John Wayne had one. So did Mae West: a distinctive walk that’s instantly recognizable, as unique as a fingerprint. This isn’t just true of movie stars and supermodels; everyone has a distinct gait pattern that’s all their own. And like a fingerprint, it can provide important clues to solve a mystery.

At Temple’s Gait Study Center, researchers are using patients’ gaits to solve their medical mysteries. In this high-tech laboratory, located at the School of Podiatric Medicine, doctors are studying the way their patients stand and walk in order to identify the underlying causes of pain not only in the feet and ankles, but also in the hips, back or neck.

“If something’s not right with the way you’re walking, it sets off what we call a kinetic chain,” said Howard Palamarchuk, D.P.M., associate professor of medicine and orthopedics and director of sports medicine at the School of Podiatric Medicine. “When our feet or ankles are bothering us, it sets off a chain reaction that can shoot all the way up the spine and cause problems elsewhere. If a patient comes in with back pain, we’ll look at the way they’re standing or walking to see if there’s a problem there.”

Gait analysis can help determine underlying problems such as bone deformities, movement restrictions, muscle weakness, nerve dysfunction, skeletal or joint malalignments, neuromuscular disorders such as cerebral palsy and complications with arthritis.

“For example, a patient who comes in with a bunion or a plantar wart will modify the way they’re walking — by putting pressure on the outside of the foot, or the heel — to avoid that pain,” said Palamarchuk. “This causes balance issues and can lead to pain elsewhere in the body.”

Researchers in the lab use a number of different tools to get to the bottom of the problem:

• Force and pressure measurements: The centerpiece of the lab is a high-tech catwalk of sorts, outfitted with several plates which record the amount of force and pressure exerted as the patient walks. This information is then sent to computers which show two and three-dimensional pictures of how the foot hits the floor.
• Foot step analysis: Also embedded in the walkway are series of pressure sensitive switches that are activated as the patient walks over them. A computer program captures the impressions of the feet — think of walking across sand — and then analyzes them to calculate the walking pattern, walking speed, stride length and step time.
• 3-D motion analysis: Infrared light is reflected by special markers placed on the skin of the pelvis and lower extremities. A computerized camera system captures the position of these markers in three-dimensional space, which measures joint angles and movements as the patient walks.
• Muscle function measurements: When muscles are active, they produce a small electrical signal. Sensors are placed on a patient’s skin at various points to measure these levels and help determine if there’s a muscular or nerve problem.
• Slow-motion video: Video cameras record the patient as he or she walks. Reviewing slow motion and freeze frame video allows researchers to provide a more detailed analysis of how the patient walks.

“All of these help us perform a gait analysis, which can help us determine what the problem is and how to best fix it, whether it be surgery, a different shoe type or an orthotic,” said Palamarchuk. “It can be instrumental in getting a patient’s quality of life back.”