Gait Lab Marks Milestone: 1,000th Patient

from The Children's Hospital (TCH) News, March 2005

Physical Therapist Bobbie Riedner, left, and Kinesiologist

Megan Outcalt of The Children’s Hospital’s Center for Gait

and Movement Analysis (CGMA) help Anissa Miller, who

has cerebral palsy, walk using her walker. Anissa was the

CGMA’s 1,000th patient.

The Center for Gait and Movement Analysis (CGMA) at The Children’s Hospital marked a landmark occasion in early February – its 1,000th patient.

“Ten years ago, we couldn’t conceive we’d have 1,000 patients,” said Co-Medical Director Frank Chang, MD, who pioneered the lab with Dennis Matthews, MD, in 1999.

James Carollo, PhD, PE, director of the CGMA, agreed that the event is a significant milestone – one not all clinical gait labs in the U.S. have been able to achieve.

CGMA is the only clinical gait laboratory in Colorado, so it fills a void for many patients in the region who need comprehensive walking assessment. This also means that CGMA is the only clinical program at Children’s that routinely evaluates both children and adults.

“In comparison to other Children’s clinics, we see a limited number of patients,” Carollo said. “However, we study them very closely and consider all alternative treatments before making recommendations. We limit the number of adults we see based on our staffing and because our primary focus remains children.”

Eighty percent of the pediatric patients who receive care in the gait lab – one of about 40 such labs in the U.S. – have cerebral palsy, which requires extensive follow-up.

“As long as a child with cerebral palsy is growing, there is the potential for significant walking problems,” Carollo said. “We are continually refining their treatment plans as they mature.”

The 1,000th patient, for example, was on her third visit to the gait lab. Anissa Miller, a 9-year-old with cerebral palsy, first came to Children’s several years ago. She was in a wheelchair; when she did walk, it was with a walker. Her feet turned inward, Dr. Chang said. After analyzing her walking patterns, the CGMA team recommended orthopedic surgery to straighten her bones.

“The unbalanced pull of her muscles caused her bones to twist,” Carollo said.

She came back after the surgery, and the team analyzed her walk to determine the next step. The answer was to lengthen some of her muscles and re-align or transfer other muscles, Dr. Chang said. On her third visit, she was able to walk with and without her walker, but the team will make another recommendation – whether it’s physical therapy, braces or another surgery – that will improve her gait even more.

“It’s like peeling an onion,” Carollo said. “We’ll improve one aspect of her walking and make it a little bit better. We expect that she’ll continue to get stronger, and with each year, she’ll see improvement.”

CGMA’s five full-time staff members – a physical therapist, two kinesiologists, a biomedical engineer and a patient services coordinator – also educate students and conduct clinical research. The team currently is developing mathematical models of children with walking problems, finding new ways to measure outcomes for children with cerebral palsy, and analyzing treatment protocols to improve the gait of these children.

“This lab has improved our ability to understand children who have problems walking and develop the best treatment plan to help them reach their maximum potential,” Dr. Chang said. “The improved and expanded facility planned for Fitzsimons will only enhance our understanding and improve their treatment.”