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Otti DA, Ghijselings S, Staes F, Scheys L. How reliable are femoropelvic kinematics during deep squats? The influence of subject-specific skeletal modelling on measurement variability. Gait Posture 2024; 112:120-127. [PMID: 38761585 DOI: 10.1016/j.gaitpost.2024.05.006] [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: 11/07/2023] [Revised: 04/12/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Biplanar radiography displays promising results in the production of subject-specific (S.specific) biomechanical models. However, the focus has predominantly centred on methodological investigations in gait analysis. Exploring the influence of such models on the analysis of high range of motion tasks linked to hip pathologies is warranted. The aim of this study is to investigate the effect of S.Specific modelling techniques on the reliability of deep squats kinematics in comparison to generic modelling. METHODS 8 able-bodied male participants attended 5 motion capture sessions conducted by 3 observers and performed 5 deep squats in each. Prior to each session a biplanar scan was acquired with the reflective-markers attached. Inverse kinematics of pelvis and thigh segments were calculated based on S.specific and Generic model definition. Agreement between the two models femoropelvic orientation in standing was assessed with Bland-Altman plots and paired t- tests. Inter-trial, inter-session, inter-observer variability and observer/trial difference and ratio were calculated for squat kinematic data derived from the two modelling approaches. RESULTS Compared to the Generic model, the S.Specific model produced a calibration trial that is significantly offset into more posterior pelvis tilt (-2.8±2.7), hip extension (-2.2±3.8), hip abduction (-1.2±3.6) and external rotation (-13.8±11.4). The S.specific model produced significantly different squat kinematics in the sagittal plane of the pelvis (entire squat cycle) and hip (between 40 % and 60 % of the squat cycle). Variability analysis indicated that the error magnitude between the two models was comparable (difference<2°). The S.specific model exhibited a lower variability in the observer/trial ratio in the sagittal pelvis and hip, the frontal hip, but showed a higher variability in the transverse hip. SIGNIFICANCE S.specific modelling appears to introduce a calibration offset that primarily translates into an effect in the sagittal plane kinematics. However, the clinical added value of S.specific modelling in terms of reducing experimental sources of kinematic variability was limited.
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Affiliation(s)
- Dalia Al Otti
- Institute for Orthopaedic Research and Training, Department of Development and Regeneration, KU Leuven/University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium.
| | - Stijn Ghijselings
- Institute for Orthopaedic Research and Training, Department of Development and Regeneration, KU Leuven/University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Filip Staes
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101 - bus 1500, Leuven 3001, Belgium
| | - Lennart Scheys
- Institute for Orthopaedic Research and Training, Department of Development and Regeneration, KU Leuven/University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium
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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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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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Bonnet-Lebrun A, Linglart A, De Tienda M, Nguyen Khac V, Ouchrif Y, Berkenou J, Pillet H, Assi A, Wicart P, Skalli W. Combined gait analysis and radiologic examination in children with X-linked hypophosphatemia. Clin Biomech (Bristol, Avon) 2023; 105:105974. [PMID: 37148614 DOI: 10.1016/j.clinbiomech.2023.105974] [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: 11/28/2022] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND X-linked hypophosphataemia causes bone deformities and gait abnormalities that tend to worsen with age in the absence of appropriate treatment. However, doctors do not currently use quantitative tools to characterize these symptoms and their possible interactions. METHODS Radiographs and 3D gait data from 43 non-surgical growing children with X-linked hypophosphataemia were acquired prospectively. Data from age-matched typically developing children were used to form the reference group. Subgroups based on radiological parameters were compared with each other and with the reference population. Linear correlations between radiographic parameters and gait variables were examined. FINDING X-linked hypophosphatemic patients differed from the control group in pelvic tilt, ankle plantarflexion, knee flexion moment and power. High correlations with tibiofemoral angle were found for trunk lean, knee and hip adduction, and knee abduction moment. The Gait Deviation Index was below 80 for 88% of the patients with a high tibiofemoral angle (varus). Compared to other subgroups, varus patients had augmented trunk lean (+3°) and knee adduction (+10°) and decreased hip adduction (-5°) and ankle plantarflexion (-6°). Femoral torsion was associated with alterations in rotation at the knee, and hip. INTERPRETATION Gait abnormalities induced in X-linked hypophosphataemia have been described in a large cohort of children. Links between gait alterations and lower limb deformities were found, with varus deformities standing out. Since bony deformities appear when X-linked hypophosphatemic children start walking and have been found to alter gait patterns, we suggest that combining radiology with gait analysis may improve the clinical management of X-linked hypophosphataemia.
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Affiliation(s)
- Aurore Bonnet-Lebrun
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France.
| | - Agnès Linglart
- APHP, Service d'endocrinologie pédiatrique, Hôpital Bicêtre Paris Sud, 94270 Le Kremlin-Bicêtre, France; Centre de référence Maladies Rares du Métabolisme du Calcium et du Phosphore, 94270 Le Kremlin Bicetre, France
| | - Marine De Tienda
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France; APHP, Service d'orthopédie infantile, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Virginie Nguyen Khac
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France; APHP, Service d'orthopédie infantile, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Younes Ouchrif
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France; APHP, Service d'orthopédie infantile, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Jugurtha Berkenou
- Centre de référence Maladies Rares du Métabolisme du Calcium et du Phosphore, 94270 Le Kremlin Bicetre, France
| | - Hélène Pillet
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France
| | - Ayman Assi
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Philippe Wicart
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France; APHP, Service d'orthopédie infantile, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Wafa Skalli
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Sciences et Technologies, 151 Boulevard de l'Hôpital, 75013 Paris, France
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Eyssartier C, Billard P, Robert M, Thoreux P, Sauret C. Which typical floor movements of men's artistic gymnastics result in the most extreme lumbar lordosis and ground reaction forces? Sports Biomech 2022:1-16. [PMID: 36377511 DOI: 10.1080/14763141.2022.2140702] [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: 03/11/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022]
Abstract
Back pain is prevalent among gymnast populations and extreme flexion or extension of the lumbar spine along with high ground reaction forces (GRFs) are known to increase intervertebral stress. The aim of this study was to determine which postures and dynamic conditions among common floor movements provide the greatest risk of injury in men's artistic gymnastics (MAG). For this purpose, lumbar spine curvatures, obtained through a full-body subject-specific kinematic model fed by motion capture data, and GRFs on feet and hands were compared between typical floor movements of MAG (pike jump, round off back handspring, front handspring, forward and backward tucked somersaults) performed by six adolescent gymnasts. The round off back handspring and the pike jump resulted respectively in the largest lumbar extension and flexion, and the forward tucked somersault take-off in the highest GRF. At ground impacts, the largest lumbar flexion was during the backward tucked somersault landing and only the back handspring hands ground contact phase led to lumbar extension. Such identification of high-risk conditions should enable better back pain management in gymnastics through more tailored training adaptations, particularly in case of pathologies or musculoskeletal specificities.
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Affiliation(s)
- C Eyssartier
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
- Fédération Française de Gymnastique, Paris, France
| | - P Billard
- Fédération Française de Gymnastique, Paris, France
| | - M Robert
- Fédération Française de Gymnastique, Paris, France
| | - P Thoreux
- Hôpital Hôtel-Dieu, AP-HP, Paris, France
- Université Sorbonne Paris Nord, Arts et Métiers Institute of Technology, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
| | - C Sauret
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC-Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
- Centre d'Etudes et de Recherche sur l'Appareillage des Handicapés, Institution Nationale des Invalides, France
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Vafadar S, Skalli W, Bonnet-Lebrun A, Assi A, Gajny L. Assessment of a novel deep learning-based marker-less motion capture system for gait study. Gait Posture 2022; 94:138-143. [PMID: 35306382 DOI: 10.1016/j.gaitpost.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/25/2022] [Accepted: 03/14/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Marker-less systems based on digital video cameras and deep learning for gait analysis could have a deep impact in clinical routine. A recently developed system has shown promising results in terms of joint center position but has not been yet evaluated in terms of gait outcomes. RESEARCH QUESTION How does this novel marker-less system compare to a marker-based reference system in terms of clinically relevant gait parameters? METHODS The deep learning method behind the developed marker-less system was trained on a dedicated dataset consisting of forty-one asymptomatic and pathological subjects each performing ten walking trials. The system could estimate the three-dimensional position of seventeen joint centers or keypoints (e.g., neck, shoulders, hip, knee, and ankles). We evaluated the marker-less system against a marker-based system in terms of differences in joint position (Euclidean distance), detection of gait events (e.g., heel strike and toe-off), spatiotemporal parameters (e.g., step length, time), kinematic parameters (e.g., hip and knee extension-flexion), and inter-trial reliability for kinematic parameters. RESULTS The marker-less system was able to estimate the three-dimensional position of joint centers with a mean difference of 13.1 mm (SD = 10.2 mm). 99% of the estimated gait events were estimated within 10 ms of the corresponding reference values. Estimated spatiotemporal parameters showed zero bias. The mean and standard deviation of the differences of the estimated kinematic parameters varied by parameter (for example, the mean and standard deviation for knee extension flexion angle were -3.0° and 2.7°). Inter-trial reliability of the measured parameters was similar to that of the marker-based references. SIGNIFICANCE The developed marker-less system can measure the spatiotemporal parameters within the range of the minimum detectable changes obtained using the marker-based reference system. Moreover, except for hip extension flexion, the system showed promising results in terms of several kinematic parameters.
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Affiliation(s)
- Saman Vafadar
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
| | - Wafa Skalli
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
| | - Aurore Bonnet-Lebrun
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
| | - Ayman Assi
- Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon.
| | - Laurent Gajny
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
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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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9
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States RA, Krzak JJ, Salem Y, Godwin EM, Bodkin AW, McMulkin ML. Instrumented gait analysis for management of gait disorders in children with cerebral palsy: A scoping review. Gait Posture 2021; 90:1-8. [PMID: 34358847 DOI: 10.1016/j.gaitpost.2021.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/09/2021] [Accepted: 07/16/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The use of Instrumented Gait Analysis (IGA) for the clinical management of individuals with cerebral palsy (CP) has increased in recent years. Previous systematic reviews have been completed to evaluate and summarize the evidence related to the efficacy of IGA in general. However, a focused summary of research studies on IGA for children with CP related gait disorders is needed. RESEARCH QUESTION The purpose of the current work was to perform a scoping review to describe and categorize the range of existing literature about IGA as applied to the clinical management of children with CP related gait disorders. METHOD A health sciences librarian developed a search strategy to include four key inclusion criteria of original research study, population included children with CP, study employed IGA, available in English. The available literature was organized into six study categories: reliability and validity, documentation of subgroups or model development, IGA for clinical decision making, effectiveness of treatments that depend on IGA, cost effectiveness, IGA used to evaluate the outcome of surgical, medical or rehabilitation treatment. RESULTS 909 studies met the inclusion criteria and were placed into the six study categories. 14 % of studies were in reliability and validity, 33 % in subgroups or modeling, 2% in IGA for clinical decision making, 2% in treatments that depend on IGA, 1% in cost effectiveness, and 49 % of studies had IGA used as an outcome measure for treatment. SIGNIFICANCE This scoping review has documented the wide range, diversity and extent of original research studies investigating the use of IGA for the clinical management of children with CP related gait disorders. The large volume of studies provides a basis for future work to develop a CPG about the use of IGA for the clinical management of children with CP related gait disorders.
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Affiliation(s)
- Rebecca A States
- Long Island University - Brooklyn, Department of Physical Therapy, United States
| | - Joseph J Krzak
- Midwestern University, Physical Therapy Program, Downers Grove, IL, United States; Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, United States
| | - Yasser Salem
- Hofstra University, School of Health Professions and Human Services, United States; Cairo University, Faculty of Physical Therapy, Egypt
| | - Ellen M Godwin
- Long Island University - Brooklyn, Department of Physical Therapy, United States
| | - Amy Winter Bodkin
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, United States
| | - Mark L McMulkin
- Walter E. & Agnes M. Griffin Motion Analysis Center, Shriners Hospitals for Children, Spokane, WA, United States.
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10
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Ganokroj P, Chaowalitwong J, Kerdsomnuek P, Sudjai N, Lertwanich P, Vanadurongwan B. Three-dimensional motion analysis of ten common Asian sitting positions in daily living and factors affect range of hip motions. BMC Musculoskelet Disord 2021; 22:618. [PMID: 34253220 PMCID: PMC8276444 DOI: 10.1186/s12891-021-04487-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sitting involves many activities of daily life and requires most motion in the hip joint. Asians have more hip flexion and external rotation motions than Westerners owing to cultural and lifestyle differences. Being aware of the normal range of hip motion is essential in clinical practice. Limited research has focused on the hip motions of common sitting positions. The objective was to determine the hip motions of 10 common sitting positions, and to determine whether gender or being overweight affects the range of hip motions. METHODS An experimental cross-sectional study was conducted to determine hip motions by using a standard, three-dimensional, motion-analysis system. Healthy subjects performed 10 sitting positions during 3 trials. All hip-kinematic data were measured on the dominant leg of each participant, except for the right- and left-monk positions (both hips were analyzed). Density plots were constructed and statistical analyses were performed to detect the differences between groups (male and female; non-overweight and overweight). RESULTS The 48 participants comprised 24 males and 24 females. Most were right-leg dominant (45 participants, 93.8%). Of the 22 participants in the overweight group (body mass index ≥23 kg/m2), 18 (75%) were male. Squatting showed the highest flexion angle (99.7°, 47.3°-122°). Cross-legged sitting had the highest abduction angle (28.9°, 9.9°-45.7°) and the largest external rotation angle (62°, 37.6°-81.7°). In the female group, there were trends toward a greater flexion angle (4 out of 10 sitting positions) and a smaller abduction angle (6 out of 9 positions), with P values < 0.05. As to body weight, the overweight participants had a smaller flexion angle but a greater abduction angle, with 5 out of 9 positions having a P value < 0.05. Kinematic data of the transverse plane revealed that the heterogeneity of the rotational angles depended on the sitting position. CONCLUSIONS This study provided the functional hip motions of common Asian sitting positions. The kinematic data can be utilized in clinical practice as reference values to determine safe positions. Gender and being overweight affected the hip angles in the sagittal and frontal planes. TRIAL REGISTRATION Number TCTR20181021004 , retrospectively registered at the Thai Clinical Trials Registry (http//:www.clinicaltrials.in.th).
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Affiliation(s)
- Phob Ganokroj
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Jirayu Chaowalitwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Pichitpol Kerdsomnuek
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Narumol Sudjai
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Pisit Lertwanich
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Bavornrat Vanadurongwan
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 2 Prannok Road, Bangkok Noi, Bangkok, 10700, Thailand.
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Lahkar BK, Rohan PY, Assi A, Pillet H, Bonnet X, Thoreux P, Skalli W. Development and evaluation of a new methodology for Soft Tissue Artifact compensation in the lower limb. J Biomech 2021; 122:110464. [PMID: 33932915 DOI: 10.1016/j.jbiomech.2021.110464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 03/22/2021] [Accepted: 04/14/2021] [Indexed: 01/12/2023]
Abstract
Skin Marker (SM) based motion capture is the most widespread technique used for motion analysis. Yet, the accuracy is often hindered by Soft Tissue Artifact (STA). This is a major issue in clinical gait analysis where kinematic results are used for decision-making. It also has a considerable influence on the results of rigid body and Finite Element (FE) musculoskeletal models that rely on SM-based kinematics to estimate muscle, contact and ligament forces. Current techniques devised to compensate for STA, in particular multi-body optimization methods, often consider simplified joint models. Although joint personalization with anatomical constraints has improved kinematic estimation, these models yet don't represent a fully reliable solution to the STA problem, thus allowing us to envisage an alternative approach. In this perspective, we propose to develop a conceptual FE-based model of the lower limb for STA compensation and evaluate it for 66 healthy subjects under level walking motor task. Both hip and knee joint kinematics were analyzed, considering both rotational and translational joint motion. Results showed that STA caused underestimation of the hip joint kinematics (up to 2.2°) for all rotational DoF, and overestimation of knee joint kinematics (up to 12°) except in flexion/extension. Joint kinematics, in particular the knee joint, appeared to be sensitive to soft tissue stiffness parameters (rotational and translational mean difference up to 1.5° and 3.4 mm). Analysis of the results using alternative joint representations highlighted the versatility of the proposed modeling approach. This work paves the way for using personalized models to compensate for STA in healthy subjects and different activities.
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Affiliation(s)
- Bhrigu K Lahkar
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France.
| | - Pierre-Yves Rohan
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France
| | - Ayman Assi
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France; Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - Helene Pillet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France
| | - Xavier Bonnet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France
| | - Patricia Thoreux
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France; Université Sorbonne Paris Nord, Bobigny, France
| | - Wafa Skalli
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris, France
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Karam M, Bizdikian AJ, Khalil N, Bakouny Z, Obeid I, Ghanimeh J, Labaki C, Mjaess G, Karam A, Skalli W, Kharrat K, Ghanem I, Assi A. Alterations of 3D acetabular and lower limb parameters in adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:2010-2017. [PMID: 32246232 DOI: 10.1007/s00586-020-06397-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/11/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the 3D deformity of the acetabula and lower limbs in subjects with adolescent idiopathic scoliosis (AIS) and their relationship with spino-pelvic alignment. METHODS Two hundred and seventy-four subjects with AIS (frontal Cobb: 33.5° ± 18° [10°-110°]) and 84 controls were enrolled. All subjects underwent full-body biplanar X-rays with subsequent 3D reconstructions. Classic spino-pelvic and lower limb parameters were collected as well as acetabular parameters: acetabular orientation in the 3 planes (tilt, anteversion and abduction), center-edge angle (CEA) and anterior and posterior sector angles. Subjects with AIS were represented by both lower limb sides and classified by elevated (ES) or lowered (LS), depending on the frontal pelvic obliquity. Parameters were then compared between groups. Determinants of acetabular and lower limb alterations were investigated among spino-pelvic parameters. RESULTS Acetabular abduction was higher on the ES in AIS (59.2° ± 6°) when compared to both LS (55.6° ± 6°) and controls (57.5° ± 3.9°, p < 0.001). CEA and acetabular anteversion were higher on the LS in AIS (32° ± 6.1°, 20.5° ± 5.7°) when compared to both ES (28.7° ± 5.1°, 19.8° ± 5.1°) and controls (29.8° ± 4.8°, 19.1° ± 4°, respectively, p < 0.001). Anterior sector angle was lower on both ES and LS in AIS when compared to controls. CEA, acetabular abduction and acetabular anteversion were found to be mostly determined (adjusted R2: 0.08-0.32) by pelvic tilt and less by frontal pelvic obliquity, frontal Cobb and T1T12. CONCLUSIONS Subjects with AIS had a more abducted acetabulum at the lowered side, more anteverted acetabulum and a lack of anterior coverage of both acetabula. These alterations were strongly related to pelvic tilt.
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Affiliation(s)
- Mohammad Karam
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Aren Joe Bizdikian
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Nour Khalil
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Ziad Bakouny
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | | | - Joe Ghanimeh
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Chris Labaki
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Georges Mjaess
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Aya Karam
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Wafa Skalli
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Khalil Kharrat
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Ismat Ghanem
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon
| | - Ayman Assi
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon.
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France.
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Sensor-to-Segment Calibration Methodologies for Lower-Body Kinematic Analysis with Inertial Sensors: A Systematic Review. SENSORS 2020; 20:s20113322. [PMID: 32545227 PMCID: PMC7309059 DOI: 10.3390/s20113322] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
Kinematic analysis is indispensable to understanding and characterizing human locomotion. Thanks to the development of inertial sensors based on microelectronics systems, human kinematic analysis in an ecological environment is made possible. An important issue in human kinematic analyses with inertial sensors is the necessity of defining the orientation of the inertial sensor coordinate system relative to its underlying segment coordinate system, which is referred to sensor-to-segment calibration. Over the last decade, we have seen an increase of proposals for this purpose. The aim of this review is to highlight the different proposals made for lower-body segments. Three different databases were screened: PubMed, Science Direct and IEEE Xplore. One reviewer performed the selection of the different studies and data extraction. Fifty-five studies were included. Four different types of calibration method could be identified in the articles: the manual, static, functional, and anatomical methods. The mathematical approach to obtain the segment axis and the calibration evaluation were extracted from the selected articles. Given the number of propositions and the diversity of references used to evaluate the methods, it is difficult today to form a conclusion about the most suitable. To conclude, comparative studies are required to validate calibration methods in different circumstances.
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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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Gasparutto X, Wegrzyk J, Rose-Dulcina K, Hannouche D, Armand S. Can the fusion of motion capture and 3D medical imaging reduce the extrinsic variability due to marker misplacements? PLoS One 2020; 15:e0226648. [PMID: 31995610 PMCID: PMC6988975 DOI: 10.1371/journal.pone.0226648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/30/2019] [Indexed: 11/18/2022] Open
Abstract
In clinical gait analysis, measurement errors impede the reliability and repeatability of the measurements. This extrinsic variability can potentially mislead the clinical interpretation of the analysis and should thus be minimised. Skin marker misplacement has been identified as the largest source of extrinsic variability between measurements. The goal of this study was to test whether the fusion of motion capture and 3D medical imaging could reduce extrinsic variability due to skin marker misplacement. The fusion method consists in using anatomical landmarks identified with 3D medical imaging to correct marker misplacements. To assess the reduction of variability accountable to the fusion method, skin marker misplacements were voluntarily introduced in the measurement of the pelvis and hip kinematics during gait for two patients scheduled for unilateral hip arthroplasty and two patients that underwent unilateral hip arthroplasty. The root mean square deviation was reduced by -78 ± 15% and the range of variability by -80 ± 16% for the pelvis and hip kinematics in average. These results showed that the fusion method could significantly reduce the extrinsic variability due to skin marker misplacement and thus increase the reliability and repeatability of motion capture measurements. However, the identification of anatomical landmarks via medical imaging is a new source of extrinsic variability that should be assessed before considering the fusion method for clinical applications.
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Affiliation(s)
- Xavier Gasparutto
- Laboratory of Kinesiology Willy Taillard, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Jennifer Wegrzyk
- Laboratory of Kinesiology Willy Taillard, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Kevin Rose-Dulcina
- Laboratory of Kinesiology Willy Taillard, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Didier Hannouche
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphane Armand
- Laboratory of Kinesiology Willy Taillard, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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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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Passmore E, Graham HK, Sangeux M. Defining the medial-lateral axis of the femur: Medical imaging, conventional and functional calibration methods lead to differences in hip rotation kinematics for children with torsional deformities. J Biomech 2018; 69:156-163. [DOI: 10.1016/j.jbiomech.2018.01.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/09/2018] [Accepted: 01/14/2018] [Indexed: 11/29/2022]
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Detecting Anatomical Leg Length Discrepancy Using the Plug-in-Gait Model. APPLIED SCIENCES-BASEL 2017. [DOI: 10.3390/app7090926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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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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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: 163] [Impact Index Per Article: 20.4] [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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