Pediatric gait and motion analysis: Current limitations and emerging opportunities for quantitative assessment

Abstract

Studies of human locomotion have historically paralleled developments in photographic technology. Early works of the late 19th century by Muybridge and Marey employed sequential photography. Later works by Braun and Fischer introduced illuminated tubes on limb segments, and multiple cameras. With these early contributions began the maturation of gait analysis from a research-based activity to a more clinically relevant assessment tool. Significant clinical advances began in the 1960's and have continued to the current time. Recognized clinical contributors include David Sutherland, Jacqueline Perry, Sheldon Simon, Freeman Miller, and James Gage. Today, the majority of pediatric clinical applications focus on the lower extremities (LE) with segmental motions distal to the ankle seldom considered. Methods for expanding current LE analysis methods are presented. These include functional means of assessing hip joint center location and refinement of a biomechanical foot model to include segmental (heel, forefoot, hallux) motion. Emerging opportunities for clinically relevant pediatric assessment, pre-treatment decision making, and post-treatment rehabilitative follow-up are included.