Overview

Preface In 1996, while in Perth, Australia, Ray Smith and I started a website called 'Clinical Gait Analysis' http://www univie.ac.at/cga with a companion email list for the discussion of walking disorders. Shortly afterwards, I moved to Vienna, Austria, where Andreas Kranzl helped develop the site further with 'Case of the Week'. Eight years later, the list has over 1200 subscribers from around the world; more than 40 clinical cases have been presented and a multitude of technical issues debated. This book is an attempt at collecting together some of the material contributed over that time. Gait is undoubtedly complex, making its understanding a daunting challenge for the beginner. In this endeavour, many insights can be gained from looking not only at normal level gait, but also the compensations that are made for age, speed, inclines, stairs, etc. The effects of abnormalities such as weakness, spasticity, deformity and pain can greatly enlighten the study of normal function. Moreover, the ways in which function is improved or restored by the therapist and surgeon, or substituted by the prosthetist and orthotist, can reinforce the theoretical knowledge learned. For this reason, although this book is not intended as a treatment manual for gait disorders, relevant clinical interventions and prosthetic or orthotic designs are included wherever possible, with the aim of consolidating the biomechanical theory. In my own teaching of biomechanics, I have often found that true understanding comes only with practical experience. For this reason, I have included occasional laboratories wherever possible. I have tried to limit the amount of equipment needed for these laboratories to readily available devices such as stopwatches, tape measures and personal computers. The various technology vendors have kindly supplemented this with digital videos, animations and sample data from their products. Some areas of gait analysis excite great controversy and debate. Rather than hide these issues from the student, I think it best to highlight them when they arise. A useful way to do this is to encourage a debate between students, each arguing for a particular position. Doing this stimulates critical thinking and provides a useful incentive for background reading and literature searches. There is no doubt that the greatest challenge in biomechanics is also its greatest strength: mathematics. Being able to express concepts in equations and figures (even if they are approximate) elevates understanding greatly. As Lord Kelvin pointed out1, you never really understand something until you can put numbers to it. Very often, insight can be gleaned merely from the act of calculating something. I have therefore sprinkled occasional multiple-choice question through the text in order to provide opportunities for testing your grasp of the more tricky sections. The book is broadly divided into Theory and Practice. This is partly for practical necessity, in that theoretical foundations need to be laid down before a biomechanical understanding of gait can proceed; yet it is also meant as a separation between the science of measurement, which is imperfect but ought to be objective, and the clinical interpretation of the results, which inevitably is contaminated by opinion, past experience and even prejudices. It is important to realize that the clinical application of biomechanics is still relatively new and subject to winds of change as research proceeds. This can sometimes make gait analysis frustrating and inconsistent but is also the source of much of the excitement that accompanies any pursuit on the edge of our understanding. There is still much to know about normal gait, let alone that affected by pathology. Finally, it has to be said that biomechanics can be tough going, with all this emphasis on mathematics and physics. With this in mind, I have included a number of boxes addressing interesting but slightly peripheral aspects of gait. I hope you enjoy this miscellany of art, history and philosophical rumination!

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.,. as a reference book on clinical gait anlaysis this text is excellent. <br>.,. it has much to offer the chiropodist/podiatrist who is using biomechanics as a treatment modality.<br> I particularly liked the easy-to-use layout, clear diagrams, and multi-choice-questions and debating points. These last two should encourage the reader to think about issues which are current and contentious in podiatry. <br>.,. to those who have an interest in gait anlaysis and to those who are doing or intend to do, a top-up degree I can wholeheartedly recommend this book. <br>David Holland BSc(Hons), MSc(Research) Bioengineering, Consulting Podiatrist.<br>In Chiropody Review Vol. 63 No. 3.<br> [T]his book is a breath of fresh air in what is considered to be a complex field combining various aspects of motion analysis into a clinical content ... the self-assessment questions are a very good teaching method to assess one's knowledge as the reader (especially the student) is progressing through the book. The appearance of 'Debating Points' throughout the book is also a nice innovative feature. It highlights 'controversial' issues that require further research without expressing the author's personal opinion. <br>The Foot v. 16 issue 4, Dec 2006 <br> This book has proved to be an excellent resource to aid my attempt to get to grips with what is a very complex area. I found the variety of illustrations and diagrams particularly helpful, representing information in a range of different formats, which enabled me to gain an understanding of the many elements involved in gait. The glossary provides a quick and accessible tool to assist when trying to assimilate the new terminology. I also liked the pagelayout, with clear headings and coloured tables. The key points at the end of each chapter and multi-choice questions help to reinforce the main points. I have no doubt that this is a book that I will continue to use for many years and I would recommend it to anyone studying podiatry. <br>Liz Perkins, student at Southampton University

... as a reference book on clinical gait anlaysis this text is excellent. ... it has much to offer the chiropodist/podiatrist who is using biomechanics as a treatment modality. I particularly liked the easy-to-use layout, clear diagrams, and multi-choice-questions and debating points. These last two should encourage the reader to think about issues which are current and contentious in podiatry. ... to those who have an interest in gait anlaysis and to those who are doing or intend to do, a top-up degree I can wholeheartedly recommend this book. David Holland BSc(Hons), MSc(Research) Bioengineering, Consulting Podiatrist. In Chiropody Review Vol. 63 No. 3. [T]his book is a breath of fresh air in what is considered to be a complex field combining various aspects of motion analysis into a clinical content ... the self-assessment questions are a very good teaching method to assess one's knowledge as the reader (especially the student) is progressing through the book. The appearance of 'Debating Points' throughout the book is also a nice innovative feature. It highlights 'controversial' issues that require further research without expressing the author's personal opinion. The Foot v. 16 issue 4, Dec 2006 This book has proved to be an excellent resource to aid my attempt to get to grips with what is a very complex area. I found the variety of illustrations and diagrams particularly helpful, representing information in a range of different formats, which enabled me to gain an understanding of the many elements involved in gait. The glossary provides a quick and accessible tool to assist when trying to assimilate the new terminology. I also liked the page layout, with clear headings and coloured tables. The key points at the end of each chapter and multi-choice questions help to reinforce the main points. I have no doubt that this is a book that I will continue to use for many years and I would recommend it to anyone studying podiatry. Liz Perkins, student at Southampton University

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