We were recently asked to talk about how we do gait analysis for kids with neuromuscular challenges such as cerebral palsy. We have a few things that we do depending on what we are trying to find out. For this post I will talk about our go to method.
Our main method of doing gait analysis is to use video. We video a child walking looking at them from the front, the back, the left, and the right. We generally do this with them walking overland as opposed to on a treadmill (we have done running analysis on a treadmill using stickers and video as well if you want to hear more about that). I just want to be clear, we are not a gait analysis lab. We are trying to get a better look at what is happening throughout the body while a child is walking and then from there try to break it down to find out potential causes.
When using this method we will very often slow the video down so that we can really see what is happening. You can use the slow-mo video function on your iPhone but what we tend to use is Coach’s Eye. It allows us to upload videos and then view them in slow motion. We can also freeze a frame and draw lines or measure angles (I believe the angle feature is an in-app purchase but you can always draw lines and then use a goniometer). Video also allows you to compare over time. So we can see if there are changes from initial evaluation to 1 month or 6 months out.
Once we have the visual, we will look at the stages of gait and see what is happening. For instance, is their hip dropping in stance phase, are they getting heel strike or foot flat at initial contact, are their step lengths equal? Generally we have a reason we are looking at the gait to begin with so it gives us a place to start. It can be really overwhelming to try to adjust everything at once. So, say we notice that someone is having different step lengths, and their hip is dropping during stance phase, we will look at their hip abduction strength and see if addressing that will impact their gait. I’m not saying we only focus on one thing at a time, but we will often make a hypothesis of what the 1 or 2 biggest potential contributing factors might be and start there and then after a period of time, re-assess and see if we want to address a different target area.
And just because we see an anomaly in the gait pattern, it isn’t always that one specific muscle is weak. It may be working on core stability while they are moving so that they have better balance and can add in reciprocal arm swing and increase their speed. There are so many components to walking that we truly use the analogy – How do you eat an elephant? One bite at a time!
You can also do this in a systematic way by taking the phases of gait and looking at each joint, starting at either the head and going down to the foot, or the foot and going up to the head. Make a chart and fill in what you are seeing at each component.
I took a few screen shots (the lines are not perfect, but I wanted to show how you can draw right on the screen).
If you want more information or going further in depth, let us know and we can look at doing a video with a gait analysis on a child.