Research Communications

Walk This Way 

Capturing the movements of physical therapy patients on high-definition film could lead to better treatments

June 13, 2011

Whether they’re working with stroke survivors, injured athletes, or patients recovering from knee surgery, physical therapists must have a keen eye for detail. The subtle movements patients make when lifting a heel or putting weight on an ankle when walking can mean a big difference in the type of treatments and orthotics a therapist prescribes.

Physical therapy students primarily learn the art of diagnosis by carefully watching a wide variety of patients. Training videos exist, but—shot 30 to 40 years ago with a static camera—they offer limited insight into the human gait.

 A team of physical therapists and video production experts at Ohio University hope to change that through a new project that uses multiple slow-motion, high-definition cameras to better capture the movements of patients in treatment. The project could result in a new series of DVDs marketed to medical and physical therapy schools that could speed and enhance student learning.

Physical therapy students learn the art of filming patients for a new instructional DVD project.
Physical therapy students learn the art of filming patients for a new instructional DVD project. Photo courtesy of Eric Williams.

“Students are telling us that this is helping them to catch small issues in the field,” says project leader Petra Williams, an assistant professor of physical therapy. “Students don’t always see things right away—such as a 2 millimeter change in a patient’s arch, for example—but that can impact the orthotic interventions.”

Williams, Gary Chleboun, professor of physical therapy, and Eric Williams, an assistant professor of media arts and studies, received a grant from the Ohio University 1804 Fund two years ago to purchase HD video cameras and editing stations for the project, which was integrated into the School of Communication Sciences and Disorders’ graduate student curriculum. Williams recruited video and multimedia students to assist with filming and post-production work, including editing and the creation of information graphics.

The physical therapy students, however, don’t sit on the sidelines during shoots. Part of the goal of the project is to train these future clinicians to get comfortable with the cameras so that they might continue this high-tech observation and analysis in their careers.

“The technology is now more accessible than it used to be—cameras cost about $1,000 compared to $10,000 a piece in the past,” says Eric Williams, who adds that the quality of slow-motion video footage has improved as well.

Media arts and studies students helped create graphics for the DVDs that explain the biomechanics of walking.
Media arts and studies students helped create graphics for the DVDs that explain the biomechanics of walking. Photo courtesy of Eric Williams.

For an early Friday morning shoot last fall, the project team has transformed a physical therapy classroom into a film studio. Dark curtains create a neutral backdrop; long pieces of white Charlotte pipe are laid across the floor to serve as tracks for the two cameras. A volunteer who walks with a limp stands ready in gym shorts and sneakers. A physical therapy student claps her hands together to help line up audio and video in post-production, and Eric Williams calls out “Action!” The volunteer walks across the room, the two physical therapy student camera operators following behind and at the side of the subject to capture multiple views.

The process calls for a few takes—sometimes the timing of the clap or the camera movements aren’t quite in sync—but soon the team has finished the shoot and has moved on to a elderly stroke survivor and a college student with an injured knee. Several third-year graduate students confirm that participation in the shoots and access to the footage has made a positive impact on their learning to diagnose and work with patients.

The project also directly benefits patients, too, Petra Williams says, as viewing the footage can help them identify areas for change. The team was able to show one woman, for example, that she walked with greater confidence and ease when she lifted her head and looked forward, instead of staring at her feet.

The initiative already has helped match better orthotics to patients as well. The Ohio University team sent the video to a collaborator who fabricates the orthotics, which allowed her to design more effective devices for 12 clients in treatment, Petra Williams says.

The team sees huge potential for the DVDs that will result from the project, given the growing need for physical therapists in the medical field. Since those early, grainy training videos were shot in the 1970s or 1980s, patient needs have changed, Petra Williams notes. More people are surviving strokes and spinal cord injuries, and new surgeries are available for total knee and hip replacements. Many of these patients require short- or long-term physical therapy to aid in their recovery.

By Andrea Gibson

This article appears in the Spring/Summer 2011 issue of Perspectives magazine.