In 1995, the National Center for Medical Rehabilitation Research (NCMRR) within the National Institutes of Health (NIH) sponsored a workshop entitled “Gait Analysis in Rehabilitation Medicine”. The purpose of the workshop was to develop and prioritize a set of recommendations pertaining to the role of gait analysis in enhancing the function of people with locomotor disabilities. The results of the workshop were 37 prioritized recommendations. Professional organizations and societies were charged with the responsibility of further synthesizing the workshop products. Government agencies, industry, and professional organizations were challenged to work cooperatively towards achieving advancements for the future use of gait analysis in rehabilitation medicine. In the decade since the NCMRR workshop, there have not been any reports of systematic attempts to assess or redefine research priorities in the gait analysis community. Since the workshop, the field of gait and motion analysis has continued to mature. The GCMAS Research Council decided that a reassessment of priorities was necessary. The purpose of the project was to reassess and redefine a priority list for investigations of gait and clinical movement analysis.
A three-step process was used. In April of 2004, the Council met in Lexington, KY and reviewed the 37 recommendations of the NCMRR Gait Analysis Workshop. The council selected by consensus the four recommendations considered to be most relevant to the mission of the GCMAS. In April of 2007, a discussion session open to all members of the GCMAS and other conference attendees was held at the annual meeting in Springfield, MA to discuss these recommendations. Forty members attended the meeting. Four focus groups were formed to discuss the recommendations. From the meeting, four additional recommendations were developed for a total of eight recommendations. The recommendations were framed in a similar format to those of the NCMRR workshop. From November 15 to December 15 of 2007, the entire GCMAS membership had the opportunity to prioritize the eight recommendations via an electronic voting process through the GCMAS website. The results of this voting are listed below in rank order (highest priority to lowest priority).
A symposium was held at the 2008 meeting to address the results. The purpose of this symposium was to develop plans and strategies to permit research centers to collaborate and/or participate in research addressing the two highest primary objectives identified by GCMAS members to advance the field of human movement analysis. Approximately 40 participants divided into two groups to discuss the two research objectives, and each group developed a plan/strategy/timeline/action items that would permit research of the specific objective to be accomplished. The results are available for download below.
Gait analysis is an effective tool in the clinical decision making process for improving treatment outcome in individuals. (9.1, SD 1.2)
The primary reason for the inconsistent utilization of clinical gait analysis is the lack of efficacy data demonstrating that functional outcomes are improved as a direct result of gait analysis. The consequence of this uncertainty is that individuals with disabilities are either deprived of a useful assessment tool or are subjected to a time consuming and unnecessary evaluation. The purpose of this recommendation is to demonstrate that clinical gait analysis alters treatment decisions so as to improve functional outcomes.
Gait/motion analysis has applications beyond gait in individuals with cerebral palsy. (7.8, SD 2.0)
Gait analysis is frequently used in guiding the selection and assessing outcome of orthopedic surgical procedures for individuals with cerebral palsy. However, other medical pathologies may benefit in a similar manner. The purpose of this line of research is to demonstrate the effectiveness of gait/motion analysis in guiding selection and assessing outcome in other medical conditions besides cerebral palsy and to explore the assessment of movement other than gait (e.g., upper extremity).
Gait/motion analysis is an effective functional outcome measure. (7.8, SD 2.3)
There is a paucity of quantitative research documenting the advantage of computerized gait analysis over traditional clinical evaluations or questionnaires as a functional outcome assessment tool. Historically, most orthopaedic surgeons and rehabilitation specialists have relied primarily on static examination and observational gait analysis to assess outcomes. Recently, questionnaires have been developed that may overlap with gait analysis assessments. The purpose of this line of research is to demonstrate that gait analysis is an effective functional outcome measure.
Gait/motion analysis is an accurate, precise, and valid method of quantifying movement. (7.2, SD 2.1)
Advances in instrumentation and computer technology have substantially increased the accuracy and precision of the data collected in gait/motion analysis process. Nevertheless, there are relatively few studies that have comprehensively identified the real and potential artifacts inherently involved in transforming the basic collected data set (e.g., spatial location of body markers) into assessment variables (e.g., joint angles). The purpose of this line of research is to document the inherent limitations and uncertainties associated with motion analysis techniques, investigate their effects on the information made available for clinical interpretation, and develop new approaches that improve quality relative to accuracy, precision, sensitivity, reproducibility, and validity.
Gait/motion analysis is underutilized due to the lack of understanding by clinicians of its benefits and limitations. (6.6, SD 2.0)
A major barrier to a wider use of gait/motion analysis for directing interventions or in outcome assessment is the lack of a basic understanding by physicians, therapists, orthotists/prosthetists, and other medical professionals regarding its capabilities, benefits, and limitations. The purposes of this line of research are to develop and implement educational methods that can assist medical professionals in understanding the concepts involved in gait/motion analysis.
Gait/motion analysis is a cost effective patient management tool. (6.4, SD 2.1)
The cost effectiveness of gait analysis as a clinically useful tool has yet to be demonstrated as it relates to an individual’s participation, functional limitations, and disability. The lack of information has impeded the ability to justify the benefits of gait analysis to the consumer, medical community, and insurance providers. The purpose of this line of research is to demonstrate the cost effectiveness of gait/motion analysis as a patient management tool.
Gait/motion analysis data are difficult to share. (5.0, SD 2.3)
Sharing data among motion analysis laboratories is typically difficult due to differences in methods. Not enough work has been done to develop procedures for sharing. This can limit understanding, interpretation, and presentation of results. The purposes of this line of research are to develop and implement systematic methods of sharing data among motion analysis laboratories to expand the body of knowledge and to support advances within the field.
Gait/motion analysis laboratories lack systematic business practices and organization to promote and sustain the field of gait/motion analysis. (4.6, SD 2.3)
The field of gait/motion analysis is comprised of individual researchers, individual laboratories and networked systems within clinical and academic sites. Such diverse individualization makes it difficult to advance the standing of the field within business markets and political arenas. The purpose of this line of research is to develop better systematic business practices and organization to promote and sustain the field of gait/motion analysis.research objective 2 discussion.pdf research objective 1 discussion.pdf