Innovations in Podiatry

Paul Harradine MSc FCPodMed Cert Ed

Innovation…..

A new method, idea, product, etc:

Dartfish have asked me to explain why

video gait analysis is such an essential

part of my daily practice, for full details

on new technology and innovations,

please see the trade stands.

Why use Video Gait

Analysis? Do you actually need to use this for

your podiatric practise?

1. Does your patients gait possibly link to

their symptoms?

2. Are you possibly hoping to change you

patients gait as part of their treatment

plan?

3. If not, do all your patients have wings?

Simply put, it helps you observe and report

gait.

But, there are limitations. Examples

include:

1. Reliability of markers / bisections

2. Lack of ‘normal data’

…... Its only one part of your assessment….

Why use Quick Video Gait

Analysis?

Static tests do NOT tell us how patients walk and / or run....they are a static analysis of a dynamic structure

Why is so much effort being spent on trying to find a static test which will tell us how our patient walks and runs.

Shoes, terrain, dynamic muscle stability, speed, momentum etc, too many variables and differences between dynamic and static...

Why don’t we just WATCH THEM?!

So why bother with gait?

It allows us to:

1. Slow it down

2. Observe from different directions

3. Take measurements and average them

4. Check changes in gait with treatment,

looking for good things OR bad things!

5. Improved patient feedback / education

Why use Quick Video Gait

Analysis?

It does not

1. Give you accurate normal and

abnormal reliable angles.

2. Give you all the answers!!!

Why use Quick Video Gait

Analysis?

It does allow me to:

1. See the effects in the frontal and

sagittal plane of footwear, orthotics,

manips, physio rehab programs etc

2. Review changes in gait over minutes or

YEARS.

3. Supply more information with which to

help with linking function to injury and

treatment to benefits (or otherwise!)

Why use Quick Video Gait

Analysis?

Video set up - Frontal

Video set up - Sagittal

When standing tests make no

sense and you NEED to asses

gait

Recognising need for better

trainers, core stability, orthotics

etc

Information for consultant...

“why can’t I walk in them, but

running is great?”

“But I have a nice arch? I’m a

doctor you know and I’ve read

runners world....”

Treadmills Vrs

Overground…

Riley et al Gait Posture. 2007 Jun;26(1):17-24. Epub

2006 Aug 14. A kinematic and kinetic comparison of

overground and treadmill walking in healthy

subjects.

Having demonstrated the essential equivalence of

treadmill and overground gait, it is now possible for

clinical movement analysis to take advantage of

treadmill-based protocols

Parvataneni K et al. Clin Biomech. 2009 Jan;24(1):95-100.

Epub 2008 Oct 30. Kinematic, kinetic and metabolic

parameters of treadmill versus overground walking in

healthy older adults.

While treadmill and overground walking are biomechanically

similar, the metabolic cost of treadmill walking is higher.

Clinically this may be important when using a treadmill for

gait retraining in patient populations as it may lead to

premature fatigue or undesirable physiologic challenge.

.

Sagittal plane

foot, but also

excellent for hip

and knee.

Midfoot

1st

MTPJ

1st

IPJ

Examples of use, pictures taken

from video to send to GPs,

coaches, physio, patients etc.

Midstance running....

Heel strike running....

Swing phase running....

Questions