CGA FAQ: Starting a gait-lab


from BIOMCH-L 22/6/95
        If you're considering getting into the gait lab business, let me suggest
that you search
out the experience of established gait labs and learn from their process
instead of
reinventing the wheel.  There are several gait labs of excellence throughout
the US:
        Newington Children's Hospital in Newington, CT
        Biomotion Laboratory at Massachusetts General Hospital (Boston)
        Children's Hospital at San Diego
        Rancho Los Amigos Rehabilitation Center in Downey, CA

All of the above mentioned labs are staffed jointly by engineers of one
discipline or another,
PTs, and MDs - some more present than others. The Children's Hospital-San
Diego group
teaches a week long course every fall (usually towards the end of
september/beginning of
October) which is well worth the time and effort for all participating
regardless of training
(e.g. PT, engineer, MD, etc.)

        An alternative network you may wish to seek is the East Coast Gait Lab
Consortium.  If you contact either Newington, or MGH they could put you in
touch with
the entirety of the consortium. (Yes there is a west coast analogue).

        Finally, an excellent source is the lab of David Winter, Ph.D. at the
University of
Waterloo (Ontario, CAN).  Dr. Winter is retiring or has retired, but has
left an established
legacy of excellent work.  In fact, his group is hosting a conference at
Waterloo this June (I
believe) the topics being gait and posture.

        Best of luck.  If you need more help, I can put you in touch with the
Boston and
San Diego people directly.

Carolynn Patten, PT
Department of PT
Boston University
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We just renovated our gait lab so we were forced to address many of the
questions you are
asking (we also have the resources to make or program anything - is we had
enough time
and money).  To get right to the point.  The Ariel Performance Analysis
System is such a
cost effective way to add 3D kinematic and kinetic motion analysis to a gait
lab that is
would be silly to build it yourself ($10,000.00 US - complete). Ours has not
arrived yet but
the system appears stable, accurate, and easy to use.  We already have an
AMTI force
plate and our own EMG system.  We will use the AMTI with Ariel System and
probably
hook our EMG bioamps into the Ariel A/D board.  You could make your own
calibration
frame and accessories to save money.  We also bought the panning accessory
since our lab
is a bit narrow and would benefit from a larger image of the patient on-screen.

Thats all for now.  Let me know if you have any specific questions.  Good luck.

Ed Lemaire, MSc
The Rehabilitation Centre
Ottawa, Ontario, Canada
613-737-7350 x5592
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Surf into the web (WWW) at:
  http://ben.extern.ucsd.edu/~ariel/
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What you are suggesting is quite an undertaking.  I have worked with a
variety of gait and
biomechanics laboratories, and so have an idea of what is needed in one.  I
can mostly
address the resources that you will need.
Three basic things you need are a facility, equipment and personnel.
For the facility, you need an area where gait can be performed; i.e., large
enough for a
walkway for gait to be performed (>25 ft for walking, >50 ft for running).
For equipment, budget at least $200k to start-up.  Basic purchases you will
want will
include:  $100k for a motion analysis system, $20k per force plate, $20k for
EMG, $20k
for misc. electronics and computers.  These are very rough estimates.
The most important thing to establishing a lab is your personnel.  You want
to have people
who are already knowledgeable in the collection of gait data.  Once a
commitment is made
by the Sports Medicine Department to have a gait lab, the first thing you
should do is find
someone experienced in this type of work to put together a full plan and
have it happen.
Good Luck.
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I'm the President of Medical Analytical Products.  We specialize in the
measurement of
human performance and then offer solutions to the treatment and
rehabilitation of any
musculoskeletal injuries that may arise. We carry the Noraxon EMG equipment,
which is
the best EMG around, and we are in contact with, and can interface with all
the major
motion measurement systems.  The EMG can be telemetered out to 300 yards.
This will
allow for complete freedom of movement that is necessary when analyzing
real-world
sports situations.  We can also telemeter goniometers and footswitches that
allow for the
ROM/EMG relationship to be precisely analyzed.
Give me a call or drop me a note if you'd like more information or any help
with your
startup plans.

Sincerely,
Michael

Michael Rowling
President,
Medical Analytical Products
1625 East Darby Road
Havertown, PA 19083
(610) 449-4879 (800) 352-2301  Fax: (610) 853-2925 E-Mail: Sup123@aol.com
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Dr. Bob Soutas-Little (soutas@egr.msu.edu) has a consulting firm for setting up
biomechanics labs.  Good luck.
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I suggest you get a quote from Edi Cramp at Motion Lab Systems in Baton
Rouge (504)
928-0616.  He is the rep for Vicon.  We use the system in a clinical setting
and although
expensive it is outstanding--fast and accrate.  ---Michael Orendurff
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I recently wrote a chapter on computerized gait analysis for a book titled
clinical
biomechanics of the lower extremity.  It should be coming out soon.


In researching the field I found very few concrete uses for gait analysis.
 One of the major problems is that we do not know what to measure and if we find
something to measure are we sure that it correlates with or causes pathology.

The chapter is written with the expected audience of medical practitioners,
so it may not be
exactly what you are looking for.  If you want more info e-mail me.

Eric Fuller DPM
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Dean, I have started looking into the similar equipment some time ago--
wanted to come up
with some tools to measure and evaluate the students performance in the
martial arts school
I attend.
  The most info I picked up was from vendors on a list in the Biomechanics
Yellow pages
and the article of the Korean researcher on the low-cost video measuring
system from last
week note (you are probably familiar with the sources). Also, magnetic,
optical and other
(Power Glove, etc.) trackers are used in Virtual Reality applications and
there are
discussions on them on the vrapp-l@vmd.cso.uiuc.edu list.
  The cost of the equipment for what I had in mind (force plates and
tracking) is prohibitive
for me as an individual so I was very glad to see your note. I am a software
engineer here in
Atlanta, so if you ever need one on your staff (full time or on volunteer
basis) give me a
holler.
  Good luck on your lab,


                                                      Yakov
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I work for a company called Novel, in Munich, who research, develop and then
sell
pressure distribution measuring systems, including a platform for analysing
the pressure
distribution between the foot and the ground, and flexible insoles for
measuring the pressure
distribution between the foot and the shoe. Such systems are also obviously
capable of
measuring the applied normal force and are often used in conjunction with
gait analysis
systems.

We have a sister company in the USA called Novel Electronics Inc., and I
suggest that if
you are interested in any further information you contact Mrs. Susan
Diekraeger. The
address is:

        Novel Electronics Inc.
        Business and Technology Center Suite 266
        Box 82
        511 11 Av.
        S. Minneapolis
        MN 55415

        Tel: 612-332-8605
        Fax: 612-332-9606

Susan is a very easy person to approach and I am sure would be very happy to
give you
any advice about these systems that you may need.

Best wishes

Dr. Anna Hayes
Biomechanics Research Laboratory
Novel gmbh
Beichstrasse 8
80802 Munich
Germany

Tel: 089-390102
Fax: 089-337432
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You might also want to check out this ref: From:    John Baker

  Subject: Sci-VW: ONLINE: Technical Report - VR Tracking Systems After some
requests, I'm posting the location my tech report which describes some VR
tracking
systems and one I built in 1993.
  http://rdt.monash.edu.au/~johnb/ or ftp ftp.rdt.monash.edu.au
/pub/techreports/RDT/94-
12.ps.Z
  All queries etc  Email : johnb@rdt.monash.edu.au

  It's a compressed postscript file.


                                                      Yakov
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    I am writing in response to your request for advice/leads on developing
a gait lab that is
posted in the "biomech" Newsgroup on the Internet.  I hope you find this
information useful.
    I am an employee of Northern Digital Inc., a company based in Waterloo,
Ontario.
Northern Digital developes and manufactures a device that can track rapid
motions of
objects in three dimensional space.  This device, the OPTOTRAK, is an
infrared marker
based optical measurement system that is used in a wide variety of
applications, including
gait analysis.
    If you would like more information about the OPTOTRAK, please do not
hesitate to
contact me.  My address, e-mail, phone and fax numbers are listed below.
Thank you for
your attention.

    Andy Johnston
    403 Albert Street
    Waterloo, Ontario
    CANADA N2L 3V2

    Phone: 800-265-2741
    Fax: 519-884-5184
    e-mail: andy@ndigital.com
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It is much better to buy what is available, like a turn-key system from B&L
Engineering.
They install VICON Systems and EMG measurement systems. The equipment alone
costa
about $200,000.
I did this for Vanderbilt University's new rehab hospital a few years ago.
Call me if you
need any detailed information.

Sincerely,

Rich Shiavi
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Our Gait Research Lab has been in operation for approximately 4 years.  It
has taken us
about that amount of time to piece the equipment together from various
financial sources.
A fully equiped gait lab will cost about $250,000.
It would include 3-4 camera video analysis, forceplate, Telemetry EMG, pressure
assessment devices and accompanying computers.  I suggest since you are just
starting out
that you *tour* and talk to several gait labs across the country before you
dive in.  If you
don't, chances are you will not have what you think you want when it is
done.  Also attend
the Clinical Gait Conference which is held annually.  Good luck, but look
before you leap!
Mark W. Cornwall, PhD, PT
Dept. of Physical Therapy
Northern Arizona University
Flagstaff, AZ
(520) 523-1606
(520) 523-9289  FAX
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C. Dean Preston
Research Design Engineer
Medical Illustrator
Medical College of Georgia
Biomedical Engineering

from BIOMCH-L 22/6/95 ************** About the space in general ******************** *Avoid pillars (which would obstruct your cameras' view). *Make sure you can black the windows out so that you can use infra-red cameras, but can remove the blackout so that it is pleasant for people to work in there. Make sure that extraneous people can't stare at your subjects. Make sure disabled people can get from their cars and into your lab easily (i.e. level access). A toilet, changing area and tea facilities for your subjects would be nice. Make sure you can lock up the lab securely so that you can leave equipment set up overnight. * 18m is too short for running studies. We got around this by utilizing the hallway. the wall of the lab was replaced with a rolling up garage type door. thus i can have cameras in the lab and the subjects run down th ehallway. obviously not practical at all times, but we collect running data in off hours. * I went for no fixed tables/lab benches. this allows lots of flexibility. it is hard to anticipate all needs. * If you can avoid it don't have the running track and force platform along one side of the lab (as ours unavoidably is), this restricts camera placement and subject movement (e.g. side stepping). *Following experience of a 3D PEAK study of overarm throwing we know we require at least 40 squ metres of ceiling height (that is) at least 4 M centred over the force platforms, to be certain of acheiving camera positions allowing minimal loss of markers. *To get sufficient run-up to the force platforms we are considering special landscaping for a distance outside the entrance to the lab. *Having fought hard for our space, we were shattered to discover that the University specifications for building structure are such that at least 4 columns are required in the middle of the lab space to hold up the three floors above. Removing these default columns is very expensive. Beware! *About the best thing about our lab is the possibility of moving to a different room and having it demolished!! We can always dream! Good luck with your plans. *I work in a fairly low tech lab but two major difficulties we've had are with light reflection on the floor and vibration of the building interfering with force platform data. I don't know what movement analysis system you'll get but you may want to check with them about the light reflection. * We have teaching space as general purpose and specialised areas and have kept separate rooms for project areas, video and film analysis, video editing, storage, technical etc. Having been through this process several times, I suggest you visit a number of labs and take your pen pad and camera with you. * Space requirements depend not only on the motion to be measured but the limitations of the measurement system. If you plan to capture data with a camera, that camera must be placed so that the field of view of the camera covers the volume within which that motion takes place. A long thin runway may be adequate for the motion, but it may not be possible to place cameras at the sides of the runway to allow them to capture useful data. If you want to capture upper body motion the same issues apply to the vertical dimensions as for the horizontal ones. If using a video based system, i.e. using taped measurement, measurements are best made against a high-contrast surface, e.g. a blank wall. If using an automatic tracking system provision needs to be made for the volume calibration procedure, which usually involves hanging up an object. * Our lab (being in England) has to cope with very cold days (often) and reasonably hot days (not so often). With a large volume such as a motion analysis lab it is quite difficult to control the temperature without air conditioning. There is a requirement to keep scantily clad subjects warm and computer equipment cool. * Secure storage of expensive video and computer equipment is also an issue, the lab below ours has been broken into three times and had their computers stolen. I would blame this on visibility from outside the building. High on my wish list is a secure console/workstation. * Optometric systems usually require distributed cameras linked to VCRs or computers, lots of trailing wires, power cables, major safety issues. A modular flexible trunking system to allow a number of lab configurations would be a huge boon, these things can get very expensive. We find we never have enough power sockets in the correct places. Tied in with this is that since labs may use a number of different experimental protocols, one needs to access the backs of computers etc, may compromise issues of secure storage. * Subject prep room should lead into the lab, and ideally there should be a toilet either off the lab area or the prep room, so that preped subjects do not have to wander half-naked thru public areas. Prep room ideally needs its own sink and a shower would be ideal, especially if you are going to get subjects to run around getting sweaty and then have to go back to work etc. * Most impressive lab facility I have seen is the Malaysian "Sports Institute" still under construction in Kuala Lumpur (AIS times 5 i'd guess!). I'll send some info in the mail. * Avoid pillars (which would obstruct your cameras' view). * Lab on ground floor, i.e. only concrete beneath it. * At no point rely on the liason between the architect and equpment suppliers. They are both after your money, and will ignore much of what they really must do. * See if you will want at any time in the future hang anything from the ceiling, such as fixed position cameras. Make provisions now. Ask the architects to build in a number of mounting brackets strong enough to support heavy weights (such as that of an athelete). *-enough distance between performance level and cameras - *-possibility for moving cameras *-30m before and after the force plate will be the minimum distance for running. Therefore, I'd like to suggest similar method as in AIS (Canberra) where they can open the doors when necessary. The weather is not the problem there. * -for EMG-measurements no any electrical disturbances ******************** About the floor ************************* * Make sure you've got a rigid floor to mount your forceplate and cameras. Another arrangement I saw was to mount the force plate to the concrete underneath a sprung wooden floor. In that case, maybe it would be more sensible to mount the cameras to the walls, but then you would lose flexibility in positioning them. * The complexity of the force platform mount really depends upon the environment of the lab. Our lab is not on the ground floor, so we have had to use anti-vibration mounting. Most (if not all) force platforms results are only guaranteed by the manufacturer for a very particular mounting, especially flat stable floor. Best results are obtained if the platform is coupled to a large non-vibatory mass, at least 10x the load expected to be measured. We have used a concrete raft sitting on a anti-vibration material called TICO-PAD used for machine mounts. It provides a wide-range filter for low amplitude vibrations. Our raft is free standing, the floor rests on the sides of the pit the raft is in. * We perform mainly gait studies in our lab, with people walking barefoot. We have opted for a lino floor so that it can be cleaned more easily. Some people recommend carpeted floors since they the surfaces that most people walk on with bare feet, the advantage with a lino over concrete floor is that it provides much more of a reproducable condition lab to lab. A non-reflective floor surface is vital. * -a separate huge block for force plates for preventing oscillation of the surrounding ground *-floor material depends also on the reasearch: for spike shoes Novotan, Recortan, Mondo etc. will be necessary. For many purposes force plate without any covers will the best. ******************** Ceiling height *************************** * We have a beam at about 8 feet (2.4m) which I think will cause problems when we use our set of 2 stairs. * I'd like high "real" ceilings (about 16ft). real= not hung acoustic ceiling. this lets me attach things to the roof solidly, plenty of room for storage up high. it gets stuff out of the way. here in N. california we must secure it well for the inevitable big earthquake. * -the height of the lab depends on the research interest *********************** Floor ****************************** * Force plates are in a pit. thus they are flush with the floor. I also had them put in a cable tunnel so that we don't have wires all over the place. * Lab floor: concrete, Forceplates mounted flush, then cover with plastic tiles. * Make room for at least three forceplates, even you only have one. * Put forceplates flush against a level floor. Avoid awalkway. * position F-plates such that subjects walking over a very large figure of 8 will pass over it. ********************* Services ****************************** * Lots of electrical outlets. we have 5 or 6 ceiling mounted receptacles with hanging/retractable cords that lead to a four plug base. this again keeps wires off the floor. * Put the overhead lights on several ciruits/switches. that way we can keep half the lab dim to allow for retroreflective video kinematic markers while others work in good light in the other half of the lab. * Mostly data is collected and then analysed, mostly on computer. If you use the same computer for both it reduces available lab time. We use a network to store data on network drive and process on another computer on the same network * Ensure lighting of the lab is adequate and problem free. * Best to avoid Fluorescent lighting. * Use Dichroic coated lamps (transmit heat rearward and reflect light forward). * Use safe power levels. 600 watts may have harmful blue components. the architect must ue Internationally recognised health & safety standards. * Remember you cannot have trailing cables all over the place. So insist on having conduits particularly from the F-plates. Have them large enough to allw cables passing easily. * You will also need enough number of power points. Remember you can have them on the floor flush mounted with a cover too. * enough lights and power supplies *-permanent network connections from the lab to the analysis ********* Motion Analysis system requirements *************** * We use a VICON370 system, which uses infra-red cameras, so bright sunlight can mess things up. In any case it would probably desirable to be able to control the lighting for any optometric based motion analysis system. ******************* THANKS TO *********************** Rodger Kram Assistant Professor Human Biodynamics Dept. 103 Harmon University of California Berkeley, CA 94720-4480 phone (510) 643-9370 FAX (510) 642-3355 e-mail rkram@garnet.berkeley.edu WWW http://garnet.berkeley.edu:80/~rkram/ Robin Burgess-Limerick robin@hms01.hms.uq.oz.au Department of Human Movement Studies The University of Queensland 4072 AUSTRALIA Ph. +61 7 3365 4718 Fax +61 7 3365 6877 Trisha Bate | email : P.Bate@LaTrobe.edu.au School of Physiotherapy | Phone : 03 285 5259 Faculty of Health Sciences | or : 03 481 1718 La Trobe University | Fax : 03 285 5225 Julie Steele Connie Bock Ryegate Childrens Centre Sheffield England 100622.3224@compuserve.com Joe Spadaro, Ph.D. S.U.N.Y. Health Science Center - Syracuse spadaroj@vax.cs.hscsyr.edu * Barry D. Wilson, Ph. D. Phone: 64 (03) 479 8987 * * School of Physical Education Fax: 64 (03) 479 8309 * * University of Otago Email: bwilson@pooka.otago.ac.nz * * Dunedin * * New Zealand * Richie Gill Research Engineer University of Oxford OOEC, Nuffield Orthopaedic Centre England Jane Elizabeth Barrance Organization: University Of East London Hamid Rassoulian Senior Bioengineer Dept. of Medical Physics & Medical Engineering Southampton General Hospital Southampton SO16 6YD United Kingdom "Heikki Kyr|l{inen" Organization: Liikunnan laboratorio Finland C. Calame Kistler Instrumente AG Winterthur, P.O.Box 304, CH-8408 Winterthur, Switzerland Tel: +41 52 224 11 11, Fax: +41 52 224 14 14 Telex 896 296 KAG CH, E-Mail: 100072.1173@compuserve.com -----------------------------------------------------------

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