Gait (def): a manner of walking or moving on foot
Everyday we get into our car, turn the key and drive to where we want to go. Most of us take this daily routine for granted. Not until the car has a mechanical problem and prevents us from getting to our intended destination do we think twice about the ease in which we typically travel. To prevent the car from not working correctly we have preventative maintenance performed on a routine basis: change the oil, align the wheels, clean and wax, and perform tune ups. We know even small wheel alignment asymmetries cause premature wear and tear to the automobile that will cause bigger and more expensive problems down the line. The human body is not much different.
Like our car, the simple task of walking is taken for granted until injury or illness causes limitation or pain in the gait cycle. Anyone who has used crutches for a few days begins to appreciate the task of walking at a whole new level! Like the car alignment causing uneven wear and tear on the tires, scientific studies have given researchers a glimpse that future illness and injury can be predicted by sub clinical (undetected by the human eye) changes in the gait cycle. Certain aspects of the gait cycle can be used to quantify walking ability. Gait measures such as speed (cadence), step frequency, variability, and step-length can serve as markers to predict fall and future cognitive decline.
In a Mayo Clinic study, researchers measured the stride length, cadence and velocity of more than 1,341 participants through a computerized gait instrument (Gait Rite System) at two or more visits roughly 15 months apart. Those with lower cadence, velocity and length of stride experienced significantly larger declines in global cognition, memory and executive function. The author (Dr. Savica) noted, “These changes support a possible role of gait changes as an early predictor of cognitive impairment”.
Another large study of 1,153 adults with a mean age of 78, by researchers at the Basel Mobility Center in Basel, Switzerland, found that gait became “slower and more variable as cognition decline progressed.”
Participants were divided into groups based on cognitive diagnoses: cognitively healthy, mild cognitive impairment (MCI) or Alzheimer’s dementia. Gait was measured using a walkway with 30,000 integrated sensors. Those with Alzheimer’s walked slower than those with MCI, who walked slower than those who were cognitively healthy. Other researchers (Kikkert, et al. 2016) also recommend gait analysis, including dynamic gait parameters, in clinical evaluations of patients with suspected cognitive decline.
One annual test might not work with everyone, as many witness their spouse or loved one walking much better during the gait test than they typically do at home. In fact research was conducted on 19 dementia-free volunteers at Oregon Health and Science University in Portland. They measured gait speed during MRIs and gait speeds at home. The results showed that participants walked faster in the lab than at home. Slower in-home walking speed was associated with smaller total brain size and dementias cause brain shrinkage.
We think waiting for possible cognitive decline to test gait is like waiting until your tires are unevenly worn AND THEN getting the wheel alignment checked. Doing the preventative maintenance for the car and the body can help prolong the life of the ‘machines’ that we use every day.
Gait is the blueprint to ones ability to demonstrate flexibility, stability and balance in motion. Testing gait as a baseline prior to injury and then re-testing intermittently (every 6 months) can be preventative in nature, just like getting the car’s wheels aligned. Using our state of the art Optogait biomechanical analysis system allows us to take a blueprint of your movement. If there is an injury after baseline testing then the goal of rehabilitation of the injury would be to return you to your normal gait. For example, if you sprain your knee skiing, pain typically causes limping. Limping alters the gait cycle. Altering the gait cycle for a period of time can cause compensatory problems on the other side of the body. Your brain remembers this new way of movement (right or wrong) and the compensations will continue until addressed. If your alignment isn’t right, future wear and tear of your body is imminent.
“Most of the time compensations occur functionally in the
lower extremities, hips and pelvis to compensate for the
differences in step length to ensure gait progression in a
straight line. It is these longstanding complex
compensations, which are necessary to procure a straight line gait, that are the generators of many of our patient’s
complaints.” (Waerlop, I and Allen, S, 2005 Pedograph and
Gait Analysis: Clinical Pearls and Case Studies)
If any abnormal aspects of the gait cycle are detected a more detailed examination is performed to determine why the gait is altered. Based on our examination findings, flexibility, strengthening and balance exercises are prescribed in conjunction with training on a treadmill using our biofeedback system to improve all aspects of the gait cycle are prescribed.
Considering running is even more challenging to the human body than walking, those who are running for recreation or competition need to be evaluated for proper running gait after walking gait is evaluated. Improper running gait can lead to poor performance and future injury. Because running is a repetitive single leg stance, running gait challenges the stability, mobility and balance of the human body on one leg. Therefore testing on one leg is important to determine deficiencies that can be corrected prior to injury or during the rehabilitation process. In addition to dynamic testing a pedograph analysis is performed to see how the foot makes contact with the ground. Power testing using the OptoGait is done to determine differences from the left and right sides of the body.
If you have been prescribed orthotics in the past we perform multiple gait analysis’ (barefoot, with shoes, with shoes and inserts) to determine if the orthotics are still performing their functional role. Many times we find strengthening the foot in addition to the orthotic is necessary for proper foot function over time.
Previously gait analysis could only be performed in a very expensive lab and took hours to perform. The data would take a long time to evaluate before the findings could be reported to patients. Now with the OptoGait an analysis can be performed quickly with instant results at a reasonable price. What was once restricted to the elite few (at a fancy Gait lab), is now being brought to the masses.
Click Here to Schedule A Walking or Running Gait Analysis with Dr. Le Cara at our RiNo location
Cost: $299 (90 minutes) Please bring the last couple sets of running shoes you have worn and clothes to walk and run in comfortably.