Utilizing three dimensional clinical gait analysis to optimize mobility outcomes in incomplete spinal cord damage

Area of Science:

• Neurology
• Biomechanics
• Rehabilitation Medicine

Background:

• Three-dimensional gait analysis (3DGA) is widely used in neurological conditions like stroke and cerebral palsy.
• Its application in spinal cord damage (SCD) populations has not been established through expert consensus.

Purpose of the Study:

• To investigate how 3DGA-based impairment reporting influences individualized clinical decision-making in adults with incomplete SCD.
• To assess the clinical utility of 3DGA in guiding interventions for this patient group.

Main Methods:

• A retrospective open cohort case series of 48 adults with incomplete SCD was analyzed.
• 3D gait data were used to identify impairments, classifying gait patterns using the plantarflexor-knee extension couple index and Gait Profile Score (GPS).
• Referral reasons and post-3DGA recommendations were documented to evaluate 3DGA's value in decision-making for targeted interventions.

Main Results:

• Participants with SCD exhibited reduced gait speed; the tetraplegia group showed a significantly lower GPS without distinct gait patterns.
• Referrals to the Clinical Gait Analysis Service (CGAS) primarily aimed to inform clinical intervention decisions.
• Ankle foot orthosis prescription was the most common recommendation post-3DGA, occasionally differing from the referrer's initial plan.

Conclusions:

• 3DGA offers valuable guidance for managing gait in patients with incomplete SCD, potentially preventing inappropriate interventions.
• The study demonstrates the clinical utility of 3DGA in supporting clinicians' decision-making for personalized interventions in the SCD population.