Clinical gait analysis in alkaptonuria

We perform clinical gait analysis for all patients in the UK who were born with alkaptonuria and so develop early osteoarthritis.

Alkaptonuria is a rare metabolic disease leading to accumulation of homogentisic acid which damages cartilage, heart valves, kidneys and such. The National Alkaptonuria Centre (NAC), based at the Royal Liverpool Hospital, is monitoring, treating and researching this medical condition. As part of the long term service provided to patients with alkaptonuria in collaboration with the Alkaptonuria Society, clinical gait analysis is performed for patients at LJMU funded by the NAC.

We examine the natural progression of the disease with a focus on changes in movement function due to the special form of osteoarthritis which develops in patients with alkaptonuria. A clinical drug trial of nitisinone is currently under way and an advanced form of gait analysis is used to identify the optimal timing of treatment. 

We have recently developed real-time gait training protocols using the M-Gait system and D-Flow software (Motek) to reduce joint loading and related pain. Patients modify their gait under continuous feedback about their knee joint moments, aiming to reduce loading by 10%.

Our procedures and processes of clinical gait analysis have been accredited by the Clinical Movement Analysis Society of UK and Ireland since 2021, confirming the continuous high quality of our commitment to excellence.

The high level of our direct involvement with clinical gait analysis has been recognised in 2025 by the European Society of Movement Analysis in Adults and Children, who endorse our teaching of gait analysis at LJMU. Some of us routinely teach or participate in the annual ESMAC Gait Course and online Advanced Case Discussions.

Our staff

• Prof Gabor Barton
• Jacob Beesley
• Dr Mark Robinson