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Galindo-Martínez A, Vallés-González JM, López-Valenciano A, Elvira JLL. Alternative Models for Pelvic Marker Occlusion in Cycling. J Appl Biomech 2024; 40:176-182. [PMID: 38176398 DOI: 10.1123/jab.2023-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/26/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024]
Abstract
Bike fitting aims to optimize riders' positions to improve their performance and reduce the risk of injury. To calculate joint angles, the location of the joint centers of the lower limbs needs to be identified. However, one of the greatest difficulties is the location of the hip joint center due to the frequent occlusion of the anterior superior iliac spine markers. Therefore, the objective of this study was to validate a biomechanical model adapted to cycling (modified pelvic model, MPM), based on the traditional pelvic model (TPM) with an additional lateral technical marker placed on the iliac crests. MPM was also compared with a widely used model in cycling, trochanter model (TM). Thirty-one recreational cyclists pedaled on a roller bike while the movement was captured with a 7-camera VICON system. The position of the hip joint center and knee angle were calculated and compared with the TPM continuously (along 10 pedaling cycles) and discreetly at 90° and 180° crank positions. No significant differences were found in the position of the hip joint center or in the knee flexion/extension angle between the TPM and the MPM. However, there are differences between TPM and TM (variations between 4.1° and 6.9° in favor of the TM at 90° and 180°; P < .001). Bland-Altman graphs comparing the models show an average difference or bias close to 0° (limits of agreement [0.2 to -8.5]) between TPM and MPM in both lower limbs and a mean difference of between -4° and -7° (limits of agreement [-0.6 to -13.2]) when comparing TPM and TM. Given the results, the new cycling pelvic model has proven to be valid compared with the TPM when performing bike fitting studies, with the advantage that the occluded markers are avoided. Despite its simplicity, the TM presents measurement errors that may be relevant when making diagnoses, which makes its usefulness questionable.
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Affiliation(s)
| | | | - Alejandro López-Valenciano
- Department of Education Science, Universidad Cardenal Herrera-CEU, CEU Universities, Castellon de la Plana, Spain
| | - Jose L L Elvira
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University, Elche, Spain
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Kruger KM, Fischer P, Augsburger S, Feng J, Girouard JF, Gregory DL, Johnson L, MacWilliams BA, McMulkin ML, Nelson B, Warshauer S, Saraswat P, Chafetz RS. The Shriners Children's Gait Model (SCGM). Gait Posture 2024; 110:84-109. [PMID: 38552301 DOI: 10.1016/j.gaitpost.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
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Horsak B, Durstberger S, Krondorfer P, Thajer A, Greber-Platzer S, Kranzl A. Which method should we use to determine the hip joint center location in individuals with a high amount of soft tissue? Clin Biomech (Bristol, Avon) 2024; 115:106254. [PMID: 38669918 DOI: 10.1016/j.clinbiomech.2024.106254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This study investigated the most accurate method for estimating the hip joint center position in clinical 3D gait analysis for young individuals with high amounts of soft tissue. We compared position estimates of five regression-based and two functional methods to the hip joint center position obtained through 3D free-hand ultrasound. METHODS For this purpose, the data of 14 overweight or obese individuals with a mean age of 13.6 (SD 2.1 yrs) and a BMI of 36.5 (SD 7.1 kg/m2, range 26-52 kg/m2) who underwent standard clinical 3D gait analysis were used. The data of each participant were processed with five regression-based and two functional methods and compared to the hip joint center identified via 3D free-hand ultrasound. FINDINGS The absolute location errors to 3D free-hand ultrasound for each anatomical plane and the Euclidean distances served as outcomes next to their effects on gait variables. The data suggest that regression-based methods are preferable to functional methods in this population, as the latter demonstrated the highest variability in accuracy with large errors for some individuals. INTERPRETATION Based on our findings we recommend using the regression method presented by Hara et al. due to its superior overall accuracy of <9 mm on average in all planes and the lowest impact on kinematic and kinetic output variables. We do not recommend using the Harrington equations (single and multiple) in populations with high amounts of soft tissue as they require pelvic depth as input, which can be massively biased when a lot of soft tissue is present around the pelvis.
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Affiliation(s)
- Brian Horsak
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten 3100, Austria.
| | - Sebastian Durstberger
- FH Campus Wien - University of Applied Sciences, Department Health Sciences, Favoritenstrasse 226, 1100 Vienna, Austria; Orthopaedic Hospital Speising, Laboratory of Gait and Movement Analysis, Speisinger Str. 109, Vienna 1130, Austria
| | - Philipp Krondorfer
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten 3100, Austria
| | - Alexandra Thajer
- Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Guertel 18-20, Vienna 1090, Austria
| | - Susanne Greber-Platzer
- Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Guertel 18-20, Vienna 1090, Austria
| | - Andreas Kranzl
- Orthopaedic Hospital Speising, Laboratory of Gait and Movement Analysis, Speisinger Str. 109, Vienna 1130, Austria
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Dranetz J, Chen S, Choi H. Impact of model geometry and joint center locations on inverse kinematic/dynamic predictions: A comparative study of sexually dimorphic models. J Biomech 2024; 169:112147. [PMID: 38768542 DOI: 10.1016/j.jbiomech.2024.112147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/14/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
This work illustrates the sensitivity of demographically characteristic body segment inertial properties and subject-specific customization on model performance. One characteristic demographic, gender, and one subject-specific characteristic, hip joint center location, were represented with musculoskeletal modeling to evaluate how design decisions may alter model outputs. Generic sexually dimorphic musculoskeletal models were developed from the commonly used Rajagopal model using male and female data adapted by Dumas et al. Hip joint centers of these models were adjusted based on functional joint center testing. The kinematics and dynamics of 40 gait cycles from four subjects are predicted using these models. Two-way analysis of variance (ANOVA) was performed on the continuous time series data using statistical parametric mapping (SPM) to assess changes in kinematics/dynamics due to either choice in model (Rajagopal vs Dumas) or whether joint center adjustment was performed. The SPM based two-way ANOVA of the inverse dynamics found that differences in the Rajagopal and Dumas models resulted in significant differences in sagittal plane moments during swing (0.115 ± 0.032 Nm/kg difference in mean hip flexion moment during initial swing and a 0.077 ± 0.041 Nm/kg difference in mean hip extension moment during terminal swing), and differences between the models with and without hip joint center adjustment resulted in significant differences in hip flexion and abduction moments during stance (0.217 ± 0.055 Nm/kg increased mean hip abductive moment). By comparing the outputs of these differently constructed models with each other, the study finds that dynamic predictions of stance are sensitive to positioning of joint centers, and dynamic predictions of swing are more sensitive to segment mass/inertial properties.
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Affiliation(s)
- Joseph Dranetz
- Department of Mechanical and Aerospace Engineering, Biionix Cluster, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, United States.
| | - Shuo Chen
- Department of Mechanical and Aerospace Engineering, Biionix Cluster, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, United States.
| | - Hwan Choi
- Department of Mechanical and Aerospace Engineering, Biionix Cluster, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL, United States.
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Martinez L, Lalevée M, Poirier T, Brunel H, Matsoukis J, Van Driessche S, Billuart F. Influence of Skin Marker Positioning and Their Combinations on Hip Joint Center Estimation Using the Functional Method. Bioengineering (Basel) 2024; 11:297. [PMID: 38534571 DOI: 10.3390/bioengineering11030297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 03/28/2024] Open
Abstract
Accurate estimation of hip joint center (HJC) position is crucial during gait analysis. HJC is obtained with predictive or functional methods. But in the functional method, there is no consensus on where to place the skin markers and which combination to use. The objective of this study was to analyze how different combinations of skin markers affect the estimation of HJC position relative to predictive methods. Forty-one healthy volunteers were included in this study; thirteen markers were placed on the pelvis and hip of each subject's lower limbs. Various marker combinations were used to determine the HJC position based on ten calibration movement trials, captured by a motion capture system. The estimated HJC position for each combination was evaluated by focusing on the range and standard deviation of the mean norm values of HJC and the mean X, Y, Z coordinates of HJC for each limb. The combinations that produced the best estimates incorporated the markers on the pelvis and on proximal and easily identifiable muscles, with results close to predictive methods. The combination that excluded the markers on the pelvis was not robust in estimating the HJC position.
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Affiliation(s)
- Lucas Martinez
- Unité de Recherche ERPHAN, UR 20201, UVSQ, 92380 Garches, France
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-Kinésithérapie Saint Michel, 68 rue du Commerce, 75015 Paris, France
| | - Matthieu Lalevée
- CETAPS UR3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, 76821 Mont-Saint-Aignan, France
- Department of Orthopedic Surgery, Rouen University Hospital, 37 Bd Gambetta, 76000 Rouen, France
| | - Thomas Poirier
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-Kinésithérapie Saint Michel, 68 rue du Commerce, 75015 Paris, France
| | - Helena Brunel
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-Kinésithérapie Saint Michel, 68 rue du Commerce, 75015 Paris, France
| | - Jean Matsoukis
- Département de Chirurgie Orthopédique, Groupe Hospitalier du Havre, BP24, 76083 Le Havre CEDEX, France
| | - Stéphane Van Driessche
- Polyclinique Sainte Marguerite, 5 Avenue de la Font Sainte-Marguerite, 89000 Auxerre, France
| | - Fabien Billuart
- Unité de Recherche ERPHAN, UR 20201, UVSQ, 92380 Garches, France
- Université de Versailles-Saint-Quentin-en-Yvelines, UFR Simone Veil-Santé, 20 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France
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Böhm H, Reinhold SM, Dussa CU. Anatomical leg length discrepancy in children: Can it be accurately determined using 3-D motion capturing? Gait Posture 2024; 109:311-317. [PMID: 38412684 DOI: 10.1016/j.gaitpost.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Leg length discrepancy (LLD) is common in youth and is cause by several conditions. Long leg X-rays is the gold standard technique of measuring LLD. It is highly accurate and reliable compared to clinical method, but expose the subject to radiation. Instrumented Gait Analysis (IGA) serves not only as a means to measure joint kinematics during gait but also as a valuable tool for assessing Leg Length Discrepancy (LLD) while standing. RESEARCH QUESTION The purpose of this study was to compare different methods of determining the LLD in paediatric population. We hypothesize that IGA using joint centres is more accurate and precise than the tape measurement. METHODS Thirty-one patients with mean age 12.3 (SD=2.4) years were retrospectively included in the study. Their LLD varied between 0 and 36 mm. Three methods for determining LLD were compared to radiography using Bland-Altman analysis: 1. Tape measurement, 2. IGA, summarizing the distance from the spina iliaca anterior superior to the medial malleolus marker via the medial knee condyle marker. 3. IGA, summarizing distances between ankle, knee, and hip joints centres where the latter is calculated with different equations. RESULTS The IGA joints method performed better than the tape measurement or IGA markers method. The equations of Davis calculating the hip joint centre had the highest accuracy with mean difference to radiography of 0.7 mm (SD=6.3). The simple Harrington method resulted in a slightly reduced accuracy but higher precision 0.9 mm (SD=6.2). The Harrington method with leg length as input was less accurate 1.0 mm (SD=6.7), but was still considerably better than the tape measurement 1.8 mm (SD=7.0) or IGA markers method 1.1 mm (SD=11.5). SIGNIFICANCE Determining LLD with IGA using the distances between ankle, knee and hip joints centres is a feasible method that can be applied in clinical practice to calculate LLD.
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Affiliation(s)
- Harald Böhm
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, Aschau i. Chiemgau 83229, Germany; HAWK University of Applied Sciences and Arts, Faculty of Engineering and Health Göttingen, Annastr 25, Göttingen 37075, Germany.
| | - Sophie M Reinhold
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, Aschau i. Chiemgau 83229, Germany; University of Applied Sciences Technikum Wien, Department of Biomedical, Health & Sports Engineering, Höchstädtpl. 6, Wien 1200, Austria
| | - Chakravarty U Dussa
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, Aschau i. Chiemgau 83229, Germany; Friedrich-Alexander-University of Erlangen-Nürnberg, Department of Orthopaedic Surgery, Rathsberger str 57, Erlangen 91054, Germany
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Sado N, Edagawa T, Fujimori T, Hashimoto S, Okamoto Y, Nakajima T. Hip and lumbosacral joint centre locations in asian population: Biases produced by existing regression equations and development of new equations. J Biomech 2024; 162:111866. [PMID: 37976688 DOI: 10.1016/j.jbiomech.2023.111866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
The hip and lumbosacral joint centre (HJC and LSJC) predictions are required to analyse the lumbo-pelvic-hip dynamics during various human motions. Some HJC and LSJC regression equations based on pelvic dimension have been developed; however, the pre-existing methods need to be re-evaluated, and methodological reconsideration may improve the regression methods. Here we show that pre-existing methods produce biased predictions of the LSJC and HJC in 23 male and 24 female Japanese adults, and that the biases in the LSJC differ between sexes, using magnetic resonance imaging (MRI) around the pelvis. Compared with directly measured locations on MRI, the pre-existing regression equations predict LSJC to be more posterior in males and more inferior and posterior in females, and HJC to be more medial in both sexes. The better pre-existing regression equation for LSJC height differs between sexes, with pelvic-width-base better in males and pelvic-depth-base better in females, respectively. We suggest the unsuitability of pre-existing methods to our dataset consisting of Japanese adults and the importance of considering sex differences in regression methods. We propose regression equations to predict HJC and LSJC, considering soft-tissue thickness, sex differences, and a height-directional measure, using least absolute shrinkage and selection operator regression. We validate them using leave-one-out cross-validation (LOOCV). LOOCV shows that our model produces negligible biases and smaller absolute errors than the pre-existing regressions; in particular, the anteroposterior absolute error for LSJC is less than half that of the pre-existing regression. Our regression equation can be a powerful solution for accurate motion analysis.
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Affiliation(s)
- Natsuki Sado
- Institute of Health and Sports Science, University of Tsukuba, Tsukuba, Japan.
| | - Takeshi Edagawa
- Graduate School of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Toshihide Fujimori
- Graduate School of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Shogo Hashimoto
- Graduate School of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Henry A, Benner C, Easwaran A, Veerapalli L, Gaddy D, Suva LJ, Robbins AB. Predictive estimation of ovine hip joint centers: A regression approach. J Biomech 2023; 161:111861. [PMID: 37952489 DOI: 10.1016/j.jbiomech.2023.111861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023]
Abstract
Estimation of the hip joint center in ovine biomechanical analysis is often overlooked or estimated using a marker on the greater trochanter which can result in large errors that propagate through subsequent analyses. The purpose of this study was to develop a novel method of estimating the hip joint centers in sheep to facilitate more accurate analysis of ovine biomechanics. CT scans from 16 sheep of varying ages, weight, sex, and phenotypes were acquired and the data was used to calculate the known hip joint center by sphere fitting the femoral head. Anatomical measurements and additional subject information were used to create a variety of regression models to estimate the hip joint centers in absence of CT data. The best regression equation created utilized markers placed on the tuber coxae and tuber ischii of the pelvis and resulted in a mean 3D Euclidean distance error of 6.43 ± 2.22 mm (mean ± standard deviation) between the known and estimated hip joint center. The regression models produced allow for more detailed, accurate and robust analysis of sheep biomechanics.
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Affiliation(s)
- Aaron Henry
- Department of Multidisciplinary Engineering, College of Engineering, Texas A&M University, United States of America.
| | - Carson Benner
- J. Mike Walker '66 Department of Mechanical Engineering, College of Engineering, Texas A&M University, United States of America.
| | - Anish Easwaran
- Department of Biomedical Engineering, College of Engineering, Texas A&M University, United States of America.
| | - Likhitha Veerapalli
- Department of Biomedical Engineering, College of Engineering, Texas A&M University, United States of America.
| | - Dana Gaddy
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, United States of America.
| | - Larry J Suva
- Department of Veterinary Physiology & Pharmacology, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, United States of America.
| | - Andrew B Robbins
- Department of Multidisciplinary Engineering, College of Engineering, Texas A&M University, United States of America; J. Mike Walker '66 Department of Mechanical Engineering, College of Engineering, Texas A&M University, United States of America; School of Engineering Medicine, Texas A&M University, United States of America.
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Phillips T, Brierty A, Goodchild D, Patritti BL, Murphy A, Boocock M, Dwan L, Passmore E, McGrath M, Edwards J. Australia and New Zealand Clinical Motion Analysis Group (ANZ-CMAG) clinical practice recommendations. Gait Posture 2023; 106:1-10. [PMID: 37607445 DOI: 10.1016/j.gaitpost.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Clinical motion analysis involves quantitative measurement of gait patterns to identify gait anomalies that currently or have the potential to impact function, activities of daily living and participation. Clinical motion analysis services are equipped with motion capture technology and comprise specialised staff who deliver 3-dimensional motion analysis services to children and adults who present with varying levels of gait impairment. Data is then used to inform intervention recommendations to clinicians with a view to maintaining independent, functional and pain free walking (or appropriate mobility). The ANZ-CMAG (established in 2013) identified a need to establish recommendations to assist in standardising practice guidelines for both current and new clinical motion analysis services within the region. The group serves to promote collaboration between services in quality assurance processes, clinical practices, data sets and research activities. The clinical practice recommendations described in this paper cover: i) requirements for a motion analysis service (including staffing, facilities and equipment), ii) patient assessments (requirements, clinical information and data gathered, reporting and interpretation of patient data), iii) quality assurance processes (including motion capture system / biomechanical models & limitations, marker placement, data storage / record keeping, creation of normative dataset); iv) helpful resources. Better outcomes for children and adults with gait deviations is dependent upon accurate measurement and evaluation of walking and requires input from multidisciplinary clinical teams with specialist knowledge and skills. The ANZ-CMAG hopes these clinical practice recommendations are beneficial to motion analysis services with an aim to improve clinical practices, patient outcomes, and support research collaboration.
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Affiliation(s)
- Teresa Phillips
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia.
| | - Alexis Brierty
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
| | - Denni Goodchild
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
| | - Benjamin L Patritti
- South Australian Movement Analysis Centre, Division of Rehabilitation, Aged and Palliative Care, Flinders Medical Centre, Adelaide, 5042, Australia; College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia
| | - Anna Murphy
- Clinical Gait Analysis Service, Monash Health, Victoria, 3192, Australia; Faculty of Medicine, Nursing and Allied Health Sciences, Monash University, Victoria, 3800, Australia
| | - Mark Boocock
- Health and Rehabilitation Research Institute, Auckland University of Technology, Northcote, 0627, New Zealand
| | - Leanne Dwan
- The Children's Hospital at Westmead, Sydney, 2145, Australia; School of Health Sciences, The University of Sydney, Sydney, 2006, Australia
| | - Elyse Passmore
- Royal Children's Hospital, Gait Analysis Laboratory, Parkville, 3052, Australia; Murdoch Children's Research Institute, Developmental Imaging, Parkville, 3052, Australia; University of Melbourne, Engineering and Information Technology, Parkville, 3052, Australia; University of Melbourne, Medicine, Dentistry & Health Sciences, Parkville, 3052, Australia
| | - Michelle McGrath
- Queensland Motion Analysis Centre, Department of Physiotherapy, Royal Brisbane and Women's Hospital, Herston, 4006, Australia
| | - Julie Edwards
- Queensland Children's Motion Analysis Service, Department of Orthopaedics, Children's Health Queensland Hospital and Health Service, South Brisbane, 4101, Australia
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Boekesteijn RJ, van de Ven MPF, Wilders LM, Bisseling P, Groen BE, Smulders K. The effect of functional calibration methods on gait kinematics in adolescents with idiopathic rotational deformity of the femur. Clin Biomech (Bristol, Avon) 2023; 107:106028. [PMID: 37331152 DOI: 10.1016/j.clinbiomech.2023.106028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Due to anatomical deviations, assumptions of the conventional calibration method for gait analysis may be violated in individuals with rotational deformities of the femur. Functional calibration methods were compared with conventional methods in this group for 1) localization of the hip joint center and orientation of the knee axis, and 2) gait kinematics. METHODS Twenty-four adolescents with idiopathic rotational deformity of the femur underwent gait analysis and a CT scan. During standing, distance between hip joint centers and knee axis orientation were compared between calibration methods, with CT serving as reference for hip joint center estimation. Gait kinematics were compared using statistical parametric mapping. FINDINGS The conventional calibration method estimated the hip joint center closer to the CT reference (4±12 mm more lateral) than the functional calibration method (26 ± 20 mm more lateral). Orientation of the knee joint axis was 2.6° less internal in the functional calibration method. During gait, statistical parametric mapping revealed significantly more hip flexion, less external hip rotation during the swing phase, less knee varus-valgus motion, and larger knee flexion angles when applying the functional method. INTERPRETATION Functional calibration methods were less accurate in determining the hip joint center location than the conventional calibration method and resulted in a knee joint axis that was less internally rotated. Importantly, there was less knee joint angle crosstalk during gait when using the functional method. Although differences between methods on gait kinematics were within clinically acceptable limits for the sagittal plane, relatively larger differences on transversal hip kinematics may hold clinical importance.
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Affiliation(s)
- Ramon J Boekesteijn
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
| | | | - Lise M Wilders
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Pepijn Bisseling
- Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Brenda E Groen
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Katrijn Smulders
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands
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Blythman R, Saxena M, Tierney GJ, Richter C, Smolic A, Simms C. Assessment of deep learning pose estimates for sports collision tracking. J Sports Sci 2022; 40:1885-1900. [DOI: 10.1080/02640414.2022.2117474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Richard Blythman
- V-SENSE, School of Computer Science and Statistics(SCSS), Trinity College Dublin, Dublin, Ireland
| | - Manan Saxena
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| | | | | | - Aljosa Smolic
- V-SENSE, School of Computer Science and Statistics(SCSS), Trinity College Dublin, Dublin, Ireland
| | - Ciaran Simms
- School of Engineering, Trinity College Dublin, Dublin, Ireland
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Salami F, Götze M, Campos S, Leboucher J, Hagmann S, Wolf SI. Estimation of a midfoot joint center in typically developed adults using functional calibration methods. Gait Posture 2022; 97:203-209. [PMID: 35988436 DOI: 10.1016/j.gaitpost.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND There are detailed findings on hip and knee joint parameters determined via functional calibration methods for use in instrumented 3D-gait analysis but these methods have not yet been addressed to the foot. RESEARCH QUESTION Are functional calibration methods feasible for determining foot joint parameters and may they help for clinical interpretation of foot deformities? METHODS Rigid segments were formed by markers on forefoot and hindfoot via a least square method. The position of the midfoot joint articulating both foot segments was then determined via a functional calibration motion. This two-stage procedure was applied on a cohort of 17 typically developed adults and one subject with severe planovalgus foot deformity for determining the location of the midfoot joint and kinematics of hindfoot and forefoot. RESULTS The position of the midfoot joint center could be estimated in the typically developed cohort and also in the demonstration case with planovalgus foot deformity. Depending on the choice of marker set for hindfoot and forefoot, the position of the joint center varied in the anatomic midfoot region with most robust results when addressing the marker on the navicular to the hindfoot. CONCLUSION The presented method for joint center determination within the foot and the characteristic results of the foot joint angles appear promising for typically developed feet. However, further validation of the method is needed for application in clinical context.
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Affiliation(s)
- Firooz Salami
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Marco Götze
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sarah Campos
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Julien Leboucher
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastién Hagmann
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastian I Wolf
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.
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Predicting the hip joint centre in children: New regression equations, linear scaling, and statistical shape modelling. J Biomech 2022; 142:111265. [PMID: 36027636 DOI: 10.1016/j.jbiomech.2022.111265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/21/2022]
Abstract
Determination of the hip joint centre (HJC) is important to accurately estimate hip joint motion, moments and muscle forces. The most accurate method for HJC estimation without medical imaging is an area of interest in the biomechanics community, especially in a paediatric population, which has not been widely evaluated. HJC locations were calculated by sphere-fitting to the acetabulum of three-dimensional pelvises segmented from 333 CT scans of children aged 4 to 18 years old. Three methods for determining the HJC were compared: regression equations, linear scaling, and shape model prediction. The new regression equations developed in this study produced Euclidean distance errors of 6.23 mm ± 2.90 mm. Linear scaling of paediatric bone produced errors of 3.90 mm ± 2.52 mm and adult bone scaling of 5.45 mm ± 3.26 mm. Prediction of the HJC using a paediatric statistical shape model produced mean Euclidian distance errors of 2.95 mm ± 1.65 mm. Overall, shape model prediction of the HJC produced the lowest errors, with linear scaling of a mean paediatric pelvis providing better estimates than regression equations.
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14
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Individual muscle force–energy rate is altered during crouch gait: A neuro-musculoskeletal evaluation. J Biomech 2022; 139:111141. [DOI: 10.1016/j.jbiomech.2022.111141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
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15
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Hip joint range of motion is restricted by pain rather than mechanical impingement in individuals with femoroacetabular impingement syndrome. Arch Orthop Trauma Surg 2022; 142:1985-1994. [PMID: 34585303 PMCID: PMC9296409 DOI: 10.1007/s00402-021-04185-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/19/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Discerning whether range of motion (ROM) is restricted by morphology or other pain sources is challenging in patients with femoroacetabular impingement syndrome (FAIS). Computed tomography (CT) motion simulation provides a hypothetical ROM based on morphology. This study aimed to explore associations between ROM measured using CT motion simulation and maximum passive ROM measured clinically using three dimensional (3D) motion analysis in patients with FAIS, prior to and post arthroscopic hip surgery. MATERIALS AND METHODS Eight males with FAIS (in total 12 hip joints) were included in this explorative feasibility study. Participants were examined using CT according to a low-dose protocol prior to and 7-months post arthroscopic surgery. Software was used to simulate at which ROM the impingement would occur. With the hip in 90 degrees' flexion, maximum passive range of internal hip rotation, and maximum passive internal hip rotation coupled with adduction was examined clinically using 3D motion analysis pre- and postoperatively. Spearman rank correlation coefficients and linear regressions examined associations between methods. RESULTS Preoperatively, the correlation between maximum internal hip rotation measured using CT motion simulation and 3D motion analysis was strong (r = 0.71, p = 0.009). Linear regressions demonstrated that maximal internal rotation measured using CT motion simulation was predominantly larger than when measured using 3D motion analysis. Postoperatively, and when maximum internal rotation was coupled with adduction, no correlations were found between the two methods. CONCLUSIONS The hypothetical morphology restricted ROM is larger than clinically assessed pain restricted ROM, both prior to and post hip arthroscopy. These findings suggest that ROM is restricted by pain rather than mechanical, morphology-based impingement in individuals with FAIS.
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Ravera EP, Peterson V. A regularized functional method to determine the hip joint center of rotation in subjects with limited range of motion. J Biomech 2021; 129:110810. [PMID: 34736083 DOI: 10.1016/j.jbiomech.2021.110810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/02/2021] [Accepted: 10/07/2021] [Indexed: 11/19/2022]
Abstract
The symmetrical center of rotation estimation (SCoRE) is probably one of the most used functional method for estimating the hip join center (HJC). However, it requires of complex multi-plane movements to find accurate estimations of HJC. Thus, using SCoRE for people with limited hip range of motion will lead to poor HJC estimation. In this work, we propose an anisotropic regularized version of the SCoRE formulation (RSCoRE), which is able to estimate the HJC location by using only standard gait trials, avoiding the need of recording complex multi-plane movements. RSCoRE is evaluated in both accuracy and repeatability of the estimation as compared to functional and predictive methods on a self-recorded cohort of fifteen young healthy adults with no hip joint pathologies or other disorders that could affect their gait. Given that, no medical images were available for this study, to quantify the global error of HJC the SCoRE residual was used. RSCoRE presents a global error of about 12 mm, similarly to the best performance of SCoRE. The comparison of the coordinate's errors at each coordinate indicates that HJC estimations from SCoRE with complex multi-plane movements and RSCoRE are not statistical significantly different. Finally, we show that the repeatability of RSCoRE is similar to the rest of the tested methods, yielding to repeatability values between 0.72 and 0.79. In conclusion, not only the RSCoRE yields similar estimation performance than SCoRE, but it also avoids the need of complex multi-plane movements to be performed by the subject of analysis. For this reason, RSCoRE has the potential to be a valuable approach for estimating the HJC location in people with limited hip ROM.
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Affiliation(s)
- Emiliano Pablo Ravera
- Group of Analysis, Modeling, Processing and Clinician Implementation of Biomechanical Signals and Systems, Bioengineering and Bioinformatics Institute, CONICET-UNER, Oro Verde, Argentina; Human Movement Research Laboratory, School of Engineering, National University of Entre Ríos (UNER), Oro Verde, Argentina.
| | - Victoria Peterson
- Applied Mathematics Institute (IMAL), CONICET-UNL, Santa Fe, Argentina.
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Öztürk O, Salami F, Musagara AR, Demirbüken İ, Polat MG, Wolf SI, Götze M. Functional hip joint centre determination in children with cerebral palsy. Gait Posture 2021; 90:185-189. [PMID: 34500219 DOI: 10.1016/j.gaitpost.2021.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although functional methods determining the hip joint center (HJC) are becoming increasingly popular, no systematic investigation has been conducted yet to assess the reliability of functional hip joint calibration in patients with cerebral palsy (CP). RESEARCH QUESTION What is the most reliable way to conduct functional calibration motions for estimating HJC location in children with CP and movement disorders? METHODS Twenty-two patients with CP were included in the study. A marker set for Plug-in Gait with additional cluster markers was used. Two functional calibration movements, including a new movement, were proposed and tested with one and three repetitions each. Functional HJCs were determined using the SCoRE approach and compared to results obtained by applying the conventional regression method for assessing face validity. RESULTS The choice of calibration movement had significant impact on SCoRE residuals and HJC location. Increasingly repeating calibration movements did not improve results. A modified star movement by allowing the toes to tip the ground provided the most reliable data and is feasible for children with GMFCS level I-III. The feasibility of the method is further improved by analyzing hip motion in the contralateral stance limb and, among the calibration movements, gave the most precise HJC estimation. SIGNIFICANCE Type and performance of the functional calibration movement is one key factor for determining a robust HJC. Analyzing the data in the stance leg via the modified star motion yielded robust and reasonable results for the HJC location, which should be validated in further studies that include imaging methods. Using one repetition instead of three seems promising in terms of feasibility for patients with movement disorder.
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Affiliation(s)
- Orhan Öztürk
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - Firooz Salami
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - Arik Rehani Musagara
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - İlkşan Demirbüken
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - M Gülden Polat
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany
| | - Sebastian I Wolf
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany.
| | - Marco Götze
- Heidelberg University Hospital, Centre of Orthopedics and Trauma Surgery, Heidelberg, Germany
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A novel dataset and deep learning-based approach for marker-less motion capture during gait. Gait Posture 2021; 86:70-76. [PMID: 33711613 DOI: 10.1016/j.gaitpost.2021.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/09/2021] [Accepted: 03/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The deep learning-based human pose estimation methods, which can estimate joint centers position, have achieved promising results on the publicly available human pose datasets (e.g., Human3.6 M). However, these datasets may be less efficient for gait study, particularly for clinical applications, because of the limited number of subjects, their homogeneity (all asymptomatic adults), and the errors introduced by marker placement on subjects' regular clothing. RESEARCH QUESTION How a new human pose dataset, adapted for gait study, could contribute to the advancement and evaluation of marker-less motion capture systems? METHODS A marker-less system, based on deep learning-based pose estimation methods, was proposed. A new dataset (ENSAM dataset) was collected. Twenty-two asymptomatic adults, one adult with scoliosis, one adult with spondylolisthesis, and seven children with bone disease performed ten walking trials, while being recorded both by the proposed marker-less system and a reference system - combining a marker-based motion capture system and a medical imaging system (EOS). The dataset was split into training and test sets. The pose estimation method, already trained on the Human3.6 M dataset, was evaluated on the ENSAM test set, then reevaluated after further training on the ENSAM training set. The joints coordinates were evaluated, using Bland-Altman bias and 95 % confidence interval, and joint position error (the Euclidean distance between the estimated joint centers and the corresponding reference values). RESULTS The Bland-Altman 95 % confidence intervals were substantially improved after finetuning the pose estimation method on the ENSAM training set (e.g., from 106.9 mm to 17.4 mm for the hip joint). With the new dataset and approach, the mean joint position error varied from 6.2 mm for ankles to 21.1 mm for shoulders. SIGNIFICANCE The proposed marker-less system achieved promising results in terms of joint position errors. Future studies are necessary to assess the system in terms of gait parameters.
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Rampal V, Rohan PY, Pillet H, Bonnet-Lebrun A, Fonseca M, Desailly E, Wicart P, Skalli W. Combined 3D analysis of lower-limb morphology and function in children with idiopathic equinovarus clubfoot: A preliminary study. Orthop Traumatol Surg Res 2020; 106:1333-1337. [PMID: 32113940 DOI: 10.1016/j.otsr.2019.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/08/2019] [Accepted: 11/04/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION In children treated for idiopathic equinovarus clubfoot (EVCF), the relation between morphologic defects on clinical examination and standard X-ray on the one hand and functional abnormalities on the other is difficult to objectify. The aim of the present study was to demonstrate the feasibility of combined 3D analysis of the foot and lower limb based on biplanar EOS radiographs and gait analysis. The study hypothesis was that this provides better understanding of abnormalities in form and function. METHODS Ten children with unilateral EVCF and "very good" clinical results were included. They underwent gait analysis on the Rizzoli Institute multisegment foot model. Kinematic data were collected for the hip, knee, ankle and foot (hindfoot/midfoot, midfoot/forefoot and hindfoot/forefoot). Biplanar EOS radiographs were taken to determine anatomic landmarks and radiological parameters. RESULTS Complete acquisition time was around 2hours per patient. No significant differences were found between EVCF and healthy feet except for calcaneal incidence, tibiocalcaneal angle and hindfoot/midfoot and hindfoot/forefoot inversion. DISCUSSION The feasibility of the combined analysis was confirmed. There were no differences in range of motion, moment or power between EVCF and healthy feet in this series of patients with very good results. The functional results are related to radiological results within the normal range. The protocol provided anatomic and kinematic reference data. A larger-scale study could more objectively assess the contribution of EOS radiography using optoelectronic markers. LEVEL OF EVIDENCE II, low-power prospective study.
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Affiliation(s)
- Virginie Rampal
- Institut de biomécanique humaine Georges-Charpak, Arts et Métiers ParisTech, 75013 Paris, France; Service d'orthopédie infantile, hôpitaux pédiatriques de Nice, CHU Lenval, 06000 Nice, France.
| | - Pierre-Yves Rohan
- Institut de biomécanique humaine Georges-Charpak, Arts et Métiers ParisTech, 75013 Paris, France
| | - Helene Pillet
- Institut de biomécanique humaine Georges-Charpak, Arts et Métiers ParisTech, 75013 Paris, France
| | - Aurore Bonnet-Lebrun
- Institut de biomécanique humaine Georges-Charpak, Arts et Métiers ParisTech, 75013 Paris, France
| | - Mickael Fonseca
- Institut de biomécanique humaine Georges-Charpak, Arts et Métiers ParisTech, 75013 Paris, France
| | - Eric Desailly
- Unité d'analyse du mouvement, pôle recherche et innovation, fondation Ellen-Poidatz, 77310 Saint-Fargeau-Ponthierry, France
| | - Philippe Wicart
- Service d'orthopédie infantile, hôpital Necker-Enfants-Malades, 75015 Paris, France
| | - Wafa Skalli
- Institut de biomécanique humaine Georges-Charpak, Arts et Métiers ParisTech, 75013 Paris, France
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Meng L, Millar L, Child C, Buis A. A Cluster-based Model Using Functional Methods Requires Less Operator Experience for Reliable Gait Analysis: A Preliminary Study of Intra- and Inter-assessor Reliability. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3154-3157. [PMID: 33018674 DOI: 10.1109/embc44109.2020.9176611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Reliability of three-dimensional gait analysis is important for repetitive assessments in clinical or research studies. In this paper, we hypothesized that a Strathclyde Functional Cluster Model (SFCM) in which all the joint centers and flexion axes were determined by functional methods, could improve the reliability of joint kinematics within and between operators' sessions compared to an anatomical model, Plug-in Gait (PiG). A preliminary study of intra- and inter-assessor reliability of the SFCM was been analyzed and compared to the PiG. One able-bodied participant performed eight sessions measured by four operators who have different experience level on the two models. Intra- and inter-operator reliability of the SFCM and PiG were assessed using the intraclass correlation coefficient (ICC) and standard deviation (SD). Results showed that the SFCM generated smaller SD and greater ICC values for all joint variables compared to the PiG in the inter-operator condition, suggesting that functional methods could improve the inter-operator reliability. Moreover, the intra-operator ICC results indicated that the SFCM performance was less influenced by operator experience compared to the PiG. In conclusion, as the model requires less palpation of ALs, it would benefit the users who have less experience in practical use.
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Bennett HJ, Valenzuela KA, Fleenor K, Weinhandl JT. A Normative Database of Hip and Knee Joint Biomechanics During Dynamic Tasks Using Four Functional Methods With Three Functional Calibration Tasks. J Biomech Eng 2020; 142:041011. [PMID: 31513696 DOI: 10.1115/1.4044503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Indexed: 12/13/2022]
Abstract
Although predicted hip joint center (HJC) locations are known to vary widely between functional methods, no previous investigation has detailed functional method-dependent hip and knee biomechanics. The purpose of this study was to define a normative database of hip joint biomechanics during dynamic movements based upon functional HJC methods and calibration tasks. Thirty healthy young adults performed arc, star arc, and two-sided calibration tasks. Motion capture and ground reaction forces were collected during walking, running, and single-leg landings (SLLs). Two sphere-fit (geometric and algebraic) and two coordinate transformation techniques were implemented using each calibration (12 total method-calibration combinations). Surprisingly, the geometric fit-two-sided model placed the HJC at the midline of the pelvis and above the iliac spines, and thus was removed from analyses. A database of triplanar hip and knee kinematics and hip moments and powers was constructed using the mean of all subjects for the eleven method-calibration combinations. A nested analysis of variance approach compared calibration [method] peak hip kinematics and kinetics. Most method differences existed between geometric fit and coordinate transformations (58 of 84 total). No arc-star arc differences were found. Thirty-two differences were found between the two-sided and arc/star arc calibrations. This database of functional method based hip and knee biomechanics serves as an important reference point for interstudy comparisons. Overall, this study illustrates that functional HJC method can dramatically impact hip biomechanics and should be explicitly detailed in future work.
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Affiliation(s)
- Hunter J Bennett
- Department of Human Movement Sciences, Old Dominion University, 2016 Student Recreation Center, Norfolk, VA 23529
| | - Kevin A Valenzuela
- Department of Kinesiology, HHS2-203, California State University Long Beach, Long Beach, CA 90840
| | - Kristina Fleenor
- Department of Human Movement Sciences, Old Dominion University, 2016 Student Recreation Center, Norfolk, VA 23529
| | - Joshua T Weinhandl
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, 322 HPER Building, 1914 Andy Holt Avenue, Knoxville, TN 37996-2700
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Legrand T, Richard V, Bonnefoy-Mazure A, Armand S, Miozzari HH, Turcot K. The impact of body-mass index on the frontal knee alignment estimation using three-dimensional reconstruction based on movement analysis. Knee 2020; 27:89-94. [PMID: 31870700 DOI: 10.1016/j.knee.2019.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/01/2019] [Accepted: 09/22/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND We evaluated the influence of the body-mass index (BMI) on the estimation of the static frontal knee alignment (FKA) using three-dimensional (3D) reconstruction method based on movement analysis. METHODS Two-hundred nineteen knees (120 individuals with end-stage osteoarthritis) were analyzed. The validity of the 3D method was evaluated under comparison with a reference method based on weight bearing full-leg length radiography. Extensive statistical analyses (Pearson's correlation, one-way ANOVA, linear regression, boxplot diagram) over four groups of BMI (normal, overweight, obese class I and obese classes II and III) were performed. RESULTS For BMI below 25 kg/m2, the validity of the 3D method was confirmed. For BMI over 25 kg/m2, there was an increasing error of the 3D method, especially for the obese groups affected with a large varus alignment. CONCLUSIONS In a biomechanical context of movement analysis, the results of the study suggest that the 3D method may represent a satisfying alternative to the full-leg radiograph method with limitations regarding to BMI over 25 kg/m2.
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Affiliation(s)
- Thomas Legrand
- Department of Kinesiology, Medicine Faculty, Laval University, Quebec, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada
| | - Vincent Richard
- Department of Kinesiology, Medicine Faculty, Laval University, Quebec, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada
| | - Alice Bonnefoy-Mazure
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals, Geneva University, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland
| | - Stéphane Armand
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals, Geneva University, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland
| | - Hermes H Miozzari
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland
| | - Katia Turcot
- Department of Kinesiology, Medicine Faculty, Laval University, Quebec, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada.
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Derrick TR, van den Bogert AJ, Cereatti A, Dumas R, Fantozzi S, Leardini A. ISB recommendations on the reporting of intersegmental forces and moments during human motion analysis. J Biomech 2019; 99:109533. [PMID: 31791632 DOI: 10.1016/j.jbiomech.2019.109533] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/14/2019] [Accepted: 11/16/2019] [Indexed: 02/08/2023]
Abstract
The International Society of Biomechanics (ISB) has charged this committee with development of a standard similar in scope to the kinematic standard proposed in Wu et al. (2002) and Wu et al. (2005). Given the variety of purposes for which intersegmental forces and moments are used in biomechanical research, it is not possible to recommend a particular set of analysis standards that will be acceptable in all applications. Instead, it is the purpose of this paper to recommend a set of reporting standards that will result in an understanding of the differences between investigations and the ability to reproduce the research. The end products of this standard are (1) a critical checklist that can be used during submission of manuscripts and abstracts to insure adequate description of methods, and (2) a web based visualization tool that can be used to alter the coordinate system, normalization technique and internal/external perspective of intersegmental forces and moments during walking and running so that the shape and magnitude of the curves can be compared to one's own data.
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Cao S, Wang C, Zhang G, Ma X, Wang X, Huang J, Zhang C, Wang K. In vivo kinematics of functional ankle instability patients during the stance phase of walking. Gait Posture 2019; 73:262-268. [PMID: 31382233 DOI: 10.1016/j.gaitpost.2019.07.377] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous studies showed functional ankle instability (FAI) patients have morphological ligamentous abnormality, despite having no apparent joint laxity. RESEARCH QUESTION Whether tibiotalar and subtalar joints hypermobility exists in FAI patients during stance phase of walking, remains controversial. METHODS Ten unilateral FAI patients, ten unilateral lateral ankle sprain (LAS) copers and ten healthy controls were included. A dual fluoroscopy imaging system was utilized to capture the fluoroscopic images of tibiotalar and subtalar joint during the stance phase of walking. Kinematic data from six degrees of freedom were calculated utilizing a solid modeling software. The range of motion and joint excursions about six degrees of freedom were compared among the three groups. The correlations between range of motion and Cumberland Ankle Instability Tool (CAIT) scores were assessed utilizing the Spearman's correlation coefficient (r). RESULTS During the stance phase, the FAI patients and LAS copers showed larger tibiotalar anterior/posterior translation than the healthy controls (FAI patients, p = .013; LAS copers, p = .002). The FAI patients also showed significantly larger lateral/medial translation (p = .035) and inversion/eversion rotation (p = .003) of subtalar joints than healthy controls. By contrast, the subtalar joints of the LAS copers were not different from those of the healthy controls in the lateral/medial translation (p = .459) and inversion/eversion rotation (p = .091). CAIT scores were negatively correlated with range of motion. SIGNIFICANCE During the stance phase of walking, FAI patients showed significantly larger hypermobility of subtalar joints than healthy controls, contrary to the LAS copers. These findings justify the utilization of dual fluoroscopy imaging system to detect joint hypermobility in FAI patients. Treatment for FAI patients may require stabilization of the subtalar joint.
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Affiliation(s)
- Shengxuan Cao
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Chen Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Gonghao Zhang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
| | - Xu Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiazhang Huang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Chao Zhang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Kan Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
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Leboeuf F, Reay J, Jones R, Sangeux M. The effect on conventional gait model kinematics and kinetics of hip joint centre equations in adult healthy gait. J Biomech 2019; 87:167-171. [DOI: 10.1016/j.jbiomech.2019.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
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Bahl JS, Zhang J, Killen BA, Taylor M, Solomon LB, Arnold JB, Lloyd DG, Besier TF, Thewlis D. Statistical shape modelling versus linear scaling: Effects on predictions of hip joint centre location and muscle moment arms in people with hip osteoarthritis. J Biomech 2019; 85:164-172. [DOI: 10.1016/j.jbiomech.2019.01.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/16/2019] [Indexed: 11/29/2022]
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Evaluation of functional methods of joint centre determination for quasi-planar movement. PLoS One 2019; 14:e0210807. [PMID: 30653613 PMCID: PMC6336381 DOI: 10.1371/journal.pone.0210807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/02/2019] [Indexed: 12/14/2022] Open
Abstract
Functional methods identify joint centres as the centre of rotation (CoR) of two adjacent movements during an ad-hoc movement. The methods have been used for functionally determining hip joint centre in gait analysis and have revealed advantages compared to predictive regression techniques. However, the current implementation of functional methods hinders its application in clinical use when subjects have difficulties performing multi-plane movements over the required range. In this study, we systematically investigated whether functional methods can be used to localise the CoR during a quasi-planar movement. The effects of the following factors were analysed: the algorithms, the range and speed of the movement, marker cluster location, marker cluster size and distance to the joint centre. A mechanical linkage was used in our study to isolate the factors of interest and give insight to variation in implementation of functional methods. Our results showed the algorithms and cluster locations significantly affected the estimate results. For all algorithms, a significantly positive relationship between CoR errors and the distance of proximal cluster coordinate location to the joint centre along the medial-lateral direction was observed while the distal marker clusters were best located as close as possible to the joint centre. By optimising the analytical and experimental factors, the transformation algorithms achieved a root mean square error (RMSE) of 5.3 mm while the sphere fitting methods yielded the best estimation with an RMSE of 2.6 mm. The transformation algorithms performed better in presence of random noise and simulated soft tissue artefacts.
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A normative database of hip and knee joint biomechanics during dynamic tasks using anatomical regression prediction methods. J Biomech 2018; 81:122-131. [DOI: 10.1016/j.jbiomech.2018.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/26/2018] [Accepted: 10/03/2018] [Indexed: 11/22/2022]
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Ravera EP, Crespo MJ, Catalfamo Formento PA. A subject-specific integrative biomechanical framework of the pelvis for gait analysis. Proc Inst Mech Eng H 2018; 232:1083-1097. [PMID: 30280643 DOI: 10.1177/0954411918803125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Analysis of the human locomotor system using rigid-body musculoskeletal models has increased in the biomechanical community with the objective of studying muscle activations of different movements. Simultaneously, the finite element method has emerged as a complementary approach for analyzing the mechanical behavior of tissues. This study presents an integrative biomechanical framework for gait analysis by linking a musculoskeletal model and a subject-specific finite element model of the pelvis. To investigate its performance, a convergence study was performed and its sensitivity to the use of non-subject-specific material properties was studied. The total hip joint force estimated by the rigid musculoskeletal model and by the finite element model showed good agreement, suggesting that the integrative approach estimates adequately (in shape and magnitude) the hip total contact force. Previous studies found movements of up to 1.4 mm in the anterior-posterior direction, for single leg stance. These results are comparable with the displacement values found in this study: 0-0.5 mm in the sagittal axis. Maximum von Mises stress values of approximately 17 MPa were found in the pelvic bone. Comparing this results with a previous study of our group, the new findings show that the introduction of muscular boundary conditions and the flexion-extension movement of the hip reduce the regions of high stress and distributes more uniformly the stress across the pelvic bone. Thus, it is thought that muscle force has a relevant impact in reducing stresses in pelvic bone during walking of the finite element model proposed in this study. Future work will focus on including other deformable structures, such as the femur and the tibia, and subject-specific material properties.
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Affiliation(s)
- Emiliano P Ravera
- 1 Group of Analysis, Modeling, Processing and Clinician Implementation of Biomechanical Signals and Systems, Bioengineering and Bioinformatics Institute, CONICET-UNER, Oro Verde, Argentina.,2 Human Movement Research Laboratory, School of Engineering, National University of Entre Ríos (UNER), Oro Verde, Argentina
| | - Marcos J Crespo
- 3 Gait and Motion Analysis Laboratory, FLENI Institute for Neurological Research, Escobar, Argentina
| | - Paola A Catalfamo Formento
- 1 Group of Analysis, Modeling, Processing and Clinician Implementation of Biomechanical Signals and Systems, Bioengineering and Bioinformatics Institute, CONICET-UNER, Oro Verde, Argentina.,2 Human Movement Research Laboratory, School of Engineering, National University of Entre Ríos (UNER), Oro Verde, Argentina
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Mentiplay BF, Banky M, Clark RA, Kahn MB, Williams G. Lower limb angular velocity during walking at various speeds. Gait Posture 2018; 65:190-196. [PMID: 30558929 DOI: 10.1016/j.gaitpost.2018.06.162] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although it is well established that lower limb joint angles adapt to walking at various speeds, limited research has examined the modifications in joint angular velocity. There is currently no normative dataset for joint angular velocity during walking, which would be useful to allow comparisons for patient cohorts. Additionally, understanding normal joint angular velocity may assist clinical assessment and treatment procedures to incorporate methods that replicate the movement speed of the lower limb joints during walking. RESEARCH QUESTION This study aimed to examine lower limb joint angles and angular velocities in a healthy population walking at various gait speeds. METHODS Thirty-six healthy adult participants underwent three-dimensional gait analysis while walking at various speeds during habitual and slowed walking. The peak joint angles and angular velocities during important phases of the gait cycle were examined for the hip, knee and ankle in the sagittal plane. Data were grouped in 0.2 m/s increments from a walking speed of 0.4 m/s to 1.6 m/s to represent the range of walking speeds reported in studies of people with gait impairments. RESULTS For joint angles and angular velocities, the shape of the gait traces were consistent regardless of the walking speed. However as walking speed increased, so did the peak joint angles and angular velocities for the hip, knee and ankle. The largest angular velocity occurred when the knee joint extended at the terminal swing phase of gait. For the ankle and hip joints, the largest angular velocity occurred during the push-off phase. SIGNIFICANCE This study examined how lower limb joint angular velocities change with various walking speeds. These data can be used as a comparator for data from clinical cohorts, and has the potential to be used to match clinical assessment and treatment methods to joint angular velocity during walking.
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Affiliation(s)
- Benjamin F Mentiplay
- Department of Physiotherapy, Epworth HealthCare, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Australia.
| | - Megan Banky
- Department of Physiotherapy, Epworth HealthCare, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Australia
| | - Ross A Clark
- School of Health and Sport Sciences, University of the Sunshine Coast, Australia
| | - Michelle B Kahn
- Department of Physiotherapy, Epworth HealthCare, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Australia
| | - Gavin Williams
- Department of Physiotherapy, Epworth HealthCare, Australia; Department of Physiotherapy, University of Melbourne, Australia
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Frick E, Rahmatalla S. Joint Center Estimation Using Single-Frame Optimization: Part 2: Experimentation. SENSORS 2018; 18:s18082563. [PMID: 30081601 PMCID: PMC6112042 DOI: 10.3390/s18082563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/13/2018] [Accepted: 08/03/2018] [Indexed: 11/16/2022]
Abstract
Human motion capture is driven by joint center location estimates, and error in their estimation can be compounded by subsequent kinematic calculations. Soft tissue artifact (STA), the motion of tissue relative to the underlying bones, is a primary cause of error in joint center calculations. A method for mitigating the effects of STA, single-frame optimization (SFO), was introduced and numerically verified in Part 1 of this work, and the purpose of this article (Part 2) is to experimentally compare the results of SFO with a marker-based solution. The experimentation herein employed a single-degree-of-freedom pendulum to simulate human joint motion, and the effects of STA were simulated by affixing the inertial measurement unit to the pendulum indirectly through raw, vacuum-sealed meat. The inertial sensor was outfitted with an optical marker adapter so that its location could be optically determined by a camera-based motion-capture system. During the motion, inertial effects and non-rigid attachment of the inertial sensor caused the simulated STA to manifest via unrestricted motion (six degrees of freedom) relative to the rigid pendulum. The redundant inertial and optical instrumentation allowed a time-varying joint center solution to be determined both by optical markers and by SFO, allowing for comparison. The experimental results suggest that SFO can achieve accuracy comparable to that of state-of-the-art joint center determination methods that use optical skin markers (root mean square error of 7.87–37.86 mm), and that the time variances of the SFO solutions are correlated (r = 0.58–0.99) with the true, time-varying joint center solutions. This suggests that SFO could potentially help to fill a gap in the existing literature by improving the characterization and mitigation of STA in human motion capture.
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Affiliation(s)
- Eric Frick
- Center for Computer-Aided Design, College of Engineering, The University of Iowa, Iowa City, IA 52242, USA.
| | - Salam Rahmatalla
- Department of Civil and Environmental Engineering and Center for Computer-Aided Design, College of Engineering, The University of Iowa, Iowa City, IA 52242, USA.
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Zuk M, Syczewska M, Pezowicz C. Sensitivity analysis of the estimated muscle forces during gait with respect to the musculoskeletal model parameters and dynamic simulation techniques. J Biomech Eng 2018; 140:2694845. [PMID: 30098142 DOI: 10.1115/1.4040943] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Indexed: 11/08/2022]
Abstract
The purpose of the current study was to investigate the robustness of dynamic simulation results in the presence of uncertainties resulting from application of a scaled-generic musculoskeletal model instead of a subject-specific model as well as the effect of the choice of simulation method on the obtained muscle forces. The performed sensitivity analysis consisted of the following multibody parameter modifications: maximum isometric muscle forces, number of muscles, the hip joint centre location, segment masses as well as different dynamic simulation methods, namely static optimization with three different criteria and a computed muscle control algorithm (hybrid approach combining forward and inverse dynamics). Twenty-four different models and fifty-five resultant dynamic simulation data sets were analysed. The effects of model perturbation on the magnitude and profile of muscle forces were compared. It has been shown that estimated muscle forces are very sensitive to model parameters. The greatest impact was observed in the case of the force magnitude of the muscles generating high forces during gait (regardless of the modification introduced). However, the force profiles of those muscles were preserved. Relatively large differences in muscle forces were observed for different simulation techniques, which included both magnitude and profile of muscle forces. Personalization of model parameters would affect the resultant muscle forces and seems to be necessary to improve general accuracy of the estimated parameters. However, personalization alone will not ensure high accuracy due to the still unresolved muscle force sharing problem.
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Affiliation(s)
- Magdalena Zuk
- Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
| | - Malgorzata Syczewska
- Department of Paediatric Rehabilitation, The Children's Memorial Health Institute, Warsaw, Poland
| | - Celina Pezowicz
- Faculty of Mechanical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
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Fougeron N, Rohan PY, Macron A, Travert C, Pillet H, Skalli W. Subject specific finite element mesh generation of the pelvis from biplanar x-ray images: application to 120 clinical cases. Comput Methods Biomech Biomed Engin 2018; 21:408-412. [PMID: 29969279 DOI: 10.1080/10255842.2018.1469624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Several Finite Element (FE) models of the pelvis have been developed to comprehensively assess the onset of pathologies and for clinical and industrial applications. However, because of the difficulties associated with the creation of subject-specific FE mesh from CT scan and MR images, most of the existing models rely on the data of one given individual. Moreover, although several fast and robust methods have been developed for automatically generating tetrahedral meshes of arbitrary geometries, hexahedral meshes are still preferred today because of their distinct advantages but their generation remains an open challenge. Recently, approaches have been proposed for fast 3D reconstruction of bones based on X-ray imaging. In this study, we adapted such an approach for the fast and automatic generation of all-hexahedral subject-specific FE models of the pelvis based on the elastic registration of a generic mesh to the subject-specific target in conjunction with element regularity and quality correction. The technique was successfully tested on a database of 120 3D reconstructions of pelvises from biplanar X-ray images. For each patient, a full hexahedral subject-specific FE mesh was generated with an accurate surface representation.
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Affiliation(s)
- Nolwenn Fougeron
- a Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers , Paris , France
| | - Pierre-Yves Rohan
- a Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers , Paris , France
| | - Aurélien Macron
- a Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers , Paris , France.,b CEA, LETI, CLINATEC, MINATEC Campus , Grenoble , France
| | - Christophe Travert
- a Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers , Paris , France
| | - Hélène Pillet
- a Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers , Paris , France
| | - Wafa Skalli
- a Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers , Paris , France
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Hip- and patellofemoral-joint loading during gait are increased in children with idiopathic torsional deformities. Gait Posture 2018; 63:228-235. [PMID: 29775910 DOI: 10.1016/j.gaitpost.2018.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/19/2018] [Accepted: 05/04/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Torsional deformities of the femur and tibia are associated with gait impairments and joint pain. Several studies have investigated these gait deviations in children with cerebral palsy. However, relatively little is known about gait deviations in children with idiopathic torsion and debate ensues about the management of these patients. RESEARCH QUESTION What are the effects of idiopathic increased femoral neck anteversion and external tibial torsion on lower-limb kinematics, kinetics and joint loading during gait in children and adolescents. METHODS Patient-specific musculoskeletal models were created for 12 children/adolescents (mean age of 14 years) with torsional deformities using low-dose biplane radiographic imaging and 3D gait analysis. Comparisons of joint motion and net joint torques during gait were made to an age-matched control group with no torsional deformities. The effects of torsional deformities on muscle and joint contact forces were investigated using two personalised musculoskeletal models: one with normal torsion and another with patient-specific torsion. RESULTS Femoral neck anteversion and external tibial torsion for the patients were (mean ± SD) 38° ± 9° and 40° ± 10°, respectively. Patients had increased internal hip rotation and external knee rotation as well as increased pelvic tilt during gait. Additionally, the efficacy of the plantarflexor-knee extension mechanism was diminished. Hip joint contact force was higher in the model with patient-specific torsion. The mediolateral component of the patellofemoral joint contact force was also increased despite the magnitude of the resultant patellofemoral contact force being unchanged. SIGNIFICANCE It has been previously established that idiopathic lower-limb torsional deformities alter gait kinematics. However, this study also showed that loading of the hip and patellofemoral joints are increased. This is an important insight for the clinical management of these patients and highlights that idiopathic lower-limb torsional deformities are not a purely cosmetic issue.
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Horsak B, Schwab C, Clemens C, Baca A, Greber-Platzer S, Kreissl A, Kranzl A. Is the reliability of 3D kinematics of young obese participants dependent on the hip joint center localization method used? Gait Posture 2018; 59:65-70. [PMID: 28992613 DOI: 10.1016/j.gaitpost.2017.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/15/2017] [Accepted: 09/22/2017] [Indexed: 02/02/2023]
Abstract
The aim of this study was to investigate if the test-retest reliability for three-dimensional (3D) gait kinematics in a young obese population is affected by using either a predictive (Davis) or a functional (SCoRE) hip joint center (HJC) localization approach. A secondary goal was to analyze how consistent both methods perform in estimating the HJC position. A convenience sample of ten participants, two females and eight males with an age-based body mass index (BMI) above the 97th percentile (mean±SD: 34.2±3.9kg/m2) was recruited. Participants underwent two 3D gait analysis sessions separated by a minimum of one day and a maximum of seven days. The standard error of measurement (SEM) and the root mean square error (RMSE) of key kinematic parameters along with the root mean square deviation (RMSD) of the entire waveforms were used to analyze the test-retest reliability. To get an estimate of the consistency of both HJC localization methods, the HJC positions determined by both methods were compared to each other. SEM, RMSE, and RMSD results indicate that the HJC position estimations between both methods are not different and demonstrate moderate to good reliability to estimate joint kinematics. With respect to the localization of the HJC, notable inconsistencies ranging from 0 to 5.4cm were observed. In conclusion, both approaches appear equally reliable. However, the inconsistent HJC estimation points out, that accuracy seems to be a big issue in these methods. Future research should attend to this matter.
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Affiliation(s)
- Brian Horsak
- St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria.
| | - Caterine Schwab
- St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria
| | - Christoph Clemens
- University of Vienna, Department of Biomechanics, Kinesiology and Applied Computer Science, Austria
| | - Arnold Baca
- University of Vienna, Department of Biomechanics, Kinesiology and Applied Computer Science, Austria
| | | | - Alexandra Kreissl
- Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Austria
| | - Andreas Kranzl
- Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Austria
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36
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Newcomb NRA, Wrigley TV, Hinman RS, Kasza J, Spiers L, O'Donnell J, Bennell KL. Effects of a hip brace on biomechanics and pain in people with femoroacetabular impingement. J Sci Med Sport 2017; 21:111-116. [PMID: 29074345 DOI: 10.1016/j.jsams.2017.09.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 06/02/2017] [Accepted: 09/22/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study evaluates whether hip bracing in patients with femoroacetabular impingement (FAI) (a) immediately reduces range of hip internal rotation, flexion, adduction, and pain during functional tasks; and (b) improves patient-reported outcomes when worn daily over 4 weeks. DESIGN Within-participant design followed by a case series. METHODS Twenty-five adults with symptomatic FAI underwent 3D kinematic assessment with and without a hip brace during single-leg squat, double-leg squat, stair ascent, and stair descent. A subset of this population (n=17) continued to wear the brace daily for 4-weeks. A linear mixed statistical model was used to assess pain and kinematic differences between the braced and unbraced conditions at baseline testing. Patient-reported outcomes (NRS pain, iHot-33 and HAGOS questionnaires) at 4-weeks were compared to baseline using paired t-tests. RESULTS Bracing resulted in significant but small reductions in peak hip flexion ranging between 5.3° (95% CI 0.8°-9.7°) and 5.6° (95% CI 1.1°-10.0°), internal rotation ranging between 2.5° (95% CI 0.6°-4.4°) and 6.4° (95% CI 4.5°-8.2°), and adduction ranging between 2.2° (95% CI 0.5°-3.8°) and 3.3° (95% CI 1.6°-5.0°) during all tasks, except flexion during single-leg squat, compared with the unbraced condition; pain was not significantly improved with the brace. Bracing over four weeks did not significantly change patient-reported outcomes. CONCLUSIONS Bracing subtly limited impinging hip movements during functional tasks, but did not immediately reduce pain or improve patient-reported clinical outcomes after 4 weeks in a young adult cohort with long-standing FAI.
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Affiliation(s)
- Nicolas R A Newcomb
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia
| | - Tim V Wrigley
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia
| | - Rana S Hinman
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia
| | - Jessica Kasza
- Department of Epidemiology and Preventive Medicine, Monash University, Australia
| | - Libby Spiers
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia
| | | | - Kim L Bennell
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia.
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Benedetti MG, Beghi E, De Tanti A, Cappozzo A, Basaglia N, Cutti AG, Cereatti A, Stagni R, Verdini F, Manca M, Fantozzi S, Mazzà C, Camomilla V, Campanini I, Castagna A, Cavazzuti L, Del Maestro M, Croce UD, Gasperi M, Leo T, Marchi P, Petrarca M, Piccinini L, Rabuffetti M, Ravaschio A, Sawacha Z, Spolaor F, Tesio L, Vannozzi G, Visintin I, Ferrarin M. SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference. Gait Posture 2017; 58:252-260. [PMID: 28825997 DOI: 10.1016/j.gaitpost.2017.08.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 07/31/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field.
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Affiliation(s)
| | - Ettore Beghi
- IRCCS Istituto di Ricerche Farmacologiche, Milano, Italy
| | | | - Aurelio Cappozzo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | | | | | - Andrea Cereatti
- POLCOMING Department, Bioengineering unit, University of Sassari, Italy
| | - Rita Stagni
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI Università di Bologna, Italy
| | - Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Mario Manca
- Azienda Ospedaliero-Universitaria di Ferrara, Italy
| | - Silvia Fantozzi
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI Università di Bologna, Italy
| | - Claudia Mazzà
- Department of Mechanical Engineering and Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | - Isabella Campanini
- Motion Analysis Laboratory - Rehab. Dept, AUSL Reggio Emilia and Dept. of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | | | | | | | - Ugo Della Croce
- POLCOMING Department, Bioengineering unit, University of Sassari, Italy
| | - Marco Gasperi
- Ospedale Riabilitativo Villa Rosa, Azienda Provinciale Servizi Sanitari di Trento, Italy
| | - Tommaso Leo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Pia Marchi
- Azienda Ospedaliero-Universitaria di Ferrara, Italy
| | | | | | | | | | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, Italy
| | - Luigi Tesio
- Università degli Studi and Istituto Auxologico Italiano-IRCCS, Milano, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
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Camomilla V, Cereatti A, Cutti AG, Fantozzi S, Stagni R, Vannozzi G. Methodological factors affecting joint moments estimation in clinical gait analysis: a systematic review. Biomed Eng Online 2017; 16:106. [PMID: 28821242 PMCID: PMC5563001 DOI: 10.1186/s12938-017-0396-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/08/2017] [Indexed: 01/29/2023] Open
Abstract
Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics. Therefore, both measurement errors and modelling assumptions can affect the results, to an extent that also depends on the characteristics of the motor task analysed (i.e. gait speed). Errors affecting the trajectories of joint centres, the orientation of joint functional axes, the joint angular velocities, the accuracy of inertial parameters and force measurements (concurring to the definition of the dynamic model), can weigh differently in the estimation of clinically interpretable joint moments. Numerous studies addressed all these methodological aspects separately, but a critical analysis of how these aspects may affect the clinical interpretation of joint dynamics is still missing. This article aims at filling this gap through a systematic review of the literature, conducted on Web of Science, Scopus and PubMed. The final objective is hence to provide clear take-home messages to guide laboratories in the estimation of joint moments for the clinical practice.
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Affiliation(s)
- Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
| | - Andrea Cereatti
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
- Information Engineering Unit, POLCOMING Department, University of Sassari, Viale Mancini, 5, 007100 Sassari, Italy
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Castelfidardo, 39, 10129 Turin, Italy
| | - Andrea Giovanni Cutti
- Centro Protesi INAIL, Production Directorate - Applied Research, Via Rabuina 14, 40054 Vigorso di Budrio (BO), Italy
| | - Silvia Fantozzi
- Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”, Alma Mater Studiorum University of Bologna, Via Risorgimento 2, 40136 Bologna, Italy
| | - Rita Stagni
- Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”, Alma Mater Studiorum University of Bologna, Via Risorgimento 2, 40136 Bologna, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
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Kainz H, Hajek M, Modenese L, Saxby DJ, Lloyd DG, Carty CP. Reliability of functional and predictive methods to estimate the hip joint centre in human motion analysis in healthy adults. Gait Posture 2017; 53:179-184. [PMID: 28171844 DOI: 10.1016/j.gaitpost.2017.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 01/21/2017] [Accepted: 01/24/2017] [Indexed: 02/02/2023]
Abstract
In human motion analysis predictive or functional methods are used to estimate the location of the hip joint centre (HJC). It has been shown that the Harrington regression equations (HRE) and geometric sphere fit (GSF) method are the most accurate predictive and functional methods, respectively. To date, the comparative reliability of both approaches has not been assessed. The aims of this study were to (1) compare the reliability of the HRE and the GSF methods, (2) analyse the impact of the number of thigh markers used in the GSF method on the reliability, (3) evaluate how alterations to the movements that comprise the functional trials impact HJC estimations using the GSF method, and (4) assess the influence of the initial guess in the GSF method on the HJC estimation. Fourteen healthy adults were tested on two occasions using a three-dimensional motion capturing system. Skin surface marker positions were acquired while participants performed quite stance, perturbed and non-perturbed functional trials, and walking trials. Results showed that the HRE were more reliable in locating the HJC than the GSF method. However, comparison of inter-session hip kinematics during gait did not show any significant difference between the approaches. Different initial guesses in the GSF method did not result in significant differences in the final HJC location. The GSF method was sensitive to the functional trial performance and therefore it is important to standardize the functional trial performance to ensure a repeatable estimate of the HJC when using the GSF method.
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Affiliation(s)
- Hans Kainz
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
| | - Martin Hajek
- Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; University of Applied Sciences Technikum Wien, Vienna, Austria.
| | - Luca Modenese
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Department of Mechanical Engineering, University of Sheffield, United Kingdom; INSIGNEO Institute for in Silico Medicine, The University of Sheffield, United Kingdom.
| | - David J Saxby
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - David G Lloyd
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Christopher P Carty
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Queensland Children's Motion Analysis Service, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia.
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40
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Predicting the location of the hip joint centres, impact of age group and sex. Sci Rep 2016; 6:37707. [PMID: 27883044 PMCID: PMC5121588 DOI: 10.1038/srep37707] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/03/2016] [Indexed: 11/20/2022] Open
Abstract
Clinical gait analysis incorporating three-dimensional motion analysis plays a key role in planning surgical treatments in people with gait disability. The position of the Hip Joint Centre (HJC) within the pelvis is thus critical to ensure accurate data interpretation. The position of the HJC is determined from regression equations based on anthropometric measurements derived from relatively small datasets. Current equations do not take sex or age into account, even though pelvis shape is known to differ between sex, and gait analysis is performed in populations with wide range of age. Three dimensional images of 157 deceased individuals (37 children, 120 skeletally matured) were collected with computed tomography. The location of the HJC within the pelvis was determined and regression equations to locate the HJC were developed using various anthropometrics predictors. We determined if accuracy improved when age and sex were introduced as variables. Statistical analysis did not support differentiating the equations according to sex. We found that age only modestly improved accuracy. We propose a range of new regression equations, derived from the largest dataset collected for this purpose to date.
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Sauret C, Pillet H, Skalli W, Sangeux M. On the use of knee functional calibration to determine the medio-lateral axis of the femur in gait analysis: Comparison with EOS biplanar radiographs as reference. Gait Posture 2016; 50:180-184. [PMID: 27632062 DOI: 10.1016/j.gaitpost.2016.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/05/2016] [Accepted: 09/08/2016] [Indexed: 02/02/2023]
Abstract
Accurate calibration of the medio-lateral axis of the femur is crucial for clinical decision making based on gait analysis. This study proposes a protocol utilizing biplanar radiographs to provide a reference medio-lateral axis based on the anatomy of the femur. The biplanar radiographs allowed 3D modelling of the bones of the lower limbs and the markers used for motion capture, in the standing posture. A comprehensive analysis was performed and results from biplanar radiographs were reliable for 3D marker localization (±0.35mm) and for 3D localization of the anatomical landmarks (±1mm), leading to a precision of 1° for the orientation of the condylar axis of the femur and a 95% confidence interval of ±3° after registration with motion capture data. The anatomical condylar axis was compared to a conventional, marker-based, axis and three functional calibration techniques (axis transformation, geometric axis fit and DynaKAD). Results for the conventional method show an average difference with the condylar axis of 15° (SD: 6°). Results indicate DynaKAD functional axis was the closest to the anatomical condylar axis, mean: 1° (SD: 5°) when applied to passive knee flexion movement. However, the range of the results exceeded 15° for all methods. Hence, the use of biplanar radiographs, or an alternative imaging technique, may be required to locate the medio-lateral axis of the femur reliably prior to clinical decision making for femur derotational osteotomies.
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Affiliation(s)
- Christophe Sauret
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151 boulevard de l'Hôpital, F-75013 Paris, France.
| | - Hélène Pillet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151 boulevard de l'Hôpital, F-75013 Paris, France.
| | - Wafa Skalli
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, 151 boulevard de l'Hôpital, F-75013 Paris, France.
| | - Morgan Sangeux
- Hugh Williamson Gait Analysis Laboratory, The Royal Children's Hospital, 50 Flemington Road, Parkville Victoria, 3052 Melbourne, Australia; The Murdoch Children's Research Institute, Melbourne, Australia.
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Fiorentino NM, Atkins PR, Kutschke MJ, Foreman KB, Anderson AE. In-vivo quantification of dynamic hip joint center errors and soft tissue artifact. Gait Posture 2016; 50:246-251. [PMID: 27693944 PMCID: PMC5119549 DOI: 10.1016/j.gaitpost.2016.09.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/07/2016] [Accepted: 09/09/2016] [Indexed: 02/02/2023]
Abstract
Hip joint center (HJC) measurement error can adversely affect predictions from biomechanical models. Soft tissue artifact (STA) may exacerbate HJC errors during dynamic motions. We quantified HJC error and the effect of STA in 11 young, asymptomatic adults during six activities. Subjects were imaged simultaneously with reflective skin markers (SM) and dual fluoroscopy (DF), an x-ray based technique with submillimeter accuracy that does not suffer from STA. Five HJCs were defined from locations of SM using three predictive (i.e., based on regression) and two functional methods; these calculations were repeated using the DF solutions. Hip joint center motion was analyzed during six degrees-of-freedom (default) and three degrees-of-freedom hip joint kinematics. The position of the DF-measured femoral head center (FHC), served as the reference to calculate HJC error. The effect of STA was quantified with mean absolute deviation. HJC errors were (mean±SD) 16.6±8.4mm and 11.7±11.0mm using SM and DF solutions, respectively. HJC errors from SM measurements were all significantly different from the FHC in at least one anatomical direction during multiple activities. The mean absolute deviation of SM-based HJCs was 2.8±0.7mm, which was greater than that for the FHC (0.6±0.1mm), suggesting that STA caused approximately 2.2mm of spurious HJC motion. Constraining the hip joint to three degrees-of-freedom led to approximately 3.1mm of spurious HJC motion. Our results indicate that STA-induced motion of the HJC contributes to the overall error, but inaccuracies inherent with predictive and functional methods appear to be a larger source of error.
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Affiliation(s)
- Niccolo M Fiorentino
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Penny R Atkins
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Room 3100, Salt Lake City, UT 84112, USA
| | - Michael J Kutschke
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - K Bo Foreman
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Physical Therapy, University of Utah, 520 Wakara Way, Suite 240, Salt Lake City, UT 84108, USA
| | - Andrew E Anderson
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Room 3100, Salt Lake City, UT 84112, USA; Department of Physical Therapy, University of Utah, 520 Wakara Way, Suite 240, Salt Lake City, UT 84108, USA; Scientific Computing and Imaging Institute, 72 S Central Campus Drive, Room 3750, Salt Lake City, UT 84112, USA.
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43
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Bennett HJ, Shen G, Weinhandl JT, Zhang S. Validation of the greater trochanter method with radiographic measurements of frontal plane hip joint centers and knee mechanical axis angles and two other hip joint center methods. J Biomech 2016; 49:3047-3051. [DOI: 10.1016/j.jbiomech.2016.06.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 12/01/2022]
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Assi A, Sauret C, Massaad A, Bakouny Z, Pillet H, Skalli W, Ghanem I. Validation of hip joint center localization methods during gait analysis using 3D EOS imaging in typically developing and cerebral palsy children. Gait Posture 2016; 48:30-35. [PMID: 27477704 DOI: 10.1016/j.gaitpost.2016.04.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Localization of the hip joint center (HJC) is essential in computation of gait data. EOS low dose biplanar X-rays have been shown to be a good reference in evaluating various methods of HJC localization in adults. The aim is to evaluate predictive and functional techniques for HJC localization in typically developing (TD) and cerebral palsy (CP) children, using EOS as an image based reference. Eleven TD and 17 CP children underwent 3D gait analysis. Six HJC localization methods were evaluated in each group bilaterally: 3 predictive (Plug in Gait, Bell and Harrington) and 3 functional methods based on the star arc technique (symmetrical center of rotation estimate, center transformation technique and geometrical sphere fitting). All children then underwent EOS low dose biplanar radiographs. Pelvis, lower limbs and their corresponding external markers were reconstructed in 3D. The center of the femoral head was considered as the reference (HJCEOS). Euclidean distances between HJCs estimated by each of the 6 methods and the HJCEOS were calculated; distances were shown to be lower in predictive compared to functional methods (p<0.0001). Contrarily to findings in adults, functional methods were shown to be less accurate than predictive methods in TD and CP children, which could be mainly due to the shorter thigh segment in children. Harrington method was shown to be the most accurate in the prediction of HJC (mean error≈18mm, SD=9mm) and quasi-equivalent to the Bell method. The bias for each method was quantified, allowing its correction for an improved HJC estimation.
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Affiliation(s)
- Ayman Assi
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France; Gait Laboratory, SESOBEL, Beirut, Lebanon.
| | - Christophe Sauret
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Abir Massaad
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon; Gait Laboratory, SESOBEL, Beirut, Lebanon
| | - Ziad Bakouny
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - Hélène Pillet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Wafa Skalli
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Ismat Ghanem
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon; Gait Laboratory, SESOBEL, Beirut, Lebanon; Hôtel-Dieu de France Hospital, Beirut, Lebanon
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Defining the medial-lateral axis of an anatomical femur coordinate system using freehand 3D ultrasound imaging. Gait Posture 2016; 45:211-6. [PMID: 26979908 DOI: 10.1016/j.gaitpost.2016.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 02/02/2023]
Abstract
Hip rotation from gait analysis informs clinical decisions regarding correction of femoral torsional deformities. However, it is among the least repeatable due to discrepancies in determining the medial-lateral axis of the femur. Conventional or functional calibration methods may be used to define the axis but there is no benchmark to evaluate these methods. Freehand 3D ultrasound, the coupling of ultrasound with 3D motion capture, may provide such a benchmark. We measured the accuracy in vitro and repeatability in vivo of determining the femur condylar axis from freehand 3D ultrasound. The condylar axis provided the reference medial-lateral axis of the femur and was used to evaluate one conventional method and three functional calibration methods, applied to three calibration movements. Ten healthy subjects (20 limbs) underwent 3D gait analysis and freehand 3D ultrasound. The functional calibration methods were a transformation technique, a geometrical method and a method that minimises variance of knee varus-valgus kinematics (DynaKAD). The conventional method used markers over the femoral epicondyles. The condylar axis determined by 3D ultrasound showed good accuracy in vitro, 1.6° (SD: 0.3°) and good repeatability in vivo, 0.2° (RSMD: 2.3°). The DynaKAD method applied to the walking calibration movement determined the medial-lateral axis closest to the ultrasound reference. The average angular difference in the transverse plane was 3.1° (SD: 6.1°). Freehand 3D ultrasound offers an accurate, non-invasive and relatively fast method to locate the medial-lateral axis of the femur for gait analysis.
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46
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Kiernan D, Hosking J, O'Brien T. Is adult gait less susceptible than paediatric gait to hip joint centre regression equation error? Gait Posture 2016; 45:133-6. [PMID: 26979895 DOI: 10.1016/j.gaitpost.2016.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/30/2015] [Accepted: 01/21/2016] [Indexed: 02/02/2023]
Abstract
Hip joint centre (HJC) regression equation error during paediatric gait has recently been shown to have clinical significance. In relation to adult gait, it has been inferred that comparable errors with children in absolute HJC position may in fact result in less significant kinematic and kinetic error. This study investigated the clinical agreement of three commonly used regression equation sets (Bell et al., Davis et al. and Orthotrak) for adult subjects against the equations of Harrington et al. The relationship between HJC position error and subject size was also investigated for the Davis et al. set. Full 3-dimensional gait analysis was performed on 12 healthy adult subjects with data for each set compared to Harrington et al. The Gait Profile Score, Gait Variable Score and GDI-kinetic were used to assess clinical significance while differences in HJC position between the Davis and Harrington sets were compared to leg length and subject height using regression analysis. A number of statistically significant differences were present in absolute HJC position. However, all sets fell below the clinically significant thresholds (GPS <1.6°, GDI-Kinetic <3.6 points). Linear regression revealed a statistically significant relationship for both increasing leg length and increasing subject height with decreasing error in anterior/posterior and superior/inferior directions. Results confirm a negligible clinical error for adult subjects suggesting that any of the examined sets could be used interchangeably. Decreasing error with both increasing leg length and increasing subject height suggests that the Davis set should be used cautiously on smaller subjects.
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Affiliation(s)
- D Kiernan
- Gait Laboratory, Central Remedial Clinic, Clontarf, Dublin 3, Ireland.
| | - J Hosking
- Rehabilitation Engineering Unit, Posture and Mobility Centre, Cardiff and Vale NHS Trust, UK
| | - T O'Brien
- Gait Laboratory, Central Remedial Clinic, Clontarf, Dublin 3, Ireland
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47
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Melhem E, Assi A, El Rachkidi R, Ghanem I. EOS(®) biplanar X-ray imaging: concept, developments, benefits, and limitations. J Child Orthop 2016; 10:1-14. [PMID: 26883033 PMCID: PMC4763151 DOI: 10.1007/s11832-016-0713-0] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/22/2016] [Indexed: 02/03/2023] Open
Abstract
PURPOSE In 1992, Georges Charpak invented a new type of X-ray detector, which in turn led to the development of the EOS(®) 2D/3D imaging system. This system takes simultaneous anteroposterior and lateral 2D images of the whole body and can be utilized to perform 3D reconstruction based on statistical models. The purpose of this review is to present the state of the art for this EOS(®) imaging technique, to report recent developments and advances in the technique, and to stress its benefits while also noting its limitations. METHODS The review was based on a thorough literature search on the subject as well as personal experience gained from many years of using the EOS(®) system. RESULTS While EOS(®) imaging could be proposed for many applications, it is most useful in relation to scoliosis and sagittal balance, due to its ability to take simultaneous orthogonal images while the patient is standing, to perform 3D reconstruction, and to determine various relationships among adjacent segments (cervical spine, pelvis, and lower limbs). The technique has also been validated for the study of pelvic and lower-limb deformity and pathology in adult and pediatric populations; in such a study it has the advantage of allowing the measurement of torsional deformity, which classically requires a CT scan. CONCLUSIONS The major advantages of EOS(®) are the relatively low dose of radiation (50-80 % less than conventional X-rays) that the patient receives and the possibility of obtaining a 3D reconstruction of the bones. However, this 3D reconstruction is not created automatically; a well-trained operator is required to generate it. The EOS(®) imaging technique has proven itself to be a very useful research and diagnostic tool.
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Affiliation(s)
- Elias Melhem
- Department of Orthopaedic Surgery, Hôtel-Dieu de France Hospital, University of Saint Joseph, Boulevard Alfred Naccache, Achrafieh, P.O. Box 166830, Beirut, Lebanon
| | - Ayman Assi
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint Joseph, Beirut, Lebanon
| | - Rami El Rachkidi
- Department of Orthopaedic Surgery, Hôtel-Dieu de France Hospital, University of Saint Joseph, Boulevard Alfred Naccache, Achrafieh, P.O. Box 166830, Beirut, Lebanon
| | - Ismat Ghanem
- Department of Orthopaedic Surgery, Hôtel-Dieu de France Hospital, University of Saint Joseph, Boulevard Alfred Naccache, Achrafieh, P.O. Box 166830, Beirut, Lebanon ,Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint Joseph, Beirut, Lebanon
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48
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Mantovani G, Ng KCG, Lamontagne M. Regression models to predict hip joint centers in pathological hip population. Gait Posture 2016; 44:48-54. [PMID: 27004632 DOI: 10.1016/j.gaitpost.2015.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 09/12/2015] [Accepted: 11/02/2015] [Indexed: 02/02/2023]
Abstract
The purpose was to investigate the validity of Harrington's and Davis's hip joint center (HJC) regression equations on a population affected by a hip deformity, (i.e., femoroacetabular impingement). Sixty-seven participants (21 healthy controls, 46 with a cam-type deformity) underwent pelvic CT imaging. Relevant bony landmarks and geometric HJCs were digitized from the images, and skin thickness was measured for the anterior and posterior superior iliac spines. Non-parametric statistical and Bland-Altman tests analyzed differences between the predicted HJC (from regression equations) and the actual HJC (from CT images). The error from Davis's model (25.0 ± 6.7 mm) was larger than Harrington's (12.3 ± 5.9 mm, p<0.001). There were no differences between groups, thus, studies on femoroacetabular impingement can implement conventional regression models. Measured skin thickness was 9.7 ± 7.0mm and 19.6 ± 10.9 mm for the anterior and posterior bony landmarks, respectively, and correlated with body mass index. Skin thickness estimates can be considered to reduce the systematic error introduced by surface markers. New adult-specific regression equations were developed from the CT dataset, with the hypothesis that they could provide better estimates when tuned to a larger adult-specific dataset. The linear models were validated on external datasets and using leave-one-out cross-validation techniques; Prediction errors were comparable to those of Harrington's model, despite the adult-specific population and the larger sample size, thus, prediction accuracy obtained from these parameters could not be improved.
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Affiliation(s)
| | - K C Geoffrey Ng
- Department of Mechanical Engineering, University of Ottawa, Canada
| | - Mario Lamontagne
- School of Human Kinetics, University of Ottawa, Canada; Department of Mechanical Engineering, University of Ottawa, Canada.
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Accuracy of Functional and Predictive Methods to Calculate the Hip Joint Center in Young Non-pathologic Asymptomatic Adults with Dual Fluoroscopy as a Reference Standard. Ann Biomed Eng 2015; 44:2168-80. [PMID: 26645080 DOI: 10.1007/s10439-015-1522-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
Predictions from biomechanical models of gait may be sensitive to joint center locations. Most often, the hip joint center (HJC) is derived from locations of reflective markers adhered to the skin. Here, predictive techniques use regression equations of pelvic anatomy to estimate the HJC, whereas functional methods track motion of markers placed at the pelvis and femur during a coordinated motion. Skin motion artifact may introduce errors in the estimate of HJC for both techniques. Quantifying the accuracy of these methods is an area of open investigation. In this study, we used dual fluoroscopy (DF) (a dynamic X-ray imaging technique) and three-dimensional reconstructions from computed tomography images, to measure HJC locations in vivo. Using dual fluoroscopy as the reference standard, we then assessed the accuracy of three predictive and two functional methods. Eleven non-pathologic subjects were imaged with DF and reflective skin marker motion capture. Additionally, DF-based solutions generated virtual markers placed on bony landmarks, which were input to the predictive and functional methods to determine if estimates of the HJC improved. Using skin markers, functional methods had better mean agreement with the HJC measured by DF (11.0 ± 3.3 mm) than predictive methods (18.1 ± 9.5 mm); estimates from functional and predictive methods improved when using the DF-based solutions (1.3 ± 0.9 and 17.5 ± 8.6 mm, respectively). The Harrington method was the best predictive technique using both skin markers (13.2 ± 6.5 mm) and DF-based solutions (10.6 ± 2.5 mm). The two functional methods had similar accuracy using skin makers (11.1 ± 3.6 and 10.8 ± 3.2 mm) and DF-based solutions (1.2 ± 0.8 and 1.4 ± 1.0 mm). Overall, functional methods were superior to predictive methods for HJC estimation. However, the improvements observed when using the DF-based solutions suggest that skin motion artifact is a large source of error for the functional methods.
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50
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Nérot A, Wang X, Pillet H, Skalli W. Estimation of hip joint center from the external body shape: a preliminary study. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:2018-9. [DOI: 10.1080/10255842.2015.1069603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- A. Nérot
- Arts et MetiersParisTech, LBM/Institut de Biomecanique Humaine Georges Charpak, Paris, France
- Université de Lyon, France
- Université Claude Bernard Lyon, Villeurbanne, France
- IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, Bron, France
| | - X. Wang
- Université de Lyon, France
- Université Claude Bernard Lyon, Villeurbanne, France
- IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, Bron, France
| | - H. Pillet
- Arts et MetiersParisTech, LBM/Institut de Biomecanique Humaine Georges Charpak, Paris, France
| | - W. Skalli
- Arts et MetiersParisTech, LBM/Institut de Biomecanique Humaine Georges Charpak, Paris, France
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