Daughter of Purpose (DOP) is going in for a follow-up MRI tomorrow…which is 9 months after her brain tumor was removed. We are praying for the residual amounts to be all gone again. Please pray with us!
In preparing for the experience, I was reminded that I had meant to write a post about DOP going to Shriner’s Hospital for a Gait Study several weeks ago.
For those of you that do not know, DOP had Polio as an infant while she lived in an orphanage in Russia prior to our adopting her in 2008. The effects of the polio have rendered her legs to be weak, which is why she wears braces on both ankles and walks with a funny limp. This is unrelated to the brain tumor found earlier this year.
As a result of her weak legs, DOP has been a patient at Shriner’s Hospital for many years meeting with an orthopedist, a polio specialist and various other doctors and specialists who custom make her braces. She is sometimes a “patient study” because it is very rare that American doctors get to work with a child who had polio. We are always impressed with their care and organization and willingness to try pretty much anything…even when it’s slightly unorthodox. They truly care more about helping the patient than they do about insurance, cost, standardized processes or public appearance.
So none of this may seem very exciting to you. I get that…but here is some stuff that is just simply cool.
The doctor’s requested DOP do another Gait Study. Essentially, it is a study of her gait, her walking, her movements, limps, pressure she puts on each foot and legs, the way she leans and, to some degree, the way she falls….which is kind of a lot. She has done this study before, a few years ago, but this time I got lots of pictures and video and was able to learn a lot more about the technology and process.
Here is how the process works….
DOP puts on a tight swimsuit-like top and shorts. This by far is the most awkward for DOP since she doesn’t like bikinis and she feels like she is wearing one in front of people. I tried explaining the differences between what she was wearing and a real bikini, but it didn’t seem to help. Whatever, girl….
Only the back right shoulder blade has a marker and there is a single one on the center chest. This tells the computer which is her front and which is her back since they are not symmetrical.
The technicians stick onto her body several dozen reflective markers that are silver-like balls. Placed on her shoulders, legs, knees, chest, hips, and feet, they are used to map out different portions of her body. There are 12 infrared cameras placed around the room that shine an invisible light that makes the reflective balls glow back on the cameras. A computer registers the exact location of each marker and records it in real-time. In the computer, the technician draws a line between each marker which then shows a stick-figure of the person. As DOP walks around the room, the cameras and computer produce an image that walks around the computer screen, showing and recording every angle, bend, fall, and detail of her movements. Since the image is just a stick figure, in order to keep the front of her body separate from the back, she has a single ball marker her right rear shoulder blade. Since this ball does not have one on the symmetrical side, they always know this is her backside.
The reflective markers are placed in very specific locations and adjusted to the millimeter so they match on each side of the body.
DOP was tested with this three times. First she did it with no shoes or braces, just her normal non-supported walk. Then she did two more, both with two different types of braces and shoes. The outcome is not necessarily related to either of these types of braces, but it is all we had on hand at the moment.
Without special lighting or a flash, they are plain grey in color.
Reflective Marker lit up with a flash of the camera. They glow!
Waiting to start her first walking set with no shoes or braces.
With a flash from the camera, the balls glow! They’re much brighter in real life…it’s pretty impressive actually.
All the reflective markers are placed at joints and other major locations…even on the shoes.
It is called 3D Motion and the process is frequently used in Hollywood for computer animation as well as video games. The application for the medical field is amazing. The techs record her walking around the room with both this 3D Motion system as well as regular video. The doctors can then later watch the detail of each step over and over again, zooming in or out to get better perspective. They can flip the image around and watch from the front, the side, the back or at any angle. In addition, they can merge the actual video footage with the 3D Motion footage and get a wire-frame over the top of her actual body, slow the speed down and analyze every single aspect of her gait. It’s quite amazing!
Click here for a video of the 3D Motion.
Click here for a video of her Walking with Brace and the reflective markers glowing.
Next, they tested her foot pressure. Using a pedobarograph (that’s a big medical word), they test to see how much pressure she is using on each foot while she walks. It gauges the exact movement and pressure applied to each square millimeter as she places her heal down, then the arch, then her toes…all in real-time as she walks. There is a set of silver metal plates in the floor that gauge all this as she just walks normally across it. Again, it is recorded by video so the doctors can see exactly how the movement flows…or doesn’t flow in DOP’s case.
Click here for a video of the Pedobarograph.
All of this is done so that the doctors can better analyze her gait and determine what the next best course of action is. Since all of the doctors agree that surgery is not the best thing for DOP, most likely these tests will simply provide the direction for which kind of bracing will best suit her needs and possibly strengthen her muscles a bit more in the future.
We go back in December to learn of the results and what the doctors suggest we do for bracing. In the meantime, please pray for her continued recovery from the brain tumor.
Nathan and Brandy