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  • 4th ECCGLC @ Penn State, Oct 88

    4TH EAST COAST CLINICAL GAIT LABORATORIES CONFERENCE

    Center for Locomotion Studies (CELOS), Pennsylvania State University
    October 27-28, 1988; University Park, PA 16802, U.S.A.


    The 4th Annual ECCGLC was organized by Prof. Peter Cavanagh, Director of
    CELOS, and hosted some 75 participants. Previous meetings were hosted by the
    Newington Children's Hospital in Connecticut, the Moss Rehabilitation Hospi-
    tal in Philadelphia, and by the Biomechanics Laboratory at the National In-
    stitutes of Health in Bethesda, MD. Unfortunately, the timing of the 4th
    meeting was in conflict with a meeting of the Cerebral Palsy Society in To-
    ronto and with the 7th Southern Biomedical Engineering Conference. The book
    of abstracts is available from CELOS for US $ 5,00.

    Two keynote papers (one each day) provided interesting surveys of their
    author's views on the work at their own institutions. While I would have
    preferred more general "states of the art and current trends", the practical
    nature of these presentations was quite compelling. Kadaba (Orthopedic
    Engineering and Research Center, Helen Hayes Hospital, West Haverstraw, NY)
    emphasized the utility of Gait Analysis (G.A.) for optimal treatment selec-
    tion followed by treatment evaluation assessment, using pattern recognition /
    A.I.-methods with principal components analysis and cluster analysis. Also
    Computer Aided Surgery (CAS) was shortly discussed, with reference to Mann
    (MIT). In surveying all 4 Annual ECCGLC's, he concluded that the greater ma-
    jority of papers were methodologically oriented, and that an unknown number
    was concerned with routine use of Gait Analysis.

    Stanhope (NIH Bethesda) addressed various technical/methodological problems
    in kinematics and kinetics, especially camera calibration and interpolation/
    data correction problems in a video-based Gait Analysis context (VICON).

    Sessions covered Clinical Applications, Prosthetics, Running, Foot & Ankle,
    Miscellaneous Kinematic Studies, EMG, Techniques in Kinematics, Ground Reac-
    tion Forces, a series of short commercial presentations in relation to the
    simultaneously held commercial exhibition, and a fruitful round table dis-
    cussion on "3rd Party Reimbursement for Gait Analysis". In this latter part,
    the absence of Diagnostics-Related-Groups (DRG) classifications for Gait Ana-
    lysis became apparent as a major shortcoming, with Gait Analysis often viewed
    as an experimental research facility rather than as a routine clinical tool.
    This forces to high creativity when tying Gait Analysis to existing classifi-
    cations (EMG mostly), with the risk that once a decision has been made that
    G.A. is still a research endeavour, it will be difficult to acquire clinical
    status for reimbursement later on. However, various major insurers on State
    level (Blue Shield, Blue Cross) have been sympathetic if the assessment pro-
    tocol was made clear, especially in interstate consultancy situations.

    During the debate, it became apparent that the G.A.-protocol of the Newington
    Children's Hospital (dr J. Gage) in Connecticut is emerging as a de facto
    G.A.-standard in the U.S.A., and that Oxford Metrics (UK) will be marketing
    the software system from Newington as an option to its own video-based hard-
    and software.

    In order to be able to negotiate 3rd Party Reimbursement for clinical use of
    G.A., the inauguration of a formal G.A.-Society was recommended; Prof. Cava-
    nagh will look into this issue.

    In addition to the clinical/scientific contents, short presentations were
    provided on the commercial products exhibited during the conference. Further
    details are available in the Book of Abstracts.

    Herman J. Woltring

    Research Associate, Biomedical & Health Technology, Eindhoven University of
    Technology, The Netherlands
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