The locomotion laboratory as a clinical assessment system.

As a routine clinical tool the locomotion laboratory has been a long time evolving. This paper reviews the development, successes and failures of locomotion assessment systems. A detailed picture of the state of knowledge of normal gait is presented along with some suggested directions regarding needed technological development as well as some criticism of the lack of biomechanical modelling. As examples of clinical applications, four major gait pathologies are reviewed: amputees, hemiplegia, cerebral palsy and joint replacement. The state of knowledge of each of these patient populations is presented along with a critique of the assessment methods and conclusions. It is hoped that this paper will provoke discussion regarding the real purpose of a clinical locomotion laboratory, and put some perspective on the cost in terms of equipment, space, newly trained or retrained personnnel and computer systems.