40 years of Ganglabor - an eventful history

Almost everyone in the Basel region knows the four-storey UKBB on Spitalstrasse with its colourful façade. But very few people realise this: Young patients are also examined in the basement of the building. This is where the paediatric hospital's gait laboratory is located. Children's gait is analysed here in one room using state-of-the-art measuring equipment. The laboratory celebrated its 40th anniversary in 2019. Like the children's hospital itself, it has an eventful history and has been based at various locations. Initially, in 1979, the laboratory was housed in the Felix Platter Hospital, where gait analyses for older patients are still carried out today in the Basel Mobility Centre. Since 2011, it has been located in the UKBB on Spitalstrasse. It was redesigned in 2013 and since then the walls have been adorned with characters from Walt Disney's Jungle Book painted by Basel artist Freddy Oettli - much to the delight of the children.

The gait laboratory was one of the first in Europe and, according to Prof Reinald Brunner, Head of the Department of Neuroorthopaedics, still plays a pioneering role today. „The hospital can be proud of what it has achieved in this area,“ he says. Brunner has witnessed a large part of the history of the gait laboratory. He has been Head of Neuroorthopaedics, which operates the laboratory, for 27 years. And he came into contact with the laboratory back in the 1980s, when he was still a young junior doctor. Today, gait tests are a routine part of everyday hospital life. „It's a common diagnostic tool like an MRI,“ says Brunner. However, the beginning was difficult, as it took several months to analyse the film material. Since the early 1990s, however, with the inclusion of powerful computers, it has been „really usable“ as a clinical tool.

The gait lab works as follows: Around 40 small, reflective markers are attached to the patient's skin, which are captured by twelve simultaneously running cameras and recorded by a computer. This creates three-dimensional images of the patient's movements. In addition, floor plates are used to measure the forces acting on the foot. Both measurements together allow the forces in the joints to be calculated and thus conclusions to be drawn about muscle activity and performance. The patients have to cover a distance of ten metres several times. The analyses take between one and three hours, and the evaluation of the data takes just as long.

The analyses are of great benefit in the treatment of various gait disorders, especially in neurological diseases, for example the widespread crouch gait, a gait with permanently bent hips and knees. The personal data enables the creation of individualised treatment plans. It can also show that treatment may not even be necessary, for example in the case of flat feet. „These often don't need to be treated at all,“ says Brunner. Around 300 to 350 such clinical analyses are carried out in the gait laboratory every year. According to Brunner, this number has remained „more or less constant“ in recent years.

Last but not least, the gait laboratory, which is headed by PD Dr Erich Rutz and employs around ten people, is also used for research - and thus helps to better understand the function of the human musculoskeletal system. For example, investigations are currently underway into how muscles develop when they are lengthened. Or what influence Botox has on muscles. „This research is essential for clinical treatment,“ says Brunner. But one question remains at the end: why is the gait laboratory located in the basement? The answer is simple: to minimise vibrations as much as possible - and thus not falsify the analyses.

Valentin Kressler, Communications Officer UKBB