Gait Analysis

Clinical Outcomes Research

Gait analysis data are useful for studying the outcomes of common surgical and non-surgical treatments. Studies in this area document the efficacy of surgical procedures, evaluate whether one procedure is preferable to another for the treatment of particular problems, and identify which patients are the best candidates for specific surgeries.

We have used motion analysis data to study the effects of femur (thigh bone) rotation surgery, hamstring lengthening and distal rectus femoris transfer, calf muscle lengthening procedures, and bracing with ankle-foot orthoses, among others. These studies have contributed to a better understanding of the indications for these treatments as well as recommendations for the future treatment of children with complex gait problems

Impact

We have a strong interest in studying and documenting the impact that gait analysis has on clinical decision-making, treatment, and outcomes. Our previous studies have shown that gait analysis significantly impacts pre- and post-operative clinical decision-making. Pre-operative treatment plans are changed in 89% of cases after consideration of gait analysis data, with an average of 1.5 planned procedures per patient not being performed and an average of 1.6 additional procedures per patient being performed. Repeat motion analysis following surgery results in recommendations for changes in post-operative care in 84% of cases.

We are currently studying how surgeons use gait analysis data in their decision-making process and how closely they follow the recommendations from gait analysis studies. We plan to begin studying how gait analysis affects practice patterns and clinical outcomes in the near future.

Biomechanical Modeling & Surgical Simulation

We are using computer modeling to extend the capabilities of traditional gait analysis. Utilizing a graphics-based biomechanical modeling system developed at Stanford University, we can study muscle-tendon lengths and individual muscle forces during gait, in addition to joint angles and net joint forces. We are working to develop the basic knowledge and technical tools needed to design a surgical simulation software program that will predict the outcome of multilevel surgery for specific patients, allowing the surgeon to test and fine-tune his surgical plan prior to surgery.

We are also developing models to simulate the changes that occur as a child grows. This will be useful for predicting long-term outcome and developing the most comprehensive treatment plan possible.

Publications

We would be happy to provide reprints of any of the following articles upon request.