Selected Podcast

Motion Analysis Center for Gait Evaluation

Motion analysis technology and expertise in interpreting findings and making recommendations are vital components in helping kids in need achieve the greatest mobility possible. Pooya Hosseinzadeh, MD discusses the newly-opened Motion Analysis Center at St. Louis Children's Hospital which aims to do just that-- and it's the only one in the St. Louis area.
Motion Analysis Center for Gait Evaluation
Featured Speaker:
Pooya Hosseinzadeh, MD
Pooya Hosseinzadeh, MD has clinical interests in the evaluation and treatment of neuromuscular conditions in children. He specializes in the operative and non-operative treatment of musculoskeletal conditions in children with cerebral palsy and other neuromuscular conditions. Other clinical interests include hip dysplasia, general pediatric orthopedic surgery, lower extremity deformities, and traumatic injuries.

Learn more about Pooya Hosseinzadeh, MD

Melanie Cole (Host): We all want our children to be able to play and have fun, so helping kids in need achieve the greatest mobility possible is really what motion analysis is all about, and here to tell us about it is Dr. Pooya Hosseinzadeh. He’s a Washington University Pediatric Orthopedic Surgeon at St. Louis Children’s Hospital. Dr. Hosseinzadeh, let’s just start for other providers to define motion analysis, not everybody is familiar with it. Tell us a little bit about it.

Dr. Pooya Hosseinzadeh (Guest): Thank you Melanie, so motion analysis is basically the technology that will help us objectively assess the gait. So we will be able to pain a three dimensional picture of how each segment of the body is moving relative to the other one and how that actually confers to the norm. This is very helpful in finding the exact problem in children who has complex gait problems, especially children with cerebral palsy, myelodysplasia or any other developmental problem of that sort that they have complex gait problems, we’ll be able to asses where the problem is coming from and it will help us better understand how we can help them. So we’ll use very advanced technology to look at the different segments. So we’ll break down each extremity into different segments and we’ll be able to assess the motion, and we’ll also have the ability to assess how the muscles are functioning in each part of the gait cycle.

Host: What a great lesson that was doctor, tell us about the newly opened motion analysis center at St. Louis Children’s Hospital. What are some of the goals? What does it aim to achieve for these children that you’ve mentioned?

Dr. Hosseinzadeh: So the newly opened center that we were able to open through the gift of Children’s Hospital Foundation, thanks to them – we have the ability to, as I just mentioned, look at each segment of the body and we’re also able to look at the forces that go through each joint and the muscle activity through each phase of gait. Typically if we don’t have this technology, the way we assess – base our treatment options are and only looking at the kid’s walking, and that is not – I don’t think it’s an acceptable way of assessing gait in the 21st century with all the advances in technology that we have because eyes are not the best way to assess a complex gait problem, so with the help of the center we will be able to better assess the gait and we’ll hopefully be able to better address the gait problems that these children have.

Host: Since eyes are not necessarily the best way to really assess gait in someone, tell us about some of the cool technology that’s available for children with gait issues, and what are some of the high tech evaluation capabilities?

Dr. Hosseinzadeh: So we have 8 infrared cameras. So we put markers on each segment of the body. We put markers on the trunk, the pelvis, the thigh, knee, the leg, and the foot. So there are several markers that we put on each side and we’ll have infrared cameras that actually capture these movements. Also the kids will walk over a force plate, which will show how much forces that go through their lower extremity when they walk. We’ll also capture that video and we’ll have EMG sensors which will show muscle activity in a variety of lower extremity muscles and we’ll coordinate that with the data that we get from the infrared camera and also the force plate.

Host: Doctor, at what point would a pediatrician refer a patient for this service? How old are generally the patients that you’re working with?

Dr. Hosseinzadeh: So, because they have to be able to follow the directions and the gait actually walk over the walkway, we typically want them to be over age 4, so it’s at the age that we see the patient’s compliance with the instructions becoming sufficient for a good gait analysis and of course we want the children to be mobile and either by themselves, with crutches, or with a walker to be able to complete this gait analysis. So I would say any child over age 4 who has a complex gait problem would definitely benefit from this evaluation assessment.

Host: Thank you for clarifying that. So tell us about your team. What type of providers are involved in gait management and assessment?

Dr. Hosseinzadeh: So we have two experienced physical therapists who will actually do the assessments, but I also need to mention that in addition to this comprehensive assessment that we have with the equipment, the physical therapists will also do a comprehensive physical therapy evaluation, which is instrumental for assisting these children, so we have two experienced physical therapist who are part of the team. In addition to me we also have the pediatric neurologist that will help us with the evaluation assessment as well.

Host: Wow that’s very comprehensive. What can a referring physician expect from your team? If they are referring a child over the age of 4 with some serious gait issues, what can they expect and how can they help to transition for the parents from what they were doing to this specialized service?

Dr. Hosseinzadeh: So when they come in, and if they take the test, the test typically takes about 2 to 3 hours – so as I mentioned there will be a comprehensive physical therapy evaluation in addition to the gait analysis. They will get a full report with all the grafts and all the raw data showing how each part of the body actually moves compared to the other one and the forces and the muscle activity. There will be a narrative of what we – actually the finding of these grafts and there will also be a recommendation of what we believe would be the best option for the child at this time, and I also need to mention that it doesn’t necessarily need to be a child that needs surgery or any sort of intervention. It can also help us find the best brace for a child because when the kid comes and they have a brace, we’ll have them walk with the brace and without the brace and look at how the gait changes, so even if for something as simple as finding the best brace for a child it can be very helpful, and it will all come in as a recommendation at the end of the report.

Host: I know doctor this may seem a broad question, but you’ve told us really great information about the evaluation, the assessment, the physical therapist, neurologist, everybody involved, what does the child and the parents – what is it like for them to go through this assessment and this evaluation and what can they expect as far as the types of therapy and technology that are available to correct the gait issue or help with their walking issues?

Dr. Hosseinzadeh: So as far as what they expect to get here, as I mentioned, they will come to the therapy registration, they get registered and somebody will walk them down to the motion analysis center. The test will take somewhere between 2 to 3 hours depending on how reliable the gait data is that they get and the big – about an hour to an hour and a half is actually spent on a comprehensive physical therapy evaluation and the rest will be walking with the markers on getting the data. As far as what can be done to help them, it really depends on the age of the child and the significance of the problem. A lot of the kids will only need bracing adjustments. Some of them will need some tone management, maybe with botulinum toxin or some medications. Some of them may require surgery, and I think this is critical to understand actually where the problem is so we can find out the best way to address this, so I think that is what helps us the most. So we will be able to understand if it is only the increased tone, or is it the bone that is turned the other way; it will actually help us really define the best treatment option for them would it be, as I mentioned, only with therapy, braces, only injection or surgery.

Host: You certainly have many tools in your toolbox to help with motion analysis now. So as we wrap up, what else should a referring physician know about the Motion Analysis Center at St. Louis Children’s Hospital.

Dr. Hosseinzadeh: Just I want them to know that we are – we’ve been working on getting this for several years and finally we’re ready. We have a dedicated team and I hope we’ll be able to address all the questions they have and I really encourage them to send the patient over and they’ll be able to see what information we can help with.

Host: Thank you so much doctor for joining us today, for sharing your expertise and telling us about the exciting Motion Analysis Center at St. Louis Children’s Hospital, that’s great information for other providers to hear. To consult with a specialist or to learn more about services offered at St. Louis Children’s Hospital, call the Children’s direct physician access line at 1-800-678-HELP, that’s 1-800-678-4357. You’re listening to Radio Rounds with St. Louis Children’s Hospital. For more information on resources available at St. Louis Children’s Hospital, please visit, that’s I’m Melanie Cole, thanks for tuning in.