Gait analysis seminar in Tokyo

In order to turn an event into a tradition, many high-quality repetitions and successful visitor acceptances are needed. That is exactly what we wanted to do with the summer seminar in Hachioji, Tokyo. This year we drew closer towards tradition.

Also during this summer seminar with a German speaker, the skills of the interpreter were needed in order to communicate the facts about gait analyses.

Our aim is to offer the opportunity to interested people in Japan to broaden their knowledge of human locomotion. The offers of further education in the area of locomotion analyses are usually gladly accepted and many people are ready to travel quite far to gain new knowledge. This year, Dr. Oliver Ludwig joined us. The topic was "gait analysis for practice". After Dr. Wolfgang Laube had introduced in such an impressive way the fascinating world of human sensorimotor function last year, we felt that the human gait was a consequential continuation of this series.

Dr. Ludwig has a really exciting and concentrated and yet diversified career: First human biology with its biomechanics was the core area of his studies. Orthopedics and sports medicine followed. Further studies of technical biology and bionics led to a temporary cooperation on a project of the German Research Foundation where he also could finish his doctorate: "Autonomous walking - the development of walking robots". Additionally, he worked on posture and locomotion analyses in orthopedic technology and medial gait diagnostics within his studies.

Dr. Oliver Ludwig teaches at the University of Saarland in the specialized field of sports science for posture and locomotion dysfunctions. He is a chief scientist of the permanent study on the research of postural defects in children and adolescents (www.kid-check.de). A major area of focus for him is working with sensorimotor insoles. His study on this topic may well be considered ground-breaking.

Getting to know each other the day before

I first met Mr Ludwig in person on 13 June at the Tokyo airport, the day before the seminar. We were communicating for months exclusively via e-mail as we were planning the seminar. In accordance with my experience, sufficient trust coupled with reliable communication was required to make this work.

In spite of Dr. Ludwig's long and tiring trip we met in Hachioji with Tsukishiro-San, our proven interpreter, to discuss the final details. Also a representative of Darfish was there, the company that supported us during the seminar with video technology. We ended the evening with Fukushi-San, our co-organizer, in a cosy Isakaya (Japanese "osteria") with rice beer and Sashimi (raw fish).

If you only meet in person the night before a joint seminar, a lot of trust and a reliable communication are required. To get into contact, we visited an Isakaya together in the first evening.

Communication of basics for a heterogeneous audience

The Hachioji Seminar House which already last year proved to be the perfect location for our event is located in the heart of nature, in the hills above the big city, a convenient place to be reached. The seminar buildings are dispersed in the "woods," and overnight stays are also possible which proved to be important for networking.

On Saturday morning we started the gait analysis seminar refreshed, on time, in front of a capacity audience. Shoe dealers, orthopedic surgeons, orthopedic technicians and physical therapists, but also lifestyle consultants, university lectors and staff of a big producer of sanitary products came together. A diverse audience, 31 people from greater Japan participated. Dr. Ludwig and Tsukishiro-San (P&O) immediately proved to be an excellent team. Together they introduced us to the vocabulary of human gait's concepts, showed us different observation and registration techniques and explained the principles of mechanics and control of the body. These three important rules belong to the basis of gait analyses and subsequent therapy:
1. Not every deviation from the norm is a pathology.
2. Not all symptoms show a deviation from the norm.
3. Never influence a gait pattern without necessity.

Dr. Ludwig provided us with a simplified, user-friendly four-phases-model as a variety of the usual eight phases. Oliver Ludwig then went into detail of the individual phases, the function of the individual bones and muscles, biomechanics, norm values, deviations and simple measuring techniques. He did this in a very descriptive way utilizing pictures or videos for each of these items.

Now comes the practice

Walking through the room, the participants are trying out the four gait phases for themselves.

In the afternoon more and more exercises were included, such as "feeling our own muscles" at the buttocks and the stomach while walking, more than likely to fight the usual energy low after lunch.

This was followed by the technically supported gait analysis: Dr. Ludwig explained how to feel prominent spots at the foot, leg and pelvis and how to mark them with markers or pens. Supported by Dartfish and using Fukushi-San as proband, we were shown how we can work with video software in practice. With further palpations tricks to test the flexibility or the angles for example in the knee or in the hip joint the first day of the seminar came to an end.

The second seminar day usually is more relaxed. Still we started punctually as on Sunday with the pedobarography. The speaker showed us the possibilities of this tool and what to look out for. Creact as representative of Novel in Japan supported us technically. Using print images of different feet, Dr. Ludwig showed us the illustration of the individual disease, but he also pointed out the limits of the illustration. With the help of "Pedar" orthotics, our probands could lap again and we observed what happened.

The afternoon of the second day was dedicated to the posture analyses in children and juveniles. But Dr. Ludwig showed us first what the situation was like in Germany using photos and statistics. Understanding nods from the audience showed that there are similar developments in Japan. Physical inactivity has long since become an international health problem.

Dr. Oliver Ludwig glues on markers to demonstrate the posture analysis in children and adolescents.

Our 14-years-old proband, who came from Nagano especially for the seminar, proved to be very cooperative, in spite of the tests and exercises that could be quite challenging. It was very useful that he is bilingual in Japanese and German and thus could take the pressure of our interpreter.

This posture analysis focus that we had planned according to the wish of various participants, was met with interest and Dr. Ludwig was able to present this topic in a detailed and still easy-to-understand way.

We will continue next year

The interest of the audience was impressive during the whole seminar. Although it was a heterogeneous group with very different previous knowledge, a fact that preoccupied us a lot during preparation, I am convinced that we provided some useful information for each of them. The participants exchanged ideas without status limitations or industry background and if they also had fun during the supporting program, so much the better. Our team from management, interpreter and speaker decided right away to undertake new enterprises. Surely we will meet next year with a similar team.

By Clemens Hagen