Applications of gait analysis in pediatric orthopaedics

Computerized motion analysis, through innovation in technology and data interpretation, can be used as an important clinical tool. Gait deviations commonly occur in the pediatric population, some of which require a comprehensive approach to evaluation and treatment. This article provides an overview of the clinical application of gait analysis in pediatric orthopedics. The patient populations that may benefit from gait analysis and common gait abnormalities are presented as well as a systematic approach to observational gait analysis. The application of gait analysis in quantitatively identifying gait deviations and assisting with clinical decision-making are reviewed. Major components of the testing protocol such as physical examination, three-dimensional kinematics and kinetics, foot pressure, electromyography, energy consumption, are described. Principles of patient management and the utilization of gait analysis in various stages of clinical evaluation and treatment planning (baseline, follow-up, pre-intervention and post-interventions) are discussed. Two example cases (in-toeing and cerebral palsy) are illustrated to demonstrate the use of gait analysis in forming a therapeutic plan and measuring the treatment outcome quantitatively. Supplemental video files are included to illustrate important components of computerized gait analysis, demonstrate abnormal gait patterns, and present preoperative and postoperative gait videos of the case studies.