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Gait analysis is the systematic study of animal locomotion, (more specific as a study of human walking) using the eye and the brain of observers, augmented by instrumentation for measuring body movements, body mechanics and the activity of the muscles.[1] Gait analysis is used to assess, plan and treate individuals with conditions affecting their ability to walk. It is also commonly used in sports such as athletics 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.

Contents

History

With the development of photography, it became possible to capture image sequences which reveal details of human and animal locomotion that are not noticeable by watching the movement with the naked eye. Eadweard Muybridge and Étienne-Jules Marey were pioneers of this in the early 1900s. It was photography which first revealed the detailed sequence of the horse "gallop" gait, which is usually mis-represented in paintings made prior to this discovery, for example.

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, and neuromuscular disorders, began in the 1970s with the availability of video camerasystems which 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 orthopaedic hospitals worldwide now have gait labs which are routinely used in large numbers of cases, both to design treatment plans, and for follow-up monitoring.

The forefathers of this research are Murali Kadaba, HK Ramakrishnan, and Mary Wootten. Their main papers, dealing with Euler Angles, led to the development of a marker system. This marker system, referred to as the Helen Hayes Marker System is the predecessor of modern marker systems, such as the ones used in movies.

Equipment and techniques

Gait analysis commonly involves the measurement of the movement of the body in space (kinematics) and the forces involved in producing these movements (kinetics).

Kinematics can be recorded using a variety of systems and methodologies:

  1. Chronophotography is the most basic method for the 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.[2][3]
  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), allow for very accurate measurement of movements using multiple cameras (typically five to ten cameras), simultaneously. The cameras send out infra-red light signals and detect the reflection from the markers placed on the body. Based on the angle and time delay between the original and reflected signal triangulation of the marker in space is possible. These are also used for motion capture in the motion picture industry.[4]
  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.[5]
Gait laboratory with passive infra-red cameras and embedded force platforms

A typical modern gait lab has several to many cameras (video and/or infra-red) placed around a walkway or treadmill, which are linked to a computer. The patient has single markers applied to anatomical landmarks, such as palpable bony landmarks (e.g., the iliac spines of the pelvis, the malleoli of the ankle, and the condyles of the knee), or clusters of markers applied to the middle of body segments. The patient walks down the walkway or the treadmill and the computer calculates the trajectory of each marker in three dimensions. A model is applied to compute the underlying motion of the bones. This gives a full breakdown of the motion at each joint.

In addition, to calculate movement kinetics, most laboratories have floor-mounted load transducers, also known as force platforms, which measure the ground reaction forces, including magnitude, direction, and location (called centre of pressure). Adding this to the known dynamics of each body segment, enables the solution of equations based on Newton's laws of motion and enables the computer to calculate 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 conditions, predict the outcome of treatments, or determine the effectiveness of training programs.

Applications

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Medical diagnostics

Pathological gait may reflect compensations for underlying pathologies, or be responsible for causation of symptoms in itself. The study of gait allows these diagnoses to be made, as well as permitting future developments in rehabilitation engineering. Aside from clinical applications, gait analysis is widely used in professional sports training to optimise and improve athletic performance.

Biometric identification and forensics

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 paralysis of spastic muscles using Botox or the lengthening, re-attachment or detachment of particular tendons. Corrections of distorted bony anatomy are also undertaken.

It is heavily used in the assessment of sports and investigations into the movement of a large variety of other animals.

Minor variations in gait style can be used as a biometric identifier to identify 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.[6][7]

Gait analysis was proposed as authentication for portable electronic devices.[8]

For slip and fall investigations, the incident walking surface slip resistance can be measured. The surface can be tested to identify if it is above or below accepted levels or slip thresholds.[9]

The English XL slip meter, also known as a VIT (Variable Incidence Tribometer) is a leading edge portable "slip tester", which is designed to test the coefficient of friction or "slip index" on various walking surfaces, level or incline (even steps), under dry and wet (or otherwise contaminated) conditions by mimicking certain pedestrian biomechanical parameters. The objective measurements that can be analyzed and compared with "normal" walking forces and industry standards regarding flooring slip resistance.[10][11]

Popular media

See also

References

  • Kadaba MP, Ramakrishnan HK, Wootten ME: "Measurement of lower extremity kinematics during level walking." Journal of Orthopaedic Research. 1990 May;8(3):383-92.
  1. ^ Whittle E. Michael, Gait Analysis, An Introduction, preference page, Butterworth Heinnemann, 2007.
  2. ^ Étienne-Jules Marey
  3. ^ Eadweard Muybridge
  4. ^ Robertson DGE, et al., Research Methods in Biomechanics, Champaign IL:Human Kinetics Pubs., 2004.
  5. ^ Best, Russell; Begg, Rezaul (2006), "Overview of Movement Analysis and Gait Features", in Begg, Rezaul; Palaniswami, Marimuthu, Computational Intelligence for Movement Sciences: Neural Networks and Other Emerging Techniques, Idea Group, 2006-03-30, pp. 11–18, ISBN 978-1-59140-836-9, http://books.google.com/books?id=0yis6idPgy8C&pg=PA11 
  6. ^ journalsip.astm.org/JOURNALS/FORENSIC/PAGES/4706.htm
  7. ^ geradts.com/html/Documents/gait.htm
  8. ^ www.vtt.fi/vtt/new/2005/new11.htm
  9. ^ www.kodsiengineering.com/personal.cfm
  10. ^ www.kodsiengineering.com/personal.cfm
  11. ^ englishxl.com/xl.html

External links


Gait analysis is the systematic study of animal locomotion, more specific as a study of human motion, using the eye and the brain of observers, augmented by instrumentation 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 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.

Contents

History

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, it became possible to capture image sequences which reveal details of human and animal locomotion that are not noticeable by watching the movement with the naked eye. Eadweard Muybridge and Étienne-Jules Marey were pioneers of this in the early 1900s. It was photography which first revealed the detailed sequence of the horse "gallop" gait, which is usually mis-represented in paintings made prior to this discovery, for example.

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, and neuromuscular disorders, began in the 1970s with the availability of video camerasystems which 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 orthopaedic hospitals worldwide now have gait labs which are routinely used in large numbers of cases, both to design treatment plans, and for follow-up monitoring.

Development of modern computer based systems occurred independently during the late 1970's and early 1980's in several hospital based research labs, some through collaborations with the aerospace industry [4]. Commercial development soon followed with the emergence of Vicon Motion Systems and BTS, marketing gait analysis hardware systems in the mid 1980's.

Equipment and techniques

Gait analysis commonly involves the measurement of the movement of the body in space (kinematics) and the forces involved in producing these movements (kinetics).

Kinematics can be recorded using a variety of systems and methodologies:

  1. Chronophotography is the most basic method for the 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.[5][6]
  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 very accurate measurement of movements using multiple cameras (typically five to twelve cameras), simultaneously. The cameras utilize high powered strobes (typically red, near infra-red or infra-red) 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 which are subsequently given identification labels. A computer model is then used to compute joint angles from the relative marker positions of the labeled trajectories [7]. These are also used for motion capture in the motion picture industry.[8]
  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.[9]
  5. Inertial (camera-less) systems based on MEMS inertial sensors, biomechanical models and sensor fusion algorithms. These full-body or partly systems can be used indoors and outdoors regardless of lighting conditions.[10]
File:Gait
Gait laboratory with passive infra-red cameras and embedded force platforms

A typical modern gait lab has several to many cameras (video and/or infra-red) placed around a walkway or treadmill, which are linked to a computer. The patient has single markers applied to anatomical landmarks, such as palpable bony landmarks (e.g., the iliac spines of the pelvis, the malleoli of the ankle, and the condyles of the knee), or clusters of markers applied to the middle of body segments. The patient walks down the walkway or the treadmill and the computer calculates the trajectory of each marker in three dimensions. A model is applied to compute the underlying motion of the bones. This gives a full breakdown of the motion at each joint.

In addition, to calculate movement kinetics, most laboratories have floor-mounted load transducers, also known as force platforms, which measure the ground reaction forces, including magnitude, direction, and location (called centre of pressure). Adding this to the known dynamics of each body segment, enables the solution of equations based on Newton's laws of motion and enables the computer to calculate 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 conditions, predict the outcome of treatments, or determine the effectiveness of training programs.

Applications

Medical diagnostics

Pathological gait may reflect compensations for underlying pathologies, or be responsible for causation of symptoms in itself. The study of gait allows these diagnoses to be made, as well as permitting future developments in rehabilitation engineering. Aside from clinical applications, gait analysis is widely used in professional sports training to optimise and improve athletic performance.

Biometric identification and forensics

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 paralysis of spastic muscles using Botox or the lengthening, re-attachment or detachment of particular tendons. Corrections of distorted bony anatomy are also undertaken.

It is heavily used in the assessment of sports and investigations into the movement of a large variety of other animals.

Minor variations in gait style can be used as a biometric identifier to identify 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.[11][12]

Gait analysis was proposed as authentication for portable electronic devices.[13]

For slip and fall investigations, the incident walking surface slip resistance can be measured. The surface can be tested to identify if it is above or below accepted levels or slip thresholds.[14]

The English XL slip meter, also known as a VIT (Variable Incidence Tribometer) is a leading edge portable "slip tester", which is designed to test the coefficient of friction or "slip index" on various walking surfaces, level or incline (even steps), under dry and wet (or otherwise contaminated) conditions by mimicking certain pedestrian biomechanical parameters. The objective measurements that can be analyzed and compared with "normal" walking forces and industry standards regarding flooring slip resistance.[15][16]

Popular media

See also

References

  1. ^ Whittle E. Michael, Gait Analysis, An Introduction, preference page, Butterworth Heinnemann, 2007.
  2. ^ Aristotle (2004). On the Gait of Animals. Kessinger Publishing. ISBN 1419138677. http://books.google.com/books?id=lZGxiHM2ldIC. 
  3. ^ Fischer, Otto; Braune, Wilhelm (1895) (in German). Der Gang des Menschen: Versuche am unbelasteten und belasteten Menschen, Band 1.. Hirzel Verlag. 
  4. ^ DH Sutherland: "The evolution of clinical gait analysis: Part II Kinematics" Gait & Posture. 2002; 16: 159-179.
  5. ^ Étienne-Jules Marey
  6. ^ Eadweard Muybridge
  7. ^ RB Davis, S Õunpuu, D Tyburski, JR Gage "A gait analysis data collection and reduction technique". Human Movement Science 1991;10:575-587.
  8. ^ Robertson DGE, et al., Research Methods in Biomechanics, Champaign IL:Human Kinetics Pubs., 2004.
  9. ^ Best, Russell; Begg, Rezaul (2006). "Overview of Movement Analysis and Gait Features". In Begg, Rezaul; Palaniswami, Marimuthu. Computational Intelligence for Movement Sciences: Neural Networks and Other Emerging Techniques. Idea Group. 2006-03-30. pp. 11–18. ISBN 978-1-59140-836-9. http://books.google.com/books?id=0yis6idPgy8C&pg=PA11. 
  10. ^ Ambulatory inertial gait analysis
  11. ^ journalsip.astm.org/JOURNALS/FORENSIC/PAGES/4706.htm
  12. ^ geradts.com/html/Documents/gait.htm
  13. ^ www.vtt.fi/vtt/new/2005/new11.htm
  14. ^ www.kodsiengineering.com/personal.cfm
  15. ^ www.kodsiengineering.com/personal.cfm
  16. ^ englishxl.com/xl.html

External links


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