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What to Expect From Your Child’s Gait Analysis

Once you receive a referral from your child’s primary doctor, you can make an appointment at the Center for Gait and Movement Analysis. After you’ve made the appointment, the following information can help you prepare for your visit.

Getting ready for your gait analysis

Prior to the appointment, read through general information about a visit to Children’s Hospital Colorado.

Complete the questionnaire and bring it with you to the Gait Lab appointment. We need this information before we can start the gait analysis. Call 720-777-5805 if you have any questions.

Additionally, bring any assistive devices your child typically uses, including braces, crutches or walkers. We observe movement with and without these devices.

What to wear for a gait analysis

Your child should wear clothing that allows them to move freely. This is because it’s easier to see their lower body in motion when clothing allows for free movement. We recommend bringing shorts and a bathing suit.

What to expect from a gait analysis

A pediatric gait analysis typically takes three hours, and we strive to make it as interactive possible. You are welcome to stay with your child the entire time.

The lab itself resembles a movie studio, with blue walls and photographic lighting to provide the best environment for recording movement. We’ll ask your child to walk the distance of the room several times. This is challenging for some kids, but we work with you to make sure your child is as comfortable as possible throughout the appointment. Many kids enjoy getting to dress up in the movement sensors and being turned into a so-called “robot.” Plus, they can choose a toy to take home at the end of their appointment.

Steps in a gait analysis study

A gait analysis is complex and involves numerous steps, specialists and advanced equipment to produce a motion analysis report.

When you arrive at the Center, we’ll greet you, check you in for your appointment and ask you to fill out a few forms.

The physical exam is first. Our physical therapist — who stays with your child throughout their entire visit — will collect a variety of information. This could include:

  • Height and weight
  • Measurements
  • Strength and range of motion at hips, knees and ankles
  • Muscle selectivity and spasticity
  • Foot position when standing still
  • Balance when sitting and standing
  • Sensation and skin condition
  • Medical history

We analyze this information and add it to the motion data we collect during the rest of your child’s gait analysis.

During this step of the analysis, the physical therapist will take your child to a large room with special lighting. The therapist will ask your child to walk and perform certain movements, including running if possible and walking backward.

We’ll record video of your child’s session for our gait lab specialists to review. This recording allows our team to observe your child walking at normal speed, slow motion and frame by frame.

The 3D analysis we perform includes several calculations, including kinematics, kinetics and stride characteristics. These tests allow us to create a computer-generated model of your child’s skeleton to more accurately assess their movement challenges.

The physical therapist will ask your child to walk a line the length of the room. At first, your child will complete this barefoot and, if possible, without orthotics or assistive devices. This helps us capture their most natural walking form. Then, if your child has an assistive device, the therapist will ask them to walk with it. Motion capture cameras around the room will capture your child’s movements in 3D from a 360-degree view.

What is motion capture?

Motion capture records movement using special cameras and computer programs. It’s the same technology used to make some of your child’s favorite animated movie characters and video games.

3D motion kinematics: A picture of walking

Our 3D motion capture system creates a 3D picture of how your child moves and walks. Small markers are placed on different bony landmarks on the body. These markers are reflective balls — similar to small ping pong balls — that stick to your child’s skin. Markers are typically placed on the pelvis and legs but may include the midsection and arms if necessary.

Cameras throughout the room track these markers on your child as they walk, capturing the data needed to create a 3D picture. This test is done as naturally as possible, barefoot with no assistive devices. Removing the markers is similar to removing a small bandage or sticker.

We compare your child’s walking pattern to that of a typical child. This helps us identify unusual patterns of motion and measure how different those patterns of motion are.

3D motion kinetics: Measuring the force of walking

In addition to the markers used to study motion kinematics, we also study motion kinetics, or the physical force that produces joint movement when walking. Custom force platforms embedded into the floor measure the force produced when a foot comes in contact with them.

Stride characteristics: Measuring how your child walks

“Stride” is essentially a cycle from the initial contact of one foot with the ground to the next time the same foot makes contact. During this part of the analysis, we measure your child’s stride characteristics, like average walking speed, cadence, stride length, symmetry and more. Our staff compares your child’s measures to that of a typical child to identify abnormal characteristics.

As your child is walking, we also collect data on how your child’s muscles are working while walking. We use dynamic electromyography for this, which helps determine the timing of muscle use during movement.

This is the part of the analysis where your child gets to put on the "robot suit." It’s an interesting exercise where they get to perform again for the cameras, only this time they get to dress up.

What to expect from dynamic electromyography

We attach small sensors called surface electrodes to the parts of your child’s body that need evaluation, typically the thigh muscles, hamstrings, shin and calf muscle. These sensors wirelessly transmit information to the computer. Your child will be asked to walk or perform other activities while we measure the firing of each individual muscle.

The surface electrodes attach to the skin like stickers. They do not bother most patients and are easy to remove after the test. Our staff is specially trained to make sure this is done as easily and quickly as possible.

Dynamic electromyography with fine-wire electrodes

On occasion, we need more information than the basic dynamic electromyography test performed on the skin surface can provide. For deep muscles that can’t be measured from the surface, your therapist might use a fine-wire electrode, which is just a different type of sensor than the surface electrode. This technique provides valuable information about the cause of movement problems, especially in kids with specific types of foot abnormalities.

Fine-wire electrodes are tiny wires that are inserted through the skin directly into the muscles that need further evaluation. While this is an invasive technique that may be briefly painful when the needle is inserted, most children find it only mildly irritating with few after-effects.

Fine-wire electromyography is only used if specifically ordered or if it is determined at the time of the analysis that a muscle cannot be accurately assessed using a surface electrode. It is not part of a typical visit.

Creation of the clinical report is the final stage of your child’s gait analysis. Our gait analysis clinician combines all of the motion analysis data and treatment recommendations so you can easily review the information.

A team approach to gait analysis

Our team, which includes physical therapists, orthopedic surgeons, physiatrists and bioengineers, analyzes the test data shortly after your visit and makes a treatment recommendation for your child. Recommended treatments may include surgery, orthotics prescription, Botox or phenol injections, physical therapy and electrical stimulation.

Support and resources for your family

In some cases, the gait analysis and recommended treatment can be complex and require explanation. While most families talk through the analysis and treatment plan with their referring physician, families can also request a conference with members of our team. We’re happy to answer questions and provide addition information to help support your treatment decision.

Other suggestions for your gait lab visit

Because your gait lab visit can last several hours and may involve different tasks, we like to keep the study room calm, quiet and free of distractions. If you have other children with you on the day of the appointment, you are welcome to contact Children's Colorado’s Creative Play Center for a free and safe play area.