Meet Hugo, and Anthony, a former patient, as they take you on a behind-the-scenes video tour of what happens inside the Motion Analysis Laboratory.
The John C. Wilson, Jr. Motion Analysis Laboratory calls on today’s most advanced assessment tools to assist children who have difficulty walking. As part of the acclaimed Children's Orthopaedic Center, the leading-edge Lab is one of the most advanced facilities of its kind in the United States and one of only two such labs in Southern California, focused exclusively on children and adolescents. The Lab opened in 1992, fulfilling the vision of Vernon Tolo, MD, and Robert Kay, MD, who has served as the medical director of the Lab since 1997.
The Lab offers a nine-camera system that evaluates the gait of children via strategically placed sensors on the body and force plates on the floor beneath their feet, providing guidance for treatment and surgical plans for children with walking disorders like cerebral palsy and spina bifida.
Currently more than 150 children are evaluated annually in the Lab. Nine out of 10 children who visit the Lab have improved treatment plans. The data from their visit is used to direct operative and non-operative care in these children. Using the latest computer technology, an expert, specialized staff analyzes muscle activity and joint movements in patients with such conditions as:
- Cerebral palsy
- Spina bifida
- Sequelae of head injuries
- Juvenile rheumatoid arthritis
Impact of Motion Analysis
Comprehensive motion analysis testing helps make the diagnosis and treatment of the movement disorders a more precise science. Motion analysis testing helps surgeons determine the causes of such problems as varus deformities of the feet, crouched gait, or stiff knee gait.
The data is also helpful in determining the origin of rotational problems in gait.
The impact of gait analysis is dramatic:
- Pre-operative motion analysis results in changes to surgical plans for nearly 90 percent of children seen in the motion lab.
- Pre-operative motion analysis reduces the need for additional surgeries done at a later date by 67 percent.
- Repeat motion analysis following surgery results in recommendations for changes in post-operative care in 84% of cases. Recommendations may include:
- Botox injections
- Serial casting
- Physical therapy
- Changes in bracing to maximize the outcome of surgery and further improve the patient's mobility
Motion analysis testing also allows surgeons to evaluate problems at all joints simultaneously, which enables them to perform surgical correction of all problems in a single surgical session. This leads to improved quality of life for children whose lives would otherwise be disrupted every few years for surgical procedures.
A comprehensive motion analysis test consists of:
- Detailed clinical evaluation and videotaping.
- 3-D kinematic and kinetic measures of joint motions and forces.
- Surface and fine wire dynamic electromyography measurements of muscle activity and timing.
- Integration and interpretation of the findings.
- Physician review and recommendations based on the results.
At the John C. Wilson, Jr. Motion Analysis Lab, we are constantly striving to advance the field of motion analysis. Our research includes:
- Clinical outcomes research
Studies in this area document the efficacy of surgical procedures, evaluate whether one procedure is preferable to another for the treatment of particular problems, and identify which patients are the best candidates for specific surgeries. We have used motion analysis data to study the effects of femur (thigh bone) rotation surgery, hamstring lengthening and distal rectus femoris transfer, calf muscle lengthening procedures, and bracing with ankle-foot orthoses, among others.
- Impact of gait analysis
We have a strong interest in studying the impact that gait analysis has on clinical decision-making, treatment, and outcomes. Our previous studies have shown that 89% of pre-operative treatment plans and 84% of post-operative treatment plans change after consideration of gait analysis data. We are currently studying how gait analysis affects patient outcomes.
- Biomechanical modeling & surgical simulation
We are using computer modeling to extend the capabilities of traditional gait analysis. Using biomechanical models, we can study muscle-tendon lengths and individual muscle forces during gait, in addition to joint angles and net joint forces. We are working to develop the basic knowledge and technical tools needed to design surgical simulation software that will predict the outcome of multilevel surgery for specific patients, allowing the surgeon to test and fine-tune surgical plans prior to surgery.