Shriners Children’s is an internationally recognized leader in clinical motion analysis. Our motion analysis centers complement our healthcare system’s commitment to provide excellent care to children with orthopedic conditions, including those caused by neuromuscular problems, such as cerebral palsy. When we understand how a child with these diagnoses moves, we can help them move more efficiently, effortlessly and confidently.
How motion analysis works
In the motion analysis centers, high-speed cameras, reflective markers, force platforms and muscle sensors work together to measure and record how a child is moving.
The collected data gives a complete picture of how a patient’s muscles, joints and bones are interacting. This picture provides the understanding often needed to determine the best treatment recommendations for our patients. Additionally, the availability of pre- and post-operative data helps physicians refine and adjust surgical procedures to achieve even better outcomes in the future.
The evolution of the centers
Shriners Children’s has 14 motion analysis centers in the healthcare system. While the centers were originally used for gait (walking pattern) analysis to help guide surgical decisions and outcomes, motion analysis can now also be used to provide data for the following needs:
- RETURN TO SPORTS TESTING: Determining risk of ACL (anterior cruciate ligament) injury before and after surgery, as well as improving return to sport outcomes for other injuries
- UPPER EXTREMITY BRACHIAL PLEXUS INJURIES: Measuring the volume of space a patient can reach with their arm
- SPINE/TRUNK MOBILITY: Evaluating trunk flexibility before and after scoliosis surgery
- FOOT MODELS: Understanding the details of how muscles and bones in the foot move as a patient is walking
In 2021, 3,657 patients received motion analysis services during a total of 4,009 appointments.
“It has been great to see how the labs have evolved in the last 20 years,” said Ross Chafetz, PT, Ph.D., D.P.T., MPH, corporate director of the motion analysis centers. “In the past, we completed very basic evaluations of how the patient walks. Our systems are far more precise and sophisticated now. For example, rather than a general look at the patient’s foot we can now break it down into several different segments. The increased detail gives us the ability to evaluate foot surgeries that we could not previously determine with this technology.”
Chafetz also noted how exciting it is that motion analysis has branched out into other lines of service, such as helping surgeons determine when a posterior spine fusion versus vertebral body tethering is indicated, and for helping patients return to sports. “Motion analysis allows us to evaluate the patient’s biomechanical form to prevent future injuries,” he explained.
Shriners Children’s has seven centers accredited by the Commission for Motion Laboratory Accreditation (CMLA), and by the end of 2022, we hope to have all 14 accredited – which would mean that 56% of all nationwide accredited labs would be at Shriners Children’s facilities. Accreditation ensures the highest quality of care and sets the standard for research.
The future of motion analysis
These evolving technologies will make the centers even more valuable to patient care in the future:
- Marker-less camera systems that accomplish similar evaluations with significantly less time and staff. “These systems are portable, suggesting that we can bring our lab into the community,” Chafetz said. “For example, we could capture gait analysis in our Puerto Rico clinic. For sports, we could take the system to the high school to do injury prevention testing.”
- Sensors that patients can wear in a suit throughout the day. “This will allow us to monitor joint motion and activity levels,” explained Chafetz. “We can capture how a patient truly walks during the day rather than how they walk under laboratory conditions.”
- Virtual reality and games to measure the outcomes of upper extremity surgeries. “With these games, a surgeon can determine whether the patient has a better ability to reach for objects in their immediate space,“ said Chafetz.
Motion Analysis & Research
In collaboration with Marquette University, Karen Kruger, Ph.D., our Chicago location’s motion analysis center director, and Gerald Harris, Ph.D., director emeritus, have developed biplane fluoroscopy imaging. It’s like a real-time X-ray consisting of thousands of images put together, resulting in a 3D video. In the past, they had access to limited research data, primarily from examinations, traditional X-rays and MRIs. However, with this new approach, they can more effectively study areas such as foot deformities, the use of orthotics and long-term surgical results.
In addition, Chicago’s Joe Krzak, Ph.D., PT, PCS, senior physical therapist, is developing machine-learning approaches to provide more advanced analysis. Machine learning uses artificial intelligence to analyze data, identify patterns and make decisions with minimal human involvement. The data will rapidly advance what is known and understood about how to address mobility challenges.
With these partnerships and the collaborative research being done by Shriners Children’s researchers and care providers, motion analysis data and evolving technology are guiding us toward a brighter future with countless new treatments and practices.