Gait is a bare necessity for performing most of the activities of daily living (ADL). Through gait a person is in control of getting from one place to another at any place or time, therefore good quality gait is significant for a feeling of good health and subjective quality of life. An impairment of the locomotor system can result in disability or even handicap, but many therapeutic methods exist to overcome impairment caused by trauma, disease, or wear off. Tools and methods for the evaluation of impairment such as X-ray photography are integrated in clinical routine, however, in the evaluation process little objective information is collected about improvement at the level of performance in normal daily activities. To date a method that is practical though sufficiently sensitive is missing. New methods of gait analysis based on accelerometry [1, 2] may accommodate the demand for objective gait data, as well as provide a cost-effective means for collecting and reporting such data. The aim of this paper is to discuss accelerometry compared to other gait analysis methods with regard to considerations for clinical implementation. We regarded position analysis (e.g. Vicon^®, MacReflex^®), force plates (e.g. Kistler), walkway (e.g. GAITRite^®), goniometers (e.g. Penny & Giles), pressure sensors under the feet (e.g. Infotronics) and body-fixed accelerometers (e.g. DynaPort^®). Of this range of gait analysis methods we rated the specificity, clinical validity, responsivity and ease of use. Reliability is regarded a prerequisite for all.

We rated specificity on the basis of detail and precision, clinical validity on how real and acceptable the measured samples of gait are, responsivity on the extent to which the measurements can support in assessment of clinical questions, and ease of use on how quick, simple and affordable measurement is. The authors’ ratings are presented in table 1.

Table 1. Types of gait analysis related to criteria for clinical implementation. Reliability is regarded a prerequisite for all. The criteria are rated by the authors: o = not good, + = moderate, ++ = good.

It is concluded that position analysis is the most elaborate and specific method for gait analysis, however gait is constrained and only a small number of strides can be assessed. Also, the cost and effort required to establish and operate a gait lab based is high. Though specificity is to be elaborated, accelerometry excels in clinical validity and ease of use. It offers very responsive measures of gait in almost any natural situation with minimal movement constraints. Unsupervised collection of measurement data during ADL supplies objective information as well as its dynamics over time. We conclude that for broad implementation in clinical practice accelerometry has large potential as it offers a clinically valid, easy and affordable method for gait analysis.

References

1. Veltink, P.H.; Bussmann, J.B.J.; de Vries, W.; Martens, L.W.J.; van Lummel, R.C. (1996). Detection of static and dynamic activities using uniaxial accelerometers. IEEE Trans. on Rehab. Eng., 4, 375-85.
2. Willemsen, A.Th.M.; Frigo, C.; Boom, H.B.K. (1991). Automatic stance swing phase detection from accelerometer data for peroneal nerve stimulation. IEEE Trans. on Biomed. Eng., 38, 12.