Gait crasher

Gait crasher

How one researcher is volunteering her expertise to help kids with cerebral palsy
October 12, 2011
Force plates embedded in the floor measure how
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Force plates embedded in the floor measure how Courtney's foot interacts with the ground.
Vicky Chester, UNB

For most people, walking is as natural as breathing. But for those with mobility issues, it can be extremely challenging, even impossible. That’s where University of New Brunswick (UNB) kinesiologist Vicky Chester comes in. Specializing in clinical gait analysis — the study of the mechanics of abnormal walking patterns — Chester is increasing our understanding of movement disorders.

For nearly a decade, Chester has been donating her time and using equipment funded by the Canada Foundation for Innovation (CFI) to help children with cerebral palsy. While working at the Stan Cassidy Centre for Rehabilitation (SCCR) in Fredericton, she saw kids struggling to walk across the room. “This affected me deeply,” she says. “It seemed unfair that they could not run and play and have a typical childhood.”

Chester collaborated with the SCCR to develop a process for monitoring, analyzing and interpreting kids’ movements at UNB’s Andrew and Marjorie McCain Human Performance Lab, where she conducts her regular gait-analysis research program. Going beyond the research, Chester helps make treatment decisions, such as the need for surgery or braces, by discussing the results with the children’s doctors and physiotherapists.

By placing reflective markers on a child’s skin, Chester is able to track their movements with a 12-camera Vicon T160 system, the world’s most advanced motion-capture process. Force plates in the lab’s floor measure how the foot hits and slides on the ground. “From this information, we can measure angles, such as knee bend and impact forces,” says Chester. “Combined with data on body shape and size, we can estimate the net muscle activity needed to walk.”

In disorders such as cerebral palsy, Chester says that medical interventions have the potential to change a child’s development and, in turn, his or her movement, function and quality of life. She points to her first SCCR case — a female with diplegic cerebral palsy (a form of cerebral palsy primarily affecting the legs). The patient had undergone several surgeries but was still tripping and falling because her knee did not bend enough. At other points during walking, her knee would be bent too much. “The gait data clearly identified a muscular imbalance in the patient’s knee joint,” says Chester. As a result, a procedure uncommon in the Maritimes —transferring a muscle from the front of the thigh to the back — was performed, with positive results.

“Without the surgery, the patient may not have been able to walk within a few years,” she says. Using the gait data, the team was able to pinpoint the problem, identify compensations and provide a treatment solution. “It was a success all around,” says Chester.

Since this first case, more than 100 kids have had similar success stories because of Chester’s work. “We are making better treatment decisions overall with regards to gait and mobility,” says Nicole Desaulniers, a physiotherapist at SCCR. “Patients have increased access to surgeons who use the gait-analysis data to make treatment decisions. For some of our patients, this will mean fewer surgeries and, hopefully, independent mobility that surpasses current expectations.”

And it’s not only the patients who benefit. “Vicky has fine-tuned our expertise and our observational eye,” says Desaulniers. “She is extremely well respected, and this has helped us build bridges with our clinical counterparts in the Atlantic provinces.” The SCCR now offers a 3-D gait-analysis program, which involves consultation with surgeons and clinicians from Nova Scotia and Newfoundland. “We wouldn't have been able to do that without Vicky.”

Chester credits the CFI with helping make her gait research possible. CFI contributions supported the work of three of the lab’s faculty members, as well as a significant portion of the lab’s equipment — specifically, the first-rate motion cameras used for gait tests and two force plates. The lab is where Chester studies walking patterns for those with autism, stroke and total knee arthroplasty, as well as developing children.

Chester and colleagues observe Courtney
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Chester and colleagues observe Courtney's walk to provide her doctors with valuable information they can use to properly treat her.
Vicky Chester, UNB

“Our lab is one of a kind in Canada and will undoubtedly attract and help retain students, staff and faculty,” says Chester. “The funding provided by the CFI over the years has been critical to the development of our lab, which is one of the world’s most advanced motion-capture and neuromuscular physiology laboratories.”

Physiotherapist Becky Blight applies markers and
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Physiotherapist Becky Blight applies markers and EMG electrodes to patient Courtney. Tracked by cameras, the markers provide information on movement, while the electrodes show the muscle activity needed to perform the movement.
Vicky Chester, UNB