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Roger Akers, a physical therapist with Grande Ronde Hospital, shows how he uses the gait analysis system to assess a patientís walking ability. (Trish Yerges photo)
Motion analysis technology at Grande Ronde Hospital helps therapists treat patients with gait dysfunction
by Trish Yerges/For The Observer
Physical therapists at the Grande Ronde Hospital are using a new gait motion system to assess, plan and treat patients with conditions affecting their ability to walk.
Roger Akers has been working as a physical therapist for 35 years, and he’s excited to have this technology at his disposal to help patients with their rehabilitation.
“The gait motion analysis device is a small video camera which interfaces with a small laptop computer,” Akers said. “The unit we use was donated to us by the Grande Ronde Auxiliary.”
The camera is set up on a tripod and focused on the front, back and sides of a patient as he or she walks. The video then captures image sequences, revealing human motion not noticeable by the naked eye. Step length, stride length, heel-toe placements, speed, foot angle, overall posture and center of balance are all analyzed by examining the video playback at greatly reduced speeds — even as slow as one-eighth or one-sixty fourth of real-time speed.
“With this system, it gives us a snapshot of time when walking,” Akers said. “We can replay the video repeatedly and assess to see if the patient’s hips are level or there is a drop. We can also see if the patient’s knees are straight or bowed out, the position of the ankle and whether or not the patient is walking with a heel strike or on their toes.”
Healthy patients can walk an average speed of 3 miles per hour, but most people don’t stop and think of all the body movements required to walk.
“One foot goes in front of the other, and it makes a heel strike on the floor. At the same time the other leg is starting to bend at the knee, and its foot pushes off with the toes and swings forward to make a heel strike on the floor,” Akers said.
Knowing the kinematic relationship between the ankle, knee and hip helps Akers and other physical therapists to trace a gait dysfunction to its root cause.
“How the foot hits the ground has a kinematic relationship to other joints,” Akers said.
There are many pathological conditions that can affect the way a patient walks, such as joint or spinal injuries, paralysis from a stroke, peripheral neuropathy or kyphosis, all of which can create balance issues.
“Since a patient with balance issues is more prone to falling, the patient takes smaller steps to compensate for that,” Akers said. “With peripheral neuropathy, there is decreased sensation in the feet, so the patient’s base of support isn’t in sync with the rest of what the body is doing.”
A stroke will affect one side of the body as opposed to other injuries, and the gait is affected quite a bit, Akers said. In this case, the patient may present with a slap-foot gait, and he has to think when moving his foot. Many stroke patients get rid of all throw rugs at home to minimize tripping and falling risks.
“Patients should wear good supportive shoes, firm but comfortable,” Akers said. “If they are too soft, then there is no sense of where the foot is. Being bare footed does not provide protection, and wearing high-heeled shoes can actually form the foot in a high-heeled stance where it loses elasticity.”
When Akers analyzes the video playback of the walking patient, he looks for the position of the ankle whether it turns in or out, any weakness or unleveling of the hips, muscle atrophy of the legs, toeing in or duck walking.
“We usually perform an average of two or three gait analyses on a patient, and save the video to compare ‘before and after’ images,” Akers said.
The gait analysis gives therapists documentary proof for continuing to work with the patient. “I wouldn’t say that the gait analysis system is diagnostic equipment,” Akers said, “but it is a tool to help us know how the patient is moving and about their mobility.”