Special Interest Report
Population: Pediatric
Roberta OShea, PT, DPT, PhD, Professor, Governors State University roshea@govst.edu
Nechama Karman, PT, MS, PCS, Clinical Educator Mobility Research, Litegait nechama@litegait.com
Anita Keresztury, CET, Conductive Education Teacher, Center for Independence Through Conductive Education akeresztury@cfice.org
Keywords: Plasticity, Gait Analysis, Intervention, Treadmill
Background and Purpose: This project explored a clinical friendly method of collecting objective gait data and immediately using that data to design interventions to improve gait performance in children.
Description: Clinicians yearn for easy to use measurement tools that produce reliable objective temporal gait data (velocity, step length, step frequency). Historical methods of collecting data in the clinic involve arduous, unreliable measures using stopwatches or pressure mats. It is unrealistic to install motion capture systems in all clinics. Furthermore, most clinicians do not want to spend valuable treatment time on complicated setups and the requisite data analysis. The Gait Sens 2000 treadmill and software offers an easy method of collecting temporal data that is child and clinician friendly.
The GaitSens treadmill has embedded sensors that send real time data to a tablet for collection. The therapist can quickly analyze the gait variances, set training parameters to encourage less variable performance, and record temporal data each time the child uses the treadmill. This data can then be used to design intervention sessions targeting specific impairments and provide the child with performance feedback.
Global measures, including step length symmetry and walking activity levels may be better predictors of continued improvement following therapy interventions aimed at improving walking function. Katz-Leurer et al (2009) examined gait variables in children and determined that variables differ by diagnosis and correlate to performance. Hall et al (2012) examined whether specific biomechanical variables are associated with further improvements in walking speed once treatment is withdrawn.They determined step-length symmetry may be the key to walking improvement following training in stroke survivors with hemiparesis, regardless of how that symmetry is achieved.
Summary of Use: The GaitSens 2000 was introduced into a pediatric outpatient setting. The children, aged 6-12 years old, all were diagnosed with CP GMFCS level 2 or 3. As the child ambulated on the treadmill, spatial and temporal data was collected and used to design treatment interventions. Typically, after the initial assessment, the children were able to use biofeedback to learn and practice a more symmetrical gait pattern. After 2 treatment sessions, symmetry in step length was noted.
Importance to members: Evidence based practice is essential. Technology can objectively measure gait variable changes in young patients, however, the busy clinician requires a system that can easily collect data and organize it in a way that is immediately meaningful and useful, while not interfering with the therapy delivery. The GaitSens treadmill and tablet allow the clinician to easily and objectively assess gait performance during walking. The data collected can be used immediately to design ambulation programs with specific targets to increase symmetry. Symmetry may be the best predictor of improved walking function.
Citation:
OShea, Roberta , PT, DPT, PhD; Karman, Nechama , PT, MS, PCS; Keresztury, Anita , CET. Collecting gait data in the typical clinical setting? Yes, Virginia , it can be accomplished!. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/068_oshea-et-al/