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I couldn't find anyone else documenting their gait lab experience so I wanted to share mine
under a cut cause this is long 😭 I like giving detailed explanations because I appreciate them so I included all the details
my gait eval was done for a potential future surgery to gather information on my limb difference (miserable malalignment syndrome), if you're having your gait eval is happening for another reason it might look different. I had my gait evaluation done at the gait lab at the Children's Hospital of Colorado, different gait labs might do this differently
before my gait eval I answered a questionnaire asking questions about my reason for getting a gait eval, my concerns with my gait, and my pain levels. I also had to sign a consent form to be recorded.
at my eval I had to wear shorts, the shorter the better. I came into the appointment with shorts, if you did not I imagine they would have you change into their shorts. I wear a sleeve on my leg to cover scars, I was allowed to keep this on for the first 2 parts but not the third. my top did not matter. I had to take off my shoes and socks.
the first part of my evaluation was spent taking measurements and evaluating my strength. most of the measurements were taken of angles of my legs, ankles, and hips. I had to lay on my back and stomach. the PT was very accommodating of me during the part where I had to lay on my stomach-- this can push my patellas out of place and is very painful because of this so I had trouble doing some of the movements for the measurements and had to take breaks. I also had the rotation of my legs measured again, this might not be measured if you don't have a rotational difference. during this step they used marker at several points to mark things for measurements and the cameras.
during the strength evaluation I was expected to give resistance to the PT trying to pull on my leg and foot. I was also asked to do some basic movements with my legs. if you've ever had a strength evaluation in physical therapy this is the exact same thing.
from there we moved on to the first part of the gait evaluation. in a different room with a large, high contrast pad and many cameras I was asked to walk in different ways while I was recorded. from memory I walked back and forth several times and walked backwards. I was allowed to keep my leg sleeve on for this.
after this part was done I had many sensors placed on my legs. several sensors measured my muscle impulses to make sure my muscles are moving at the correct times. to attach these sensors they cleaned my skin with an alcohol wipe and lightly sanded my skin. the sensors were stuck on with adhesive but were wrapped in vet wrap for extra security. small orbs were used for the cameras to pick up and have a point to connect the "dots" on the modeling software. these were stuck on using adhesive but most were on top of the vet wrap. I had to take my leg sleeve off for this.
after all the sensors were attached I had to do several simple exercises to make sure they were working. I was also asked to walk in front of the cameras once. I then had the chance to rest for a minute while the sensors were connected on a modeling program.
once the sensors were connected in the program I walked back and forth many, many times on an area with purple "hopscotch" tiles and a large black tile. the purple hopscotch tiles measure the force on each leg with each step while the black tile measures the pressure across your feet.
I had all the sensors taken off once I was done with the walking. they did not hurt to remove, even with leg hair!
the results will take 4-6 weeks to receive. I will have a follow up appointment to discuss them and the options for surgery. I'll probably update this post with what the follow up appointment looks like
I really have some sort of problem/obsession, haha. I’ve just finished reading a 17 page article on forces on the knee in sports. Wrote a three page summary on it for work only to come across these two gifs of Suranne Jones striding up to Crow Nest. I’m about to get real nerdy 🤓
“I’ve always been fascinated by the human body, how it works.” Come along with me down my rabbit hole. I see the gif and I"m like “Huh. That greatcoat is wide open. Like the train of the dress.” I watch it several more times and my brain goes to science. The force created by our queen to make the flaps of the greatcoat remain open and never coming all the way back to straight, or all the way relaxed against her body, is a thing of beauty. This means she had to be moving at least 3.4 miles per hour, but I would guess she’s much closer 4 miles per hour. Let’s assume there’s no wind from any direction other than headwind she’s creating on her own AND they gave her a start before they started filming. She’s not bent at the waist which would affect the aerodynamics and wouldn’t open the flaps as much because the air over her would push it down. I know we can do anything but unless she’s got superhuman fast-twitch muscles, it will take a minute for the potential energy to become kinetic energy.
Same gif but slowed down.
Force = mass x acceleration. Whatever her mass is, it’s moving, and in the slowed-down gif you can see she’s very close to marching; as one does when walking with purpose. Maybe she figured out how to kick the coat just before toe-off but I don’t see how that’s possible without changing her gait.
Here she is at “toe off.” Her left foot is just about to leave the ground and we can see the entire bottom of her boot. It doesn’t appear to me like she’s about to kick out the coat.
Though it’s grainy, here she appears to be in the slowest part of walking called the “stance phase,” where weight is being transferred from the back leg to the front leg. And STILL that coat has wind in it. 🤯
She’s also not creating much movement at her arms, so not a lot of aid in moving her forward. They are more or less just moving naturally to show her march, which means her legs are probably very strong, just like Anne Lister’s. To top it all off, she’s able to gracefully stop at the top of the stairs like she wasn’t just moving at 4 miles an hour, which means her quads are strong enough to handled the proper eccentric load to slow down.
Look at this modern day Heathcliff! Like I’m floored y’all. Not because I have an obvious crush on Suranne Jones, haha, but she met every demand Sally gave her. “Walk taller. Walk faster. Be bigger.” I think the last time I was this floored was when Bradley Cooper transformed himself for the role of Chris Kyle in American Sniper. #NAILEDIT
PS: I’d like someone to send my very scientific analysis to Suranne’s agent😂
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Fifty years ago, the groundbreaking British sketch series Monty Python’s Flying Circus premiered on BBC One and forever changed the world of comedy. The humour transcended mere absurdity by poking a subversive finger in the eye of buttoned-up British society. Here, we commemorate this cultural milestone and simultaneously call attention to an emerging concept in the health sciences, termed simplified peer review. The union of these disparate subjects motivates a formal gait analysis based on one of the troupe’s most iconic sketches, “The Ministry of Silly Walks”, a satire of bureaucratic inefficiency.
Research question
The sketch portrays peer review as exceedingly efficient, lasting all of 20 s. But was it fair? The answer depends on how one measures silliness. If silly walking can be defined as deviations from typical walking, then it can be quantified using video-based gait analysis.
Methods
To assess the quality of peer review at the Ministry of Silly Walks, we measured knee flexion in the sagittal plane of motion and calculated the Gait Variable Score (GVS) for three gait cycles, those of the Minister (n = 2) and Mr. Pudey (n = 1), an applicant for a Research Fellowship.
Results
For the Minister, we found large deviations from typical walking across two gait cycles (GVSknee(1) = 33.6, GVSknee(2) = 23.3), whereas the gait of Mr Pudey produced an intermediate score (GVSknee = 16.3). By this measure, Mr Pudney’s walk is 3.3 times more variable than typical walking, whereas an exemplary silly walk is 6.7 and 4.7 times more variable, respectively, than typical walking.
Significance
Our analysis corroborates the Minister’s assessment: Mr Pudey is a promising applicant and deserving of a Research Fellowship to advance his silly walk. We suggest that the sketch holds special resonance and uncanny prescience for researchers in the health sciences today.
House MD. : Is he using his cane on the correct side ?
House MD. : Is he using his cane on the correct side ? (hint: vascular infarct to the quadriceps muscle)
*disclaimer: Note to listeners…. there is controversy over the lyrics, there always has been and always will be …..but they are listed below at the end of the post.)
When can you ever go wrong with AC/DC ? Combine that with Hugh Laurie from HOUSE MD and you have a great mix.
So, watching this video, why is he using his cane incorrectly? We all know that House’s has a problem with the right hip and leg. “The Rules” state that with a hip problem the cane should always be used on the opposite side to change the D2 lever arm (great lesson on this:https://www.youtube.com/watch?v=FLFQOKVO6X4&feature=youtu.be). After watching this Gait Guys videos you will clearly understand (perhaps to a better level than most of your therapists and doctors who gave you the cane) why it is used on the opposite side.
So, why in the world is the brilliant Dr. House using it on the same side ? We have received this question more than once. And the answer is quite simple. His problem is likely extracapsular. In the pilot episode of House MD it was explained that he suffered a vascular infarct to the quadriceps muscle. Like bone infarcts, muscular infarcts can be painful. If he contracts the quadriceps when loading the leg there will be pain. Just like if the infarct were osseous, the loading of the cortical bone and stress on the trabecular infrastructure in that case, axial loading of the limb (muscular or osseous) will drive pain. So, to lessen the issue he uses the cane on the same side to literally share his body mass load over the length of the cane and splinting of his body mass through that right arm and the cane. He is essentially attempting to use the cane as his weight bearing limb, same as if using crutches. The cane use on the opposite side is best used when you are attempting to unload the muscular compressive forces across the hip (acetabulofemoral) joint. Contraction of the gluteus medius generates the greatest joint compressive loading of all of the hip muscles because of its orientation during gait. Thus, utilizing the cane on the opposite side acts as a hydraulic lift necessitating a shift in body mass closer to the joint and reducing the compressive demands on the gluteus medius muscle.
* Rule breaker: sure, you can still use the cane on the same side to reduce the gluteus medius forces, it is just a bit more awkward and arguably less efficient from a physics persective. But it can be done. Think about and elderly folk who had a weaker opposite arm, they would feel more comfortable using House’s strategy. The rules are not hard pressed.
* So, House is using the cane correctly for his condition. Of course, he is no dummy !
Rules are meant to be broken. When you are as smart as House you know when to break the rules.
