Technology: a gaitway to life
Prof Tim O’Brien is a co-founder of one of the first gait laboratories in the world, writes JUNE SHANNON
PROF TIM O’BRIEN, consultant orthopaedic surgeon and director of the gait analysis laboratory at the Central Remedial Clinic (CRC) in Dublin, was the first professor of orthopaedics to be appointed in Ireland.
Over the past 37 years he has been at the forefront of education, clinical research and innovation in his chosen specialty. During this time he was also diagnosed with motor neuron disease (MND).
While MND cruelly robs sufferers of the use of their body it does not affect the mind. Diagnosed in 1993 it is testament to O’Brien’s strength of character that he continues to work full-time despite being paralysed and reliant on a portable ventilator.
He communicates using special software, which enables a sensor to follow his eye movements allowing him to pick out letters on a specially adapted laptop, which then transmits the words he types into speech.
In 2005 O’Brien was awarded the prestigious Lifetime Achievement Award at the Irish Journal of Medical Science (IJMS) Doctor Awards for his life-long clinical interest and research achievements in orthopaedics, including research on the development of the immature hip joint in babies and the assessment of gait patterns in children.
In 1990, together with physiotherapist Anne Jenkinson, O’Brien established one of the world’s first gait laboratories in the CRC which remains the only clinical gait laboratory in the State.
Gait analysis is the scientific study of how somebody walks. Using technology, O’Brien and his team assess, diagnose and recommend treatment for patients with a variety of gait disorders.
“When we started it was a big investment and we did not know how it would develop as there were only a few other clinical laboratories in the world,” O’Brien explains.
The majority of patients seen at the gait lab are children with neurological disorders such as cerebral palsy. Caused by an abnormality in the brain that controls muscle movement, children with cerebral palsy suffer a range of physical disabilities that affect their ability to walk, such as a lack of muscle co-ordination and tightness or stiffness in the muscles.
Gait analysis can make a huge difference to these children particularly where it picks up issues that may stop a child from walking altogether.
The gait lab in the CRC sees about 360 patients a year and the numbers are increasing every year. Approximately 50 per cent of the patients attending the lab live outside Dublin and in an effort to reduce the amount of travelling his patients had to endure, O’Brien and the manager of the gait lab, Mike Walsh, pioneered the world’s first mobile gait analysis unit in 2004.
A mobile gait lab now travels to Limerick and Waterford a number of times a year.
The gait lab uses an impressive range of technology to assess a patient, including video to record how they walk. Computer markers are placed on specific points such as the ankle, knee and hip joints and motion analysers then replicate an accurate 3D computerised model of how the person walks. Force plates built into the floor of the lab measure the amount of force a person puts on their joints when walking and a system called electromyography (EMG) is used to measure the electrical activity in the muscles which can show if a muscle is over or underactive.