Gait analysis

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Gait analysis laboratory equipped with infrared cameras and floor mounted force platforms
Gait analysis is the systematic study of animal locomotion, more specifically the study of human
motion, using the eye and the brain of observers, augmented byinstrumentation for measuring body
movements, body mechanics, and the activity of the muscles.[1] Gait analysis is used to assess, plan,
and treat individuals with conditions affecting their ability to walk. It is also commonly used in sports
biomechanics to help athletes run more efficiently and to identify posture-related or movement-
related problems in people with injuries.
The study encompasses quantification, (i.e., introduction and analysis of measurable parameters
of gaits), as well as interpretation, i.e., drawing various conclusions about the animal (health, age,
size, weight, speed etc.) from its gait pattern.

Contents
[hide]

 1 History
 2 Process and equipment
 3 Factors and parameters
 4 Techniques
o 4.1 Temporal / spatial
o 4.2 Kinematics
o 4.3 Kinetics
o 4.4 Dynamic electromyography
 5 Applications
o 5.1 Medical diagnostics
o 5.2 Biometric identification and forensics
o 5.3 Comparative biomechanics
 6 Related videos
 7 Popular media
 8 Textbooks
 9 See also
 10 References
 11 External links
History[edit]
The pioneers of scientific gait analysis were Aristotle in De Motu Animalium (On the Gait of Animals)
[2]
and much later in 1680, Giovanni Alfonso Borelli also called De Motu Animalium (I et II). In the
1890s, the German anatomist Christian Wilhelm Braune and Otto Fischer published a series of
papers on the biomechanics of human gait under loaded and unloaded conditions. [3]
With the development of photography and cinematography, it became possible to capture image
sequences that reveal details of human and animal locomotion that were not noticeable by watching
the movement with the naked eye. Eadweard Muybridge and Étienne-Jules Marey were pioneers of
these developments in the early 1900s. For example, serial photography first revealed the detailed
sequence of the horse "gallop", which was usually misrepresented in paintings made prior to this
discovery.
Although much early research was done using film cameras, the widespread application of gait
analysis to humans with pathological conditions such as cerebral palsy, Parkinson's disease,
andneuromuscular disorders, began in the 1970s with the availability of video camera systems that
could produce detailed studies of individual patients within realistic cost and time constraints. The
development of treatment regimes, often involving orthopaedic surgery, based on gait analysis
results, advanced significantly in the 1980s. Many leading orthopaedichospitals worldwide now have
gait labs that are routinely used to design treatment plans and for follow-up monitoring.
Development of modern computer based systems occurred independently during the late 1970s and
early 1980s in several hospital based research labs, some through collaborations with the aerospace
industry.[4]Commercial development soon followed with the emergence of commercial television and
later infrared camera systems in the mid-1980s.

Process and equipment[edit]

Acquisition of information on the position of the markers in 2D through the chambers of the
left and right, this combination of information gives rise to a 3D image on the position of the
markers
A typical gait analysis laboratory has several cameras (video and / or infrared) placed around a
walkway or a treadmill, which are linked to a computer. The patient has markers located at various
points of reference of the body (e.g., iliac spines of the pelvis, ankle malleolus, and the condyles of
the knee), or groups of markers applied to half of the body segments. The patient walks down the
catwalk or the treadmill and the computer calculates the trajectory of each marker in three
dimensions. A model is applied to calculate the movement of the underlying bones. This gives a
complete breakdown of the movement of each joint. One common method is to use Helen Hayes
Hospital market set,[5] in which a total of 15 markers are attached on the lower-body. The 15 marker
motions are analyzed analytically, and it provides angular motion of each joint.
To calculate the kinetics of gait patterns, most labs have floor-mounted load transducers, also known
as force platforms, which measure the ground reaction forces and moments, including the
magnitude, direction and location (called the center of pressure). The spatial distribution of forces
can be measured with pedobarography equipment. Adding this to the known dynamics of each body
segment enables the solution of equations based on the Newton–Euler equations of motion
permitting computations of the net forces and the net moments of force about each joint at every
stage of the gait cycle. The computational method for this is known as inverse dynamics.
This use of kinetics, however, does not result in information for individual muscles but muscle
groups, such as the extensor or flexors of the limb. To detect the activity and contribution of
individual muscles to movement, it is necessary to investigate the electrical activity of muscles. Many
labs also use surface electrodes attached to the skin to detect the electrical activity or
electromyogram (EMG) of, for example, a muscles of the leg. In this way it is possible to investigate
the activation times of muscles and, to some degree, the magnitude of their activation—thereby
assessing their contribution to gait. Deviations from normal kinematic, kinetic, or EMG patterns are
used to diagnose specific pathologies, predict the outcome of treatments, or determine the
effectiveness of training programs

Factors and parameters[edit]

The gait analysis is modulated or modified by many factors, and changes in the normal gait pattern
can be transient or permanent. The factors can be of various types:

 Extrinsic: such as terrain, footwear, clothing, cargo

 Intrinsic: sex (male or female), weight, height, age, etc.
 Physical: such as weight, height, physique
 Psychological: personality type, emotions
 Physiological: anthropometric characteristics, i.e., measurements and proportions of body
 Pathological: for example trauma, neurological diseases, musculoskeletal anomalies, psychiatric
disorders
The parameters taken into account for the gait analysis are as follows:

 Step length
 Stride length
 Cadence
 Speed
 Dynamic Base
 Progression Line
 Foot Angle
 Hip Angle

Techniques[edit]
Gait analysis involves measurement,[6] where measurable parameters are introduced and analyzed,
and interpretation, where conclusions about the subject (health, age, size, weight, speed, etc.) are
drawn. The analysis is the measurement of the following:
Temporal / spatial[edit]
It consists in the calculation of "speed, the length of the rhythm, pitch, and so on. These
measurements are carried out through:

 Stopwatch and marks on the ground.

 Walking on a pressure mat.
 Range laser sensors scanning a plane a few centimeters above the floor.[7][8]
 Inertial sensors and software to interpret 3D gyroscopes and 3D accelerometric data.
Kinematics[edit]

1. Chronophotography is the most basic method for recording of movement. Strobe lighting at
known frequency has been used in the past to aid in the analysis of gait on single
photographic images.[9][10]
2. Cine film or video recordings using footage from single or multiple cameras can be used to
measure joint angles and velocities. This method has been aided by the development of
analysis software that greatly simplifies the analysis process and allows for analysis in three
dimensions rather than two dimensions only.
3. Passive marker systems, using reflective markers (typically reflective balls), allows for
accurate measurement of movements using multiple cameras (typically five to twelve
cameras), simultaneously. The cameras utilize high-powered strobes (typically red, near
infrared or infrared) with matching filters to record the reflection from the markers placed on
the body. Markers are located at palpable anatomical landmarks. Based on the angle and
time delay between the original and reflected signal, triangulation of the marker in space is
possible. Software is used to create three dimensional trajectories from these markers that
are subsequently given identification labels. A computer model is then used to compute joint
angles from the relative marker positions of the labeled trajectories.[11] These are also used
for motion capturein the motion picture industry.[12]
4. Active marker systems are similar to the passive marker system but use "active" markers.
These markers are triggered by the incoming infra red signal and respond by sending out a
corresponding signal of their own. This signal is then used to triangulate the location of the
marker. The advantage of this system over the passive one is that individual markers work
at predefined frequencies and therefore, have their own "identity". This means that no post-
processing of marker locations is required, however, the systems tend to be less forgiving
for out-of-view markers than the passive systems.[13]
5. Inertial (cameraless) systems based on MEMS inertial sensors, biomechanical models, and
sensor fusion algorithms. These full-body or partial body systems can be used indoors and
outdoors regardless of lighting conditions.[14][15][16]
Kinetics
Is the study of the forces involved in the production of movements.
Dynamic electromyography
Is the study of patterns of muscle activity during gait.

Applications
Gait analysis is used to analyze the walking ability of humans and animals, so this technology can
be used for the following applications:
Medical diagnostics
Pathological gait may reflect compensations for underlying pathologies, or be responsible for
causation of symptoms in itself. Cerebral palsy and stroke patients are commonly seen in gait labs.
The study of gait allows diagnoses and intervention strategies to be made, as well as permitting
future developments in rehabilitation engineering. Aside from clinical applications, gait analysis is
used in professional sports training to optimize and improve athletic performance.
Gait analysis techniques allow for the assessment of gait disorders and the effects of corrective
orthopedic surgery. Options for treatment of cerebral palsy include the artificial paralysis of spastic
muscles usingBotox or the lengthening, re-attachment or detachment of particulartendons.
Corrections of distorted bony anatomy are also undertaken (osteotomy).
Biometric identification and forensics
Minor variations in gait style can be used as a biometric identifier toidentify individual people. The
parameters are grouped to spatial-temporal (step length, step width, walking speed, cycle time) and
kinematic (joint rotation of the hip, knee and ankle, mean joint angles of the hip/knee/ankle, and
thigh/trunk/foot angles) classes. There is a high correlation between step length and height of a
person.[17][18]
The approach above belongs to the model-based approach. Another appearance-based approach
recognizes individuals through binary gait silhouette sequences. For example, silhouette sequences
of full gait cycles can be treated as 3D tensor samples, and multilinear subspace learning, such as
the multilinear principal component analysis, can be employed to learning features for classification.
Comparative biomechanics
By studying the gait of non-human animals, more insight can be gained about the mechanics of
locomotion, which has diverse implications for understanding the biology of the species in question
as well as locomotion more broadly.