Best web-site for interaction with doctors engaged with human gait disorder

[Saikat Chakraborty]

Hi Everyone,
Can anyone suggest me name of some authenticated web-sites for interaction with doctors engaged with human gait disorder treatment??

Saikat Chakraborty
PhD Scholar/National Institute of Technology,Rourkela/India

[Edmund Cramp]

Re: Best web-site for interaction with doctors engaged with human gait disorder

I do not know of any web-sites that provide direct interaction with medical professionals - you might find that the http://www.clinicalgaitanalysis.com web site can provide some information about the analysis of gait disorder data but this is not an active discussion site. An other option would be to attend a gait analysis course organized by a facility that provides treatments.

[Chris Kirtley]

Re: Best web-site for interaction with doctors engaged with human gait disorder

It's an interesting question why there is no such forum anymore. When I started CGA, it seemed the most obvious idea: to provide a platform for discussion of cases between clinicians and biomechanists. As an MD-PhD myself, I just assumed that everyone involved in gait analysis would be keen to to this. In the roughly 10 years (1995-2005) that CGA was active it did go some way to achieving this objective, though I would say the clinician input was minimal. These were the days before Internet 2.0, so I had to run the site completely manually, digitizing videos from VHS to AVI and copying and pasting emails to the discussion page. I have often wondered why someone hasn't remade it with the modern conveniences of digital video and social media-type discussion boards. On reflection, I think there are several possible reasons:

1. There is little academic reward for providing such a service. I found I was wellknown for CGA at conferences etc., but when it came to promotion/tenure it counted for nothing - no tangible publications or grant funding. I am retired from clinical gait analysis these days (I am in family medicine) partly because of this frustration. I don't think I made a bad decision in this respect, as it seems to me the field has not progressed much in that last 10 years. A society (BIOMCH-L, GCMAS, ESMAC etc.) should be providing this service, I think, but they are hamstrung (sorry for the gait pun) by the next consideration...

2. In these hyper-bureaucratic times, I probably would not be allowed to upload videos of children. None of the patients ever complained, but I'm sure this would not matter to the ethics committee of a modern institution. Back then, I had full control (via simple FTP file transfer) of everything I uploaded, but these days one would inevitably have to go through the IT department and they would surely tell you it cannot be done, or insist upon written permission for all clinical material. I planned to provide videos with my book, Clinical Gait Analysis (2006) but gave up in despair when confronted by the daunting clearance requirements of the publisher from patient, clinician, hospital etc. It goes without saying that video is essential for the inter-disciplinary study of gait disorders.

3. I have begun to wonder if clinicians and scientists have a genuine desire to learn from each other. There has been much in the media lately of scientific fraud and lack of repeatability. I wouldn't necessarily go this far, but it seemed clear to me that there were a lot of trivial results ("stamp-collecting") being published that never ended up influencing clinical decision-making. I could not blame the clinicians for feeling that interaction with biomechanists might be less than valuable. Equally, the clinicans tend to manage problems the way they have been told - they don't take kindly to questioning their methods. Each is operating in their own bubble.

I would emphasize that I miss CGA terribly - it was a great pleasure to connect and learn from such wonderfully diverse people. I do hope some sort of modern version is resurrected - maybe by you, Saikat?

As I mentioned earlier, these days it would likely be engineered by means of Internet 2.0 (just as BIOMCH-L was migrated from an email discussion list several years ago). This is natural and obvious, but I do wonder if it is the best approach. I personally miss the old BIOMCH-L, the thrill of reading emails every morning from Herman, Ton, even Herbert! There was a dynamism and urgency that seems lacking in the discussion-board solution. But it is quite shocking that progress has rendered such an obvious and much-needed platform impossible in the current age.

[Arnaud GOUELLE]

Re: Best web-site for interaction with doctors engaged with human gait disorder

Hi everyone,

That is obviously a very interesting question and of great importance for CGA, as far as CGA is nowadays a wide used “tools” and doctors who have to make choice based on CGA are not always specialists (I mean to read further than a flexion/extension curve).
This is right not only when considering 3D CGA but also gait analysis using other technologies like gait mats, pressure mats, IMUs, etc. For example, in France, a recent ordinance implies that medical centers for rehabilitation have a “gait analysis unit” to keep accreditation. The result is that we see a lot of these centers are looking to buy any system to be in compliance, without having often the time for reflection, no real idea about what they will do with it, no time and no specific people. And I am not yet discussing about the time for considering the interpretation of data and the clinical use.

I think the website created by Dr Chris Kirtley was (is) great. Dear Chris, we met around 2005-2006 when you were in Reims, France and I was a student. You made me want to orient myself on the CGA, and I am sorry you no longer implied in this field.

I converge with your explanation / concerns about “little academic reward for a such service”, time-consuming work that it represents, and ethics regarding use of patient’s data.
I am lucky because I work now for a private society (provider of gait system, I won’t do “advertising” here, it is not the purpose) who considers that even the best system is nothing if people are not able to capitalize on it.
Hence, we have just created the Gait and Balance Academy (www.gaitandbalanceacademy.com), with the idea to provide a web portal that offers clear and objective information about gait and balance, facilitate the brainstorming and collaboration with internationally recognized experts to offer access to classical educational resources and new innovative content. These materials, including pictures, presentations and videos, are based on validated scientific protocols and are updated regularly.
This is brand-new, but you could have a first idea of the concept with this presentation about gait initiation.
English version: http://gaitandbalanceacademy.com/25144-2/
French version: http://gaitandbalanceacademy.com/gai...nation-french/

We also contribute to research articles and clinical book.
This one, Handbook of Human Motion is not already released, but it implies well-known specialists in each field of CGA.

https://link.springer.com/referencework/10.1007/978-3-319-30808-1

I know that the way is long for a such web portal, but I hope it will help (motivate) some students and clinicians to go further with CGA.
I want also to encourage here all persons who have something they would like to share (background, ideas, questions, comments, education material, etc), you can contact me for more discussion.
arnaud@gaitandbalanceacademy.com

[Saikat Chakraborty]

Re: Best web-site for interaction with doctors engaged with human gait disorder

It's an interesting question why there is no such forum anymore. When I started CGA, it seemed the most obvious idea: to provide a platform for discussion of cases between clinicians and biomechanists. As an MD-PhD myself, I just assumed that everyone involved in gait analysis would be keen to to this. In the roughly 10 years (1995-2005) that CGA was active it did go some way to achieving this objective, though I would say the clinician input was minimal. These were the days before Internet 2.0, so I had to run the site completely manually, digitizing videos from VHS to AVI and copying and pasting emails to the discussion page. I have often wondered why someone hasn't remade it with the modern conveniences of digital video and social media-type discussion boards. On reflection, I think there are several possible reasons:

1. There is little academic reward for providing such a service. I found I was wellknown for CGA at conferences etc., but when it came to promotion/tenure it counted for nothing - no tangible publications or grant funding. I am retired from clinical gait analysis these days (I am in family medicine) partly because of this frustration. I don't think I made a bad decision in this respect, as it seems to me the field has not progressed much in that last 10 years. A society (BIOMCH-L, GCMAS, ESMAC etc.) should be providing this service, I think, but they are hamstrung (sorry for the gait pun) by the next consideration...

2. In these hyper-bureaucratic times, I probably would not be allowed to upload videos of children. None of the patients ever complained, but I'm sure this would not matter to the ethics committee of a modern institution. Back then, I had full control (via simple FTP file transfer) of everything I uploaded, but these days one would inevitably have to go through the IT department and they would surely tell you it cannot be done, or insist upon written permission for all clinical material. I planned to provide videos with my book, Clinical Gait Analysis (2006) but gave up in despair when confronted by the daunting clearance requirements of the publisher from patient, clinician, hospital etc. It goes without saying that video is essential for the inter-disciplinary study of gait disorders.

3. I have begun to wonder if clinicians and scientists have a genuine desire to learn from each other. There has been much in the media lately of scientific fraud and lack of repeatability. I wouldn't necessarily go this far, but it seemed clear to me that there were a lot of trivial results ("stamp-collecting") being published that never ended up influencing clinical decision-making. I could not blame the clinicians for feeling that interaction with biomechanists might be less than valuable. Equally, the clinicans tend to manage problems the way they have been told - they don't take kindly to questioning their methods. Each is operating in their own bubble.

I would emphasize that I miss CGA terribly - it was a great pleasure to connect and learn from such wonderfully diverse people. I do hope some sort of modern version is resurrected - maybe by you, Saikat?

As I mentioned earlier, these days it would likely be engineered by means of Internet 2.0 (just as BIOMCH-L was migrated from an email discussion list several years ago). This is natural and obvious, but I do wonder if it is the best approach. I personally miss the old BIOMCH-L, the thrill of reading emails every morning from Herman, Ton, even Herbert! There was a dynamism and urgency that seems lacking in the discussion-board solution. But it is quite shocking that progress has rendered such an obvious and much-needed platform impossible in the current age.

Thank you sir Kirtley for your valuable concern.Sir,I am working on stability
issue of Cerebral Palsy patients. But I have lacking experimental data for this purpose.
Can you point out some source from where I can get data?

[Wagner De Godoy]

Re: Best web-site for interaction with doctors engaged with human gait disorder

What data do you need for your research?
Kinematics, kinetics and emg data in patients with CP or normal gait?

Some information is in the links below:
CGA Normative Gait Database:

http://www.clinicalgaitanalysis.com/

and

[Saikat Chakraborty]

Re: Best web-site for interaction with doctors engaged with human gait disorder

Thanks for giving information.

I have an another query; as I am working with gait stability, I observed that many research papers are collecting data using some wearable sensors or camera (Vicon etc.) and through analyzing obtained data by some statistical approach gait stability is concluded. Some papers also used gait modeling approach to analyze stability.

But if we are getting necessary data from sensors (e.g. wearable and vision based) for stability analysis then what is the need gait modeling which is itself a computationally intensive procedure?

[Manvendra Singh]

Re: Best web-site for interaction with doctors engaged with human gait disorder

Modeling? Do you mean simulation?

[James Dunne]

Re: Best web-site for interaction with doctors engaged with human gait disorder

This is a completely different topic that you should start a new thread on.

[Ton van den Bogert]

Re: Best web-site for interaction with doctors engaged with human gait disorder

Good call, James. I have moved these posts into a new thread:

http://biomch-l.isbweb.org/threads/30089-Gait-stabilty-and-modeling

Please continue the discussion there.

--

Ton van den Bogert (moderator)