GRAIL

Gait Real-time Analysis Interactive Lab

The Gait Lab of the Future

Version 2, January 2013

GRAIL is the Gait Lab of the Future for Analysis and Training

GRAIL is a total package solution for gait analysis and gait training. GRAIL uses an instrumented dual-belt treadmill, a motion-capture system and synchronized Virtual Reality (VR) environments next to 3 video cameras and EMG. GRAIL supports user friendly gait analysis and gait training in challenging conditions to improve (pathological) gait patterns. Real-time adjustments in GRAIL enable analysis and training during the same session.

The complexity of an efficient human gait pattern becomes clear when it is compromised due to disease, trauma, or natural decline. Clinical gait analysis is an science extensively proven and powerful tool to identify impaired gait patterns. Traditionally, force-plates, electromyography (EMG), video cameras and a motion-capture system are used to collect gait parameters like walking-speed, step-size, joint angles, joint moments and muscle-activation.

Conventional gait analysis is generally executed in a large lab, average of 88m2 (947 ft2), and strictly limited to analysis based on an artificially targeted single step on the force-plate. Because of the time consuming, complex and thus expensive procedure, gait analysis is often only used for severe Cerebral Palsy and Stroke patients.

The advantages of GRAIL:• Your complete gait lab on 25m2 (269 ft2)• Full gait analysis with gait report within 30 minutes• All gait parameters available in real-time for monitoring and interventions• GRAIL enables for the first time gait training using VR and direct feedback• Training options enable a 100% utilization rate

GRAIL provides the full functionality of a conventional gait lab on 25m2. GRAIL is a synchronized system that consists of an instrumented dual-belt treadmill with self-paced option, an integrated motion-capture system, 3 video cameras and an EMG system. This combination allows for the calculation of all gait parameters in real-time (spatio-temporal parameters, kinematics, kinetics and muscle-activation). The Gait Off-line Analysis Tool (GOAT) offers intuitive data analysis and facilitates communication with (medical) specialist and between specialist and patient.

For the first time all gait parameters are processed in real-time and are directly available for gait training using direct feedback. GRAIL facilitates both analysis and training, efficiently and cost effective in both the use of space and time. GRAIL can now be used as a standard for a variety of patient groups like neurological- and orthopedic patients, patitients musculoskeletal complaints and elderly with increased risk of falling.

Synchronized VR environments, projected on a semi-cylindrical screen, immerse the patient in virtual worlds and natural walking environments. The self-paced mode of the treadmill allows the patient to initiate gait and walk at a self-selected speed, while the treadmill and the VR environment run in perfect synchronization. Fast treadmill pitch and sway, combined with visual stimuli, challenge patients while measuring gait behavior, providing a ‘functional gait analysis’.

Key features

GRAIL offers you a total package solution for clinical gait analysis and gait training using the latest technologies solidly integrated into one functional system.Besides the full functionality of a traditional gait lab, GRAIL provides you with:

Gait analysis: real-time Accurate gait parameters are ensured due to a natural walking pattern, facilitated by an immersive VR environment projected on a 180o semi-cylimdrical screen. This gives a subject the impression of walking in a natural environment with peripheral vision. Data can be verified in real-time.

Gait Off-line Analysis Tool (GOAT)The GOAT can produce a gait report directly after the session and facilitates video analysis, data post-processing/filtering options and extensive interactive data analysis. Recording of multiple steps makes it possible to calculate averages, standard deviations and variations of gait parameters over time.

Functional gait analysisIdentify pathology specific responses to perturbations. Visual challenges, fast pitch, sway and belt speed changes, enable identification and quantification of compensatory strategies or dynamic stability. This cannot be performed in traditional gait labs. The self-paced treadmill mode allows the subject to walk at a self-selected speed with perfectly synchronized VR environments. For example this allows you to perform the 6-minutes-walk test.

Gait training The combined gait analysis and gait training options of GRAIL ensure your lab to be used 100% of the time. GRAIL enables the use of any gait parameter in applied VR game-play to influence impaired gait in multi-sensory challenging conditions. For example; increased Knee Adduction Moments (KAM) in orthopedic patients suffering from osteoarthritis can be affectived by providing patients with personalized feedback on there KAM and Internal Hip Rotation. Various applications are available, e.g. for dynamic alignment of prostheses, cue-ing, dynamic stability, gait adaptability, cognitive dual-tasks and training of push-off/foot clearance.

Key features 

GRAIL offers you clinical gait analysis and gait training using the latest technologies solidly integrated in one functional system, providing you with the full functionality of a traditional gait lab and more. 

Gait analysis: real‐time  Accurate gait parameters are ensured due to a natural walking pattern, facilitated by an immersive VR environment projected on a 180o screen, to give a subject the impression of walking in a natural environment like a forest.  Accuracy of the data can be verified in real‐time.  Gait analysis: off‐line A gait report is available directly after the session. An off‐line analysis tool facilitates extensive interactive data analysis and post‐processing. Recording of multiple steps makes it possible to calculate averages, standard deviations and variations of gait parameters.  Functional gait analysis Due to the treadmill movements, compensatory strategies or dynamic stability can be quantified, identified and used. This cannot be performed in traditional gait labs. The self‐paced mode allows the subject to walk at a self‐selected speed, while the treadmill and the VR environment follow instantaneously. This allows you to perform the 6‐minutes‐walk test on the GRAIL system.    Gait training  The combined gait analysis and gait training options of GRAIL ensure your lab to be used 100% of the time. GRAIL enables the use of any gait parameter in applied VR game play to influence impaired gait in mechanical and visual challenging conditions. For example: a‐synchronous walking patterns can be neutralized by a game in which patients need to place their feet correctly not to step on passing objects. Or increased medial knee load in orthopaedic patients suffering osteoarthritis can be released by providing a patient feedback to re‐direct the ground reaction force to aim through the knee joint during walking. 

GRAIL:Instrumented dual-belt treadmill Self-paced modulePitch and Sway

Video, Motion-capture system and EMGSynchronized data streamsGait parameter calculations in real-time ▪ Spatio-temporal parameters, joint kinematics, joint kinetics, EMG ▪ Averages, standard deviations, variations over time

180o projection and surround sound systemImmersive Virtual Reality with peripheral vision Interactive multi-sensory feedback for gait training

Software Gait-suite ▪ Set of applications for dynamic alignment of prostheses, left-right comparison, cue-

ing, dynamic stability, gait adaptability, cognitive dual-tasks, training of push-off/foot clearance, and more.

Musculo-skeletal Human Body Model with real-time visualization of muscle forces

Gait Off-line Analysis ToolUser friendly interface ▪ Synchronized videos (3x) ▪ Extensive interactive data analysis and gait report generation ▪ Data re-processing and export functionality

Company profile

Motek Medical provides innovative products for rehabilitation, orthopaedics, neurology, performance enhancements and research. Integrated VR environments that combine motion platforms, instrumented treadmills, motion-capture systems and surround sound are used to train movement functions and improving stability. Game elements and rich immersive interactions enable better user presence. The technology uses multi sensory real-time feedback and off-line analysis tools.

Other Motek Medical products

CAREN CAREN (Computer Assisted Rehabilitation ENvironment) is our leading product. CAREN is a hardware and software system for registration, evaluation and training of functional human behavior. CAREN systems always consist of a motion base, motion-capture system, a projection screen and the D-flow software. There are three default models available, which can all be tailored to your specific needs.

STABLESTABLE is a revolutionary system for the assessment and training of postural stability and balance related disorders in neurological-, orthopaedic patients, patients with musculo-skeletal complaints and especially in elderly with increased risk of falling. Assess and improve your patient’s balance and stability, using therapeutically constructed Virtual Reality applications. STABLE uses the latest technologies to obtain objective and quantitative outcome measures for stability and balance alongside fun and motivating exer-games to train stability and balance to reduce the risk of falling.

D-Flow D-Flow is a software suite that provides real-time data streams between many types of integrated hardware. The D-Flow software enables feedback strategies through a flexible and extensible virtual reality application development framework, based on visual programming.

Keienbergweg 77 | 1101 GE | Amsterdam | The Netherlands T: +31(0)20 301 30 20 | F: +31(0)20 301 30 21 | www.motekmedical.com