COMPARISON OF CLINICAL GAIT ANALYSIS STRATEGIES BY FRENCH NEUROLOGISTS, PHYSIATRISTS AND PHYSIOTHERAPISTS
Eric Watelain A1, Jérôme Froger A2, Franck Barbier A3, Ghislaine Lensel A4, Marc Rousseaux A2, François-Xavier Lepoutre A5, André Thevenon A6
A1 Laboratoire d'Analyse du Mouvement, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Service, d'Exploration Neurophysiologique, Hôpital B, Lille, and Laboratoire d'Automatique et de Mécanique Industrielles et Humaines, Université de Valenciennes et du Hainaut-Cambrésis, Valenciennes, and Faculteés des Sciences et des Métiers du Sport, Université de Valenciennes et du Hainaut-Cambrésis, Valenciennes, France
A2 Laboratoire d'Analyse du Mouvement, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Service, d'Exploration Neurophysiologique, Hoôpital B, Lille, and CHRU de Lille, Hoôpital Swynghedauw, Service de Rééducation et de Convalescence Neurologique, France
A3 Laboratoire d'Automatique et de Mécanique Industrielles et Humaines, Université de Valenciennes et du Hainaut-Cambrésis, Valenciennes, and Facultés des Sciences et des Métiers du Sport, Université de Valenciennes et du Hainaut-Cambrésis, Valenciennes, France
A4 Laboratoire d'Etudes de la Motricité Humaine, Faculté des Sciences du, Sport et de l'Education Physique, Université de Lille 2, Ronchin, France
A5 Laboratoire d'Automatique et de Mécanique Industrielles et Humaines, Université de Valenciennes et du Hainaut-Cambrésis, Valenciennes, France
A6 Laboratoire d'Analyse du Mouvement, Centre Hospitalier Régional Universitaire (CHRU) de Lille, Service, d'Exploration Neurophysiologique, Hôpital B, Lille, and Service de Médecine Physique et de Réadaptation, Lille, France
DOI: 10.1080/16501970306104
Abstract
Clinical and functional gait analysis is used widely by different professionals dealing with patients with hemiplegia. The aim of this study was to examine the gait analysis strategies of neurologists, specialists in physical and rehabilitation medicine (physiatrists) and physiotherapists. Differences in global analysis strategy and choice of indicators between different clinicians have not previously been studied precisely, and we believe that a standardized approach would enhance the training of young practitioners. The knowledge acquisition phase (specialists' expertise identification) was completed by an identified expert with a subject groups of 5 neurologists, 5 specialists in physical and rehabilitation medicine and 5 physiotherapists, who were asked to comment on a videotape of patients with hemiplegia walking, followed by a semi-directed interview. The results show that specialists use a wide variety of gait indicators. The total number of different medical vocabulary and expressions used to describe gait was 396, semantically grouped as 60 general indicators. Specialists highlighted an analysis strategy (order, type and number of indicators) typical to each professional specialty. The neurologists tried to identify the elements allowing localization of lesions and characterized the hemiplegia globally, while the specialists in physical and rehabilitation medicine conducted a biomechanical analysis and the physiotherapists were highly descriptive. The differences in strategies adopted by each specialty contribute to an enrichment of gait analysis. This should be taken into account in teaching and determining gait assessment scales.
Lay Abstract
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