Management of a patient's gait abnormality using smartphone technology in-clinic for improved qualitative analysis: A case report

Physiother Theory Pract. 2018 May;34(5):403-410. doi: 10.1080/09593985.2017.1419326. Epub 2018 Jan 8.

Abstract

Background and purpose: Qualitative analysis has its limitations as the speed of human movement often occurs more quickly than can be comprehended. Digital video allows for frame-by-frame analysis, and therefore likely more effective interventions for gait dysfunction. Although the use of digital video outside laboratory settings, just a decade ago, was challenging due to cost and time constraints, rapid use of smartphones and software applications has made this technology much more practical for clinical usage.

Case description: A 35-year-old man presented for evaluation with the chief complaint of knee pain 24 months status-post triple arthrodesis following a work-related crush injury. In-clinic qualitative gait analysis revealed gait dysfunction, which was augmented by using a standard IPhone® 3GS camera. After video capture, an IPhone® application (Speed Up TV®, https://itunes.apple.com/us/app/speeduptv/id386986953?mt=8 ) allowed for frame-by-frame analysis. Corrective techniques were employed using in-clinic equipment to develop and apply a temporary heel-to-toe rocker sole (HTRS) to the patient's shoe.

Outcomes: Post-intervention video revealed significantly improved gait efficiency with a decrease in pain. The patient was promptly fitted with a permanent HTRS orthosis. This intervention enabled the patient to successfully complete a work conditioning program and progress to job retraining.

Discussion: Video allows for multiple views, which can be further enhanced by using applications for frame-by-frame analysis and zoom capabilities. This is especially useful for less experienced observers of human motion, as well as for establishing comparative signs prior to implementation of training and/or permanent devices.

Keywords: Clinical gait analysis; orthosis; qualitative motion analysis; triple arthrodesis; video capture.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Equipment Design
  • Foot Orthoses
  • Gait Disorders, Neurologic* / diagnosis
  • Gait Disorders, Neurologic* / physiopathology
  • Gait Disorders, Neurologic* / rehabilitation
  • Gait Disorders, Neurologic* / surgery
  • Gait*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Knee Injuries* / diagnosis
  • Knee Injuries* / physiopathology
  • Knee Injuries* / rehabilitation
  • Knee Injuries* / surgery
  • Knee Joint* / physiopathology
  • Knee Joint* / surgery
  • Male
  • Predictive Value of Tests
  • Recovery of Function
  • Smartphone*
  • Treatment Outcome
  • Video Recording* / instrumentation
  • Work Capacity Evaluation