Female patient testing movements with staff

Motion Analysis Centers

Motion Analysis Center Locations

MAC Conditions

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For some children, coordinating complex movements like running with their friends, picking up a pencil, or throwing a baseball can be uncomfortable, difficult or even impossible.

As a child grows and develops, so does their ability to move. When a child has a condition that changes typical development and makes movement difficult, advanced diagnostic techniques may be necessary to understand fully what’s causing the movement problem. Motion analysis can help us understand the movement of children with neuromuscular, acquired or congenital disorders and develop an appropriate plan based on what we learn.

The specialists at our motion analysis centers (MACs) provide information used to drive treatment decisions for patients with a wide range of conditions. This includes cerebral palsy, brachial plexus (Erb's palsy), scoliosis, spinal cord injury, arthrogryposis, clubfoot, muscular dystrophy and spina bifida.

Our technology, which includes some of the same technical special effects used in movies and video games, collects information that provides Shriners Children’s care teams with guidance for a child's surgery, braces and/or rehabilitation.

During a session, we might explore your child’s ability to walk, run, bend and twist, and even how they swing their arms. Our state-of-the-art motion capture camera system records your child’s movements through the reflective markers we place on their body. Once we analyze the information we collect, we’ll partner with your child’s Shriners Children’s care team to recommend a care plan, making changes that can reduce their pain or discomfort and ultimately make it easier to do those things that are important to them.

How is Motion Analysis Information Used?

Guide decisions regarding surgery, bracing/orthotics, medical management and/or rehabilitation
Better evaluate the outcomes of treatment (surgery, braces, etc.) on a child’s mobility and their ability to perform daily tasks
Provide a clearer understanding of how a child uses their walking aids or wheelchair
Detect subtle changes over time that, if addressed early, may prevent or minimize additional loss of function

Our network of Shriners Children’s MACs is the largest of its kind in the world. Through regular communication between our MAC locations, we share information, data and knowledge, which helps all of the children we treat.

A visit to a Shriners Children’s motion analysis center can help unravel the mystery and put your child on the path to reaching their goals and discovering their full potential. Read on, to learn more about the services our MACs offer and how to prepare for a visit to one of our centers.

Specific treatments and services may vary by location. Please contact a specific location for more information.

Types of Motion Analysis Studies We Perform

During a motion analysis test, our team collects information related to your child’s movement, their muscle activity and the forces their body uses to move.

All of our locations perform the following motion analysis tests:

Gait analysis (kinematics/kinetics)
Foot pressure analysis
Electromyography
Joint range of motion and limb alignment
Strength
Motor control

In addition, some MACs perform the following specialized testing:

Sports testing
Spine motion analysis
Wheelchair analysis (propulsion testing)
Upper extremity kinematic analysis
Jump landing analysis
Running analysis
Hip motion analysis
Static balance analysis
Oxygen consumption

Understanding Your Child’s MAC Appointments

All of the children seen at our MACs are Shriners Children’s patients referred to us by their Shriners Children’s doctor. Many children visit a MAC the same day as their appointment with their doctor, which means no lost time scheduling another appointment or driving somewhere else. A motion analysis study, which you might also hear called a gait study, walking study or walking test, can take between 90 minutes and several hours, depending on what's being evaluated.

Preparing for Your First MAC Appointment

Before you come in for your appointment, we’ll go over the specifics with you, but here are a few things that will help you and your child get ready.

Clean your child's arms, feet and legs the morning of the appointment.
Do not apply lotion to your child’s body on the day of testing.
Bring elastic waistband shorts and a T-shirt to wear during the evaluation.
Girls should also bring a non-racerback sports bra and a camisole top that does not cover the upper back or shoulders.
Bring any orthotic braces your child wears (or no longer wears) and any shoes they wear with or without braces.
Bring any assistive devices such as walkers, crutches and/or gait trainers.
Bring glasses and hearing aids if your child uses them.

Things to Think About Before Your Visit

Does your child play a sport or an instrument? What do they want to do? It’s extremely helpful for us to hear from those who interact with your child when they are, or are not, wearing or using a device. What do they do well? What do they have trouble with? Gather some notes and your questions, and bring them with you.

What happens during a motion analysis evaluation?

Using infrared cameras mounted around a large room, a child’s movements are tracked and displayed virtually as they walk down a runway and walk across or stand on a special force platform. The information gathered in this exercise is translated to 3D animation, which allows the team to analyze your child’s movement.

This process is not painful and is often fun. In fact, many of the children who visit one of our nationally recognized MACs say these are some of the most fun and least scary tests they’ve taken.

Some test specifics:

Specialized cameras capture the movements of sticky markers we attach to your child’s feet, legs and trunk (kinematics).
Electromyograph electrodes are placed on your child's legs to evaluate their muscle activity (EMG).
Platforms recessed into the floor measure forces acting on the body as your child walks (kinetics).
A special walkway measures the pressure under the surface of your child’s foot while they walk (pedobarograph).
High-definition video cameras record how your child walks, bends, raises his or her arms and legs and completes other tasks as needed.
Metabolic testing measures how much energy your child expends while walking.

The Follow-Up

After the test, the information we’ve gathered is reviewed by a multidisciplinary team of specialists, including orthopedic surgeons, an engineer, a kinesiologist, and a physical therapist. Once the results have been reviewed, you'll return with your child and discuss next steps with his or her care team. Some children return for additional MAC appointments, perhaps after surgery, after rehabilitation, after wearing a brace, etc., to have the test repeated and understand how they are progressing and adjust their treatment plan if needed.

Improving Treatment Through the Shriners Children's Motion Analysis Network (SMACnet)

The Shriners Children's Motion Analysis Network (SMACnet) is a group of Shriners Children's physicians, therapists, engineers, kinesiologists and technicians who work together to improve the clinical, research and educational activities in Shriners Children’s MACs.

The partnership and communication between SMACnet members allows us to develop innovative solutions that directly impact and increase our ability to treat complex movement disorders in children. Each MAC sees hundreds of patients per year, and with each child we assess, we collect, organize and store data. Recently, SMACnet established a combined patient database. One of the largest MAC patient databases in the world, the anonymous data from all of the patients that visit the MAC will be used together to improve treatment for children across Shriners Children's and often outside our healthcare system.

Research by Shriners MACs

Research in our MACs helps us better understand normal motion, which means we are also able to increase our understanding of uncommon motion.

As leaders in the field of motion analysis, members of SMACnet publish multiple peer-reviewed articles each year. Below are a few of the areas we’re currently involved in, with links to articles we've written about particular subjects.

Measuring Foot Motion

We've pioneered several different approaches for measuring foot motion. These new techniques help us better understand how the foot moves and the possible interventions that may improve a child's ability to walk.

A musculoskeletal foot model for clinical gait analysis (Journal of Biomechanics, 2010)
Segmental foot and ankle kinematic differences between rectus, planus, and cavus foot types (Journal of Biomechanics, 2019)
Center of pressure metrics derived from spatially registered typically developing data (Gait & Posture, 2020)

Effects of Early Mobilization on Outcomes after Cerebral Palsy Surgery

This research shows how starting rehabilitation within the first few days of multilevel cerebral palsy surgery, instead of waiting three to six weeks, can have a significant, positive impact on a child. Within the first month after surgery, improvements seen included restoring a child’s participation in daily activities, including walking and returning to school.

Evaluating Surgical Interventions that Improve Mobility

SMACnet has published many scientific papers exploring the biomechanics (structure, function and motion) of gait and surgical outcomes.

Femoral anteversion assessment: Comparison of physical examination, gait analysis, and EOS biplanar radiography (Gait & Posture, 2018)
Midstance hamstring length is a better indicator for hamstring lengthening procedures than initial contact length (Gait & Posture, 2020)
Patella Alta in Ambulatory Children With Cerebral Palsy: Prevalence and Functional Significance (Journal of Pediatric Orthopedics, 2020)
Utilization and efficacy of computational gait analysis for hamstring lengthening surgery (Gait & Posture, 2016)

Upper Extremity Motion

In addition to walking, some of our motion analysis labs have been quantifying upper extremity motion. SMACnet work in this area has included exploring upper extremity motion in cerebral palsy, spinal cord injury, scoliosis and brachial plexus (Erb's palsy) injuries.

Upper extremity biomechanics of children with spinal cord injury during wheelchair mobility (Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2014)
Analysis of Shoulder Complex Function After Posterior Spinal Fusion in Adolescents With Idiopathic Scoliosis (Journal of Pediatric Orthopedics, 2019)

Motion Analysis at Shriners Children's

Motion analysis can help us to understand the movement of children with neuromuscular-acquired or congenital disorders and develop an appropriate plan based on what we learn.

View Transcript

Fran Farley:
When a child has a condition that changes typical development and makes moving difficult, advanced diagnostic techniques may be necessary to understand fully what's causing the movement problem. Motion analysis can help us to understand the movement of children with neuromuscular-acquired or congenital disorders and develop an appropriate plan based on what we learn.

Speaker 2:
Shriners Children's has the largest motion analysis system in the world and utilizes computer-generated imagery or CGI just like in the movies. This type of in-depth gait analysis allows for a better understanding of how children walk and move, use their braces or walking aids and how we can improve their walking ability. Our team of orthopedic surgeons, physical therapists, orthotists and prosthetists meet to discuss the results of the gait analysis and create a personalized treatment plan for the patient.

Speaker 2:
From there, the MAC team determines the best plan of care going forward for the child, including recommendations for surgery, physical therapy and/or braces. The MAC provides services for a wide range of patients with diagnoses that include but are not limited to cerebral palsy, arthrogryposis, clubfoot, muscular dystrophy and spina bifida.

Speaker 2:
We start by attaching small wireless EMG sensors and reflective markers to the skin the same way you would apply a sticker. Then, we ask our patients to walk normally. As the patient moves, the 18 Vicon infrared cameras track their movements while four force plates record ground reaction forces. This information is translated into a 3D computer model of the patient walking. Our motion capture camera system is able to detect the motions of all of the joints, activity of all of the muscles and overall efficiency of walking that cannot be seen with the naked eye.

Fran Farley:
Once we analyze the information we collect, we'll partner with your child's Shriners care team to recommend a care plan, making changes that can reduce their pain or discomfort, and ultimately making it easier to do those things that are important to them. Through regular communication between our MAC locations, we share information, data and knowledge, which help all of the children we treat. A visit to the Shriners Children's Motion Analysis Center can help unravel the mystery and put your child on the path to reaching their goals and discovering their full potential.

Our motion analysis centers combine state-of-the-art technologies with highly qualified and deeply caring orthopedic specialists. Their work leads to exceptional care for children with conditions that affect their movement.

Dr. Jon Davids, Shriners Children's Northern California and Dr. Kristen Carroll, Shriners Children's Salt Lake City

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Pediatric Orthopedics: Specialized Care for Growing Bones

We're home to a renowned team of board-certified pediatric orthopedic surgeons, specialists and support teams devoted to providing progressive orthopedic treatments. Anchored in research based on real evidence, these teams take advantage of a number of minimally invasive approaches, like the EOS imaging system to reduce radiation exposure and the MAGEC system to reduce surgeries for patients with early-onset scoliosis.

Learn about our Pediatric Specialty Orthopedic Care

Conditions We Support

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Scoliosis

Scoliosis is a condition where the spine is curved sideways. With advanced treatments and world-class expertise, Shriners Children's cares for more than 10,000 children with scoliosis each year

More About this Condition

Cerebral Palsy

At Shriners Children's, our team of specialists provides individualized care for your child with cerebral palsy.

More About This Condition

Clubfoot / Club feet

Talipes equinovarus (TEV) is the medical term for "clubfoot," and Shriners Children's physicians are specialists in this common and treatable pediatric orthopedic condition.

More About This Condition

Toe-Walking

Toe-walking is when a child walks on the balls of his or her feet. It is common in toddlers, and typically children outgrow it. Shriners Children’s is here to help evaluate your toe-walker, and decide if it is time to take a closer look.

More About This Condition

Intoeing

Intoeing is a common orthopedic condition that children typically grow out of without treatment. If you have concerns about how your child walks, orthopedists at Shriners Children's can determine if treatment is needed.

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Out Toeing

Out toeing or "duck feet," a common condition in children, can be seen when a child walks and their toes turn away from their body. Treatment is not usually necessary, as a child will likely grow out of it by age 6.

Pes Planus / Pes Planovalgus

Pes Planus / Pes Planovalgus, also known as flat foot, occurs when the feet are flat on the bottom and don’t have an arch. Shriners Children's physicians typically treat it using a special shoe insert designed by our in-house technicians.

Spinal Cord Injury

Spinal cord injury occurs when nerves in the spinal column in the center of the back are damaged. Shriners Children’s offers advanced surgery options and therapy options to help restore your child’s function and mobility.

More About This Condition

Congenital Neuromuscular Disorders

Shriners Children's is a renowned leader in providing specialized pediatric medical care, utilizing the latest clinical and scientific research in our comprehensive approach to treatment for children with muscular and neuromuscular disorders.

More About this Condition

Scoliosis

Scoliosis is a condition where the spine is curved sideways. With advanced treatments and world-class expertise, Shriners Children's cares for more than 10,000 children with scoliosis each year

More About this Condition

Cerebral Palsy

At Shriners Children's, our team of specialists provides individualized care for your child with cerebral palsy.

More About This Condition

Clubfoot / Club feet

Talipes equinovarus (TEV) is the medical term for "clubfoot," and Shriners Children's physicians are specialists in this common and treatable pediatric orthopedic condition.

More About This Condition

Toe-Walking

More About This Condition

Intoeing

More About this Condition

Out Toeing

Pes Planus / Pes Planovalgus

Spinal Cord Injury

More About This Condition

Congenital Neuromuscular Disorders

More About this Condition

Scoliosis

Scoliosis is a condition where the spine is curved sideways. With advanced treatments and world-class expertise, Shriners Children's cares for more than 10,000 children with scoliosis each year

More About this Condition

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