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WestMARC

Glasgow Clinical Gait Analysis Service

The Glasgow Clinical Gait Analysis Laboratory assesses children and young people with complex gait problems. Gait analysis equipment is used to measure how the person walks and using this information a multidisciplinary team compiles a set of treatment recommendations, which can include medical, physiotherapy and orthotic interventions.

Our Team

  • Dr Bruce Carse, Clinical Scientist
  • Mr Andrew Dunne, Clinical Scientist
  • Miss Heather Read, Orthopaedic Consultant
  • Mrs Laura Wiggins, Principal Physiotherapist
  • Miss Donna McHugh, Specialist Orthotist

What is Gait analysis?

Gait analysis is a way of analysing how a person walks and helps clinicians to understand their difficulties. This information is then used to develop a treatment plan to help them walk better.

In the laboratory, we place some skin markers on the legs and trunk using sticky tape and then use 3D motion capture technology to give more information than is possible by simply observing a person walking.

We also use Video Vector Analysis which assists in identifying the forces acting on the legs and help identify how to improve the gait, possibly using an orthosis.

There is also detailed clinical examination which looks at:

  • The movement at joints
  • Muscle power
  • Bone alignment
  • The ability to control movement
  • Muscle tone
  • Balance

Walking is a complex activity involving biomechanical and neurological factors. Biomechanics relates to the movement of the joints and segments of the legs and the forces acting upon them. The neurological aspects involve the control of the muscles by the brain and the nervous system to produce forces. In particular the reactivity of muscles to stretch is of importance. We call this approach to gait analysis ‘Neurobiomechanics’.

Who do we see?

Children and young people with a physical disability which causes complex walking problems. Issues cannot be identified with simple procedures such as observational analysis or routine clinical examination.

Conditions we see include Cerebral Palsy, traumatic brain injuries and other neurological conditions, Myelomeningocele, Muscular Dystrophy, lower limb and foot deformity.

In addition the patient should be:

  • At least 4 years old
  • Able to cope with a session which can take up to two hours, although the pace of assessment can be tailored to the child
  • Able to walk at least 15 metres, independently or using assistive devices or orthoses if appropriate. The use of walking aids is acceptable (e.g. sticks, crutches, rear and forward-facing walkers), however we are not able to assess patients using aids that support the trunk during walking

Gait analysis for adults and children with amputation is arranged by Prosthetics Service staff within WestMARC, primarily as part of the Scottish Specialist Prosthetics Service.

Please refer to the ‘Patient Information Sheet’ links below for more detailed information.

Who can refer?

Orthopaedic Consultants, Paediatricians, Neurologists, Physiotherapists, Prosthetists and Orthotists
Children and families must be aware of the referral and it is helpful where appropriate for the referrer to inform the child’s wider multi-disciplinary team.

Referral Information

This must include the reason for referral, for example:
Considering an intervention and would like information to assist decision making (e.g. surgery, SDR, botulinum toxin)
Deterioration in gait is suspected and objective assessment would assist in identifying management strategies
Information to support appropriate orthotic alignment or management

Referrals should also include a clear clinical question, or information you would like the report to include. This will assist in tailoring the assessment and report to answer the clinical question.

Useful links:

Referral form:

Information about gait assessments:

IPEM: Improving mobility with gait analysis

Other:

What is an Environmental Control System?

Everyday, people use handsets to use the telephone, turn on/off TVs, operate CD players etc. For a few people using these handsets is extremly difficult due to complex physical disabilities.
An Environmental Controller is a technical system which can potentially overcome this problem.

What can they Control?

Environmental Control Systems can be set up to operate a huge range of devices, including:

  • Access and Security – community alarms, door lock
  • Communication – intercom, telephone
  • Comfort – beds, chairs, curtains, fan, lamps, lights
  • Access – door
  • Entertainment – TV, video, HiFi, DVD, Cable TV, Satellite TV, Teletext, Radio
How do Environmental Controllers Work?

Environmental Controllers are portable, so they use wireless signals to send commands to remote appliances.

Depending on the Environmental Controller you choose and the appliance you want to control, the Environmental Controller will send out either radio or infrared signals to operate the appliance remotely.

People can operate this equipment with various physical movements, such as; hand control, chin switch, head switch or voice activation

Why do I need one?

People usually install an Environmental Control to solve the following problems:

  • Cannot easily operate appliances and equipment around the home
  • Cannot open the door to let carers in, or to get out in a wheelchair
  • Cannot use ordinary remote control handsets
  • Spend some time on their own and may need to make an emergency call to a carer
  • Want to remain independent in their own home
  • Carer needs to be able to pop out without fear of person getting into trouble and being unable to call for help
Funding – Who will pay for it?

Some people choose to buy or rent Environmental COntrol Systems privately. Others may be able to obtain funds from various government sources and have the equipment supplied to them on loan.

If you meet the NHS eligibility criteria, then you may be prescribed an Environmental Control System. The NHS will only install and maintain equipment that has been approved.

Other government departments can be applied to for funding in some circumstances. These include Social Services (for Home Adaptation Grants or Disabled Facilities Grants), Local Education Authorities (for Equipment for Education Grants) and Employment Services (for ‘Access to Work’ equipment grants).

What products and services will the NHS provide?

The NHS may contract out the supply and servicing of equipment to an Environmental Control manufacturer. If so, they will agree with the manufacturer what equipment shoudl be installed and what type of maintenance contract will be required.

Typically the NHS pay for an annual service.

The NHS operate to strict guidelines for provision, so you may find that the NHS will not be able to pay for everything you ask for.

What if I want more equipment that the Health Services will provide?

You may be able to buy equipment direct from the manufacturers, or from one of their approved suppliers. If the Environmental Controller needs to be reconfigured to add in the command functions for the new equipment, then this would need to be agreed with the NHS provider.

Eligibility

A specialist assessment is required to determine a person’s suitability and eligibility. These criteria are available on request. Please contact your GP or Health Professional and ask to be referred:

Co-ordinator (Environmental Controls)
Westmarc
Southern General Hospital
1345 Govan Road
Glasgow
G51 4TF

Email: westmarc@ggc.scot.nhs.uk
Telephone: 0300 790 0129
Fax: 0141 201 2649

Referral Form

WestMARC, West of Scotland Mobility and Rehabilitation Centre, serves a population of approximately 2.6 million people and has in excess of 42,000 active wheelchair and prosthetics patients.

For wheelchair service and prosthetics service call: 0300 790 0129

Clinical services

The Wheelchair and Seating Service 

Clinics are conducted within the centre and at many satellite locations across the West of Scotland. There has been significant growth in the therapy and bioengineering team over the last four years and there is progress in delivering the service more locally across the West of Scotland area. This service works with Universities to provide placements for students

The Prosthetics Service 

The Prosthetics Service measures for, manufactures and fits artificial limbs for adults and children with amputation or limb absence. Clinics are conducted at Westmarc and at our satellite clinic at Ayr Hospital to provide new limbs and carry out maintenance and repairs for existing limb users.

We have an onsite workshop where our technical team manufacture and repair new and existing artificial limbs. This service works with Strathclyde University to provide placements for students. There are also close links to Finding Your Feet, a charity who support families affected by amputation or limb absence.

The Prosthetic Physiotherapy Service 

We work very closely with the prosthetics service to provide specialist outpatient physiotherapy care for patients who have an amputation or limb loss. This includes exercise programmes, teaching patients how to put on and off their prosthetic limb, learning how to walk and do functional tasks such as the stairs.

The Environmental Control Service

Provides services to patients within NHSGGC. This service enables people with severe disabilities to independently control their home environment including door-entry, intercom, telephony, a-v equipment, heating and lighting.

For further information please click here

The Neurobiomechanics Service

This service supports patients with complex gait problems by integrating the assessment and planning of medical, therapy and orthotic interventions making use of a range of simple and complex gait analysis equipment.

For further information please click here

The Scottish Centre of Technology for the Communication Impaired (SCTCI)

Although this as managed separately, it is also located within WestMARC. This Centre provides an assessment and advisory service across Scotland.

Reception area offers T.V. and free Wi-Fi.