1. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Diana Hodgins European Technology for Business Ltd Using information on how a person walks to keep them healthy and active

2. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk What to measure Measure how a person walks (their gait) in their natural environment. This provides an objective measurement which can be compared to a healthy subject.

3. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Applications Diagnosis of knee or hip problems or gait disorders. Monitoring the rehabilitation process after injury, identifying when a normal gait is restored, including sports injuries. Identify people at risk of falling due to an unstable gait. Setting prosthesis.

4. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk What is Gait Monitoring? Information about how you move when walking –Stride duration –Knee flexion angle – Range of Motion (RoM) –Thigh and calf movement – Adduction/ abduction & RoM –Asymmetry between the left and right leg Can be performed when –On level ground, for example in a corridor –On slopes, gravel, different surfaces etc –On stairs

5. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk The portable system Four small, light (54g) sensors Each contain 3 gyroscopes and a 3-axis accelerometer Store data for immediate analysis after the test

6. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk How the sensors are attached

7. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk The system in use at a Day centre

8. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Key gait measurements Stride duration (mean and variability) Increases for people with a problem walking Knee flexion Reduces for those with a problem walking Difference in knee flexion between the left and right Increases for people with a problem with one leg or hip

9. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Key gait measurements Abduction/ adduction Puts incorrect loading on joints, alters balance Flexion on load Reduces for those with knee OA Difference in thigh or calf between the left and right Identifies where the problem is

10. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Traffic light system Healthy people across the age range 18 to 97 have been measured. Limits for the 14 parameters summarised from the gait cycle ascertained. Amber and red flags given if the parameter falls outside the healthy range.

11. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Example from 81 year old lady who had a stroke 18 months ago

12. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk You can have a good gait at any age Excellent symmetry and knee flexion Blue – left knee, Green – right knee Attends weekly line dancing classes 73 years young Young adult who rides horses and does kick boxing 23 years old Excellent symmetry and knee flexion

13. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Elderly person following a fall Good symmetry and flexion Poor symmetry with minimal flexion on left knee Blue – left knee, Green – right knee Day after a fall, using Roller frame 2 months after fall, weekly balance classes, no Roller frame

14. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk People with early stage osteoarthritis Difficult to diagnose Pain is not a good indicator Caught early enough can be treated with drugs or exercises rather than surgery Improve the gait profile and reduce the pain

15. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Profile of person with knee OA Healthy Person – Good flexion on loadPerson with knee OA- Poor knee flexion on load

16. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Work at the London Knee Clinic All new patients are measured and findings form part of the diagnosis. Patients are monitored during rehabilitation to ensure the knee is being correctly exercised. Patients can see for themselves what is happening as they walk and can monitor their progress after treatment.

17. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Findings People are happy to be measured and find the results useful. It provides a goal if improvements are necessary. Gait abnormalities occur in people of all ages and if untreated will ultimately lead to problems such as osteoarthritis. During rehabilitation it is important that a normal healthy gait is resumed.

18. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Our future vision Gait should be monitored regularly and abnormalities corrected by exercises where possible All surgical intervention involving knee or hip should have a pre and post operative gait test Sports injuries often result in asymmetric gait patterns. These should be quantified and corrected. Every clinic treating lower limbs should have one!

19. INNOVATIVE MOTION PRODUCTS European Technology for Business Ltd, Codicote Innovation Centre, St. Albans Road, Codicote, Herts SG4 8WH, UK Tel: +44 (0)1438 822822 Web: www.etb.co.uk Thank you To all the people that have happily volunteered to be monitored To the London Knee clinic and Longmead Day Centre for providing real case study examples Diana Hodgins dmh@etb.co.uk 00 44 1438 822822