Co-designing clinical gait analysis reports with patient stakeholders
Research type
Research Study
Full title
Exploring Stakeholder Experiences of Clinical Gait Analysis and Co-Designing Health Assessment Results to Promote Shared Decision Making and Health Literacy
IRAS ID
343534
Contact name
Alan Royle
Contact email
Sponsor organisation
Sheffield Children's Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 4 months, 27 days
Research summary
There are many health conditions and childhood diseases that result in difficulty with movement and function, including walking. At Sheffield Children’s Hospital, we have a motion analysis laboratory that uses three-dimensional gait analysis (3DGA). 3DGA is a recommended tool for children and young people used to inform treatments, such as surgery, to improve their walking, as well as monitor change over time. We see a large variety of children, young people and their families, including people with cerebral palsy, a condition that describes injury to the developing brain during pregnancy, birth or early childhood and is the leading causes of childhood disability in the UK.
The Sheffield Children’s Hospital laboratory is one of fifteen accredited clinical motion analysis laboratories in the UK. Motion analysis provides precise, reliable information on the way individual’s use their bodies, such as the angle of their joints, the forces acting around those joints and other functional measures. This data is used to inform clinical decisions. Shared decision-making is a fundamental principle of health care. It ensures that individuals are meaningfully involved in making decisions about their own care. Key to this is how their health information is shared with service users, and how accessible it is to them. The information produced after motion analysis is typically very complex and involves the use of multiple measures, with reports often running to ten or twenty pages. Anecdotal evidence suggests that children and young people, their families and some health professionals may under-use this information and have challenges in accessing it. This project, therefore, seeks to explore the experiences of current service users, as well as co-designing methods with children and young people and their families that will promote shared decision making in the future.
Lay summary of study results:
BACKGROUND: Three-dimensional gait analysis provides vital but often complex information to inform treatment decisions for children and young people with disability or impaired walking function. Shared decision-making is a fundamental principle of modern health care that pivots on the ability to meaningfully inform patients and proactively involve them in making clinical choices. There is evidence to suggest that the complexity of gait analysis outcomes and a lack of familiarity with the data act as barriers to their utility by referring clinicians, and that patients experience inconsistent and often suboptimal access to the results and clinical implications of such assessments. This co-design project explores how outcomes from three-dimensional gait analysis could be better accessed and communicated for use by children and young people and their caregivers to promote their involvement in shared health decision-making processes.AIM: To investigate the experiences of children and young people and their caregivers with clinical gait analysis outcomes and collaboratively develop solutions to improve this experience through a process of co-design, and thereby facilitating health literacy and shared decision-making in the future.
METHOD: This investigation used the Design Council’s (2024) innovation framework - discover, define, develop, and deliver - to co-design improvements in gait analysis services for children and young people and their caregivers. Through three workshops held at Sheffield Hallam University’s Advanced Wellbeing Research Centre, five young people and their caregivers engaged in bespoke, creative activities to reflect on their daily routines, the challenges they faced and their mitigations, and defined their personal priorities. They then considered their experiences with gait analysis within this context and collaboratively proposed enhancements.
RESULTS: Participants identified barriers to daily activities, including health, environmental, psychological, and financial factors, and stressed the importance of effective communication and family support. Participants expressed dissatisfaction with current reporting processes, citing technical jargon and inconsistent follow-up and information sharing. While some children and young people rejected the idea of ‘child-friendly’ reports (otherwise favoured by their caregivers), all participants valued receiving actionable insights. This input informed a preliminary design for a customisable digital solution (e.g., an app) to deliver gait analysis results. Participants favoured interactive elements, such as progress tracking, peer support, and Q&A options with the clinical team or AI, enhancing engagement and supported by varied media formats.
Future work will consider the unmet needs of clinical stakeholders and pave the way for further prototype development and refinement with all key stakeholders. Quick, actionable wins will also be considered to inform service development work.REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
24/WM/0130
Date of REC Opinion
11 Jun 2024
REC opinion
Further Information Favourable Opinion