Human Performance Lab Provides Data for Planning Patient Care
The help that the Children’s Mercy Human Performance Lab provided Martin, the 5-year-old with cerebral palsy featured recently in Inside Pediatrics Season 3, is available to a wide range of children with neuromuscular and/or gait disorders.
The Inside Pediatrics segment showed how Orthopaedic Surgeon Kathryn Keeler, MD, (pictured left wtih Martin) assisted by data generated by the Human Performance Lab (located at Village West), planned the surgery that repositioned Martin’s leg bones to allow him to walk and ride his bicycle better.
The lab is equipped with state-of-the-art technology that includes 19 3D cameras, a 16-channel wireless EMG (electromyogram, which records electrical activity in muscles) and six force plates installed in the floor to simulate walking on a sidewalk, measuring pressure as movement progresses from the heel to toe and calculating force on ankle, hip and knee joints.
“3D Motion Capture and EMG together give us a full picture of how the patient is walking and moving, including forces and alignment,” said Julie Musick, MS, PT, Director-PT/OT, Physical and Occupational Therapy. “We’re able to view the patient’s walking from different angles to help us understand the nature of how the individual moves."
Patients can be measured walking barefoot or with one or more assistive devices such as braces or a walker. Reflective markers adhered to the patient at bony landmarks including the shoulder, elbow, wrist, pelvis, hip, knee, ankle and foot are read by cameras using infrared rays; a skeletal model is produced via motion analysis to assist with surgical decision-making and pre- and post-op evaluation.
“It’s the same technology used to make video games and movies, like Lord of the Rings and Avatar,” said Jennifer Mathews, Motion Analysis Lab Coordinator, the first Biomedical Engineer hired by the Orthopaedic program to manage the technical complexities of the equipment. (Pictured right.)
In addition to Dr. Keeler, Julie and Jennifer, the lab staff includes Physical Therapist Katie Link.
Data produced by the team can be valuable for making medical decisions in areas such as Orthopaedics, Neurology, Neurosurgery and Rehabilitation Medicine. The lab’s studies provide data to guide treatment decisions such as orthopaedic surgery, selective dorsal rhizotomy (SDR), baclofen pump implantation (to deliver medication to treat spasticity), deep-brain stimulation and other procedures.
The lab has performed studies on patients from the Comprehensive Movement Disorders and Spasticity Clinic and after an absence of several years, a Rhizotomy (SDR) program is being re-established with procedures performed by Neurosurgeon Michael Partington, MD, MS. SDR is a surgical procedure to sever nerve roots to relieve muscle spasticity. The lab also is preparing to perform assessments regarding the use of deep-brain stimulators.
The Human Performance Lab is able to take referrals for patients age 5 and up with neuromuscular disorders resulting from cerebral palsy (like Martin), brain injuries, prematurity or other abnormal gait conditions.
The lab emphasizes that it does not provide diagnoses.
“This is an assessment tool that generates data for conditions that have already been diagnosed,” Julie (pictured left) said. “We don’t produce a clinical plan. We do the study; Dr. Keeler or another physician looks at the data, does the interpretation and discusses the interpretation report with the referring provider to come up with a clinical plan.”
Learn more about Orthopedics at Children's Mercy.