Mike Walsh is manager of the Gait Laboratory in the Central Remedial Clinic in Clontarf, Dublin - the only clinical gait lab in the State.
Gait analysis is one of the specialist services offered by the Central Remedial Clinic (CRC). We operate the only clinical gait laboratory in the Republic of Ireland.
Gait analysis is essentially electronic movement analysis and we assess mainly children and some adults with walking difficulties. These difficulties are present in conditions such as cerebral palsy, peripheral neuropathies, spina bifida, idiopathic toe walking, genetic disorders and sometimes the diagnosis is not established.
The human eye is not fast enough to analyse everything that's happening during walking, especially abnormal walking. At the Gait Lab we apply little sensors (light emitting diodes) to various anatomical parts on the body, sensors on the muscles and force sensors are also embedded in the floor.
As subjects walk, machines called motion analysers beam out infrared light which triggers the sensors to fire. Signals from these sensors are then tracked and the information is collected and processed on computer.
A person's walk can be reconstructed and a set of graphs representative of the walk is produced. As a medical team, we interpret these graphs and suggest a management strategy.
Non-surgical management strategies include splinting, physiotherapy, casting or injection of Botulinum toxin to weaken an overactive muscle. Surgical management can consist of cutting muscles that are too tight, cutting bones that are twisted or fusing certain joints.
Every week we hold a clinic with Prof Tim O'Brien, orthopaedic director of the laboratory, where all clients for the week are presented, and medical and surgical management recommendations are made.
One full gait analysis with a completed report can take four to six man-hours per child. This amount of time is justified when you consider that sometimes the decision being made could be the difference between a child using a wheelchair or walking independently and the knock-on effects this can have through the course of a child's life.
Gait analysis is objective and provides very good pre- and post- intervention records which facilitates good evidence-based medical practice.
My day-to-day duties are to ensure that the entire service runs smoothly and I work closely with physiotherapists, orthopaedic surgeons and clinical engineers.
At the lab we are also involved in clinical research and education. Prof O'Brien and myself drive the research and we present and publish both nationally and internationally. This is very important because it is a relatively new field of medicine.
We have just developed a mobile gait analysis lab and hold clinics in Limerick and Waterford. This is the first of its kind in the world.
I am also involved in education and teach on the European Faculty of Gait Analysis as well as being an executive committee member of ESMAC (European Society for Movement Analysis in Adults and Children). I deliver educational lectures to various medical groups throughout Ireland and Europe.
The ethos of CRC centres on the well-being, happiness and achievements of people with mainly physical disability and the welfare of their families, advocates and supporters. I absolutely enjoy my work and CRC is a wonderful employer. It encourages progressive thinking, advancement and education in all of its staff and it is a 'can do' place driven from the top by chief executive Paul Kiely.
It's more than a nine-to-five job and I gain very much personally from the attitudes and determination displayed by many of our kids who, although struggling for even basic mobility, just get on with life without complaining too much.
(Interview by Fiona Tyrrell)