The most commonly used modality is video analysis and this is a useful tool to aid the clinician in making more informed decisions on an individuals movement patterns and its relationship to lower limb injury.
Smart phones have a fantastic level of technology inbuilt which makes gait assessment in clinical practice easily accessible. The ability to take and assess movement patterns are fundamental for both patient and clinician as the footage can be slowed down and reviewed frame by frame to focus on the key elements of gait function and landing mechanics.
There are numerous packages available to analyse the video footage once taken and these packages offer more potential for in-depth assessment. The type of information provided is termed “kinematic” data where the focus is on how each segment within the lower limb (hip / knee / ankle and foot) is moving and how it interacts with muscle activity and injured structures.
It is important to remember that regardless of the technologies, the systems are only as good as the questions being asked. It is also essential that the video analysis is used in conjunction with a thorough clinical assessment of the foot and ankle in regard to issues such as
joint range of movement,
the quality of joint range of movement
soft tissue length and strength
proprioception and stability around the ankle
Do I need more detailed analysis?
A small percentage of patients require further and more detailed analysis than can be provided by video. A number of systems exist that allow an assessment of how pressures act across a foot. This can provide an insight into how the lower limb functions and involves interpretation of information generated by these systems.
The type of information provided is in the form of what is termed “kinetic” data. This information is gathered by systems that involve an individual walking across a pressure plate (a mat composed of tiny pressure sensors that assess the amount of force generated over certain areas of the foot), or a thin insert made up of pressure cells that can be placed inside footwear.
This is particular useful in patients with foot ulceration in conditions such as Diabetes when designing some form of orthotic (insole) intervention to allow the ulcer to heal by reducing the forces acting on the ulcer site.
What are kinetic profiles used for?
There are multiple variables that can be assessed with the kinetic profiles and its use is relevant to fine tuning orthotic management in certain conditions.
It is important to reiterate that the use of technology is an adjunct to the clinical examination and not as a stand alone facility. The findings from this type of technology need to relate to the clinical findings.
These technologies are a component part of academic research and its clinical application more limited. Mark has used these systems for a number of research projects with both commercial and academic organisations, more recently assessing the effect of footwear design on foot pressures. These experiences have re enforced the limitations of the technology and the conditions where the specificity of these systems may play a role.
The graph above in the centre of the images illustrates a force-time curve. This is a tool that allows an understanding of how the ankle joint and big toe joint are functioning, and also allows interpretation of how the right ride is functioning compared to the left side.