronic ligament tears and osteoarthritis)
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
1. Mild Cerebral Palsy

2. Traumatic Brain Injury

3. Medial Compartment Osteoarthritis
Examples
Recognition of Abnormal Gait
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Cerebral Palsy
9 year old girl with hemiplegia

Equinovarus of her right foot
(inverted hindfoot and plantarflexed)

Caused by overpull of the tibialis
posterior and/or anterior tibialis
Tendons




Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Surgical Options
Split anterior tibialis and transfer
tendon to cuboid.
Split posterior tibial tendon and
transferred laterally to peroneus
brevis tendon
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Use of Gait Analysis
Determine if the anterior tibialis and/or
posterior tibialis was contributing to her
deformity.

Document her movement pattern for
comparison after surgery.



Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Traumatic Brain Injury
45 year male suffered TBI in car
accident in 1983

Having Left Knee Pain

Gait Evaluation




Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Knee Osteoarthritis
51 year old women with medial
compartment OA of left knee

Evaluation for OA unloader
brace prior to possible High
Tibial Osteotomy




Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Knee Osteoarthritis
Knee OA results from local
mechanical factors within the
context of systemic susceptibility
Hip-knee-ankle alignment
significantly influences
load distribution at the knee and
disease progression


Medial compartment more often
affected
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Vertical GRF
Muscular Forces
Reaction force from
external moment
Knee Loading
Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Knee Osteoarthritis
Unloader Bracing attempts to
reduce that Varus load.




Gait Analysis: Techniques and
Recognition of Abnormal Gait

April 30, 2007
Benefits of Gait Analysis
Aids in surgical planning
Assessing the efficacy of surgical intervention
Bracing issues and medication efficacy can be
addressed using gait analysis techniques
Evaluation of the rate of deterioration in
progressive disorders that affect gait can also
aid in understanding a patient's abilities and
directing care
Quantification for clinical and research
THANK YOU
April 30, 2007