Marker placement sensitivity of the Oxford and Rizzoli foot models in adults and children

Wouter Schallig,Josien C Van Den Noort,Mario Maas,Jaap Harlaar,Marjolein M Van Der Krogt

doi:10.1016/j.jbiomech.2021.110629

Wouter Schallig, Josien C Van Den Noort + Show 3 more

Open Access

https://doi.org/10.1016/j.jbiomech.2021.110629

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Abstract

Understanding the effect of individual marker misplacements is important to improve the repeatability and aid to the interpretation of multi-segment foot models like the Oxford and Rizzoli Foot Models (OFM, RFM). Therefore, this study aimed to quantify the effect of controlled anatomical marker misplacement on multi-segment foot kinematics (i.e. marker placement sensitivity) as calculated by OFM and RFM in a range of foot sizes. Ten healthy adults and nine children were included. A combined OFM and RFM marker set was placed on their right foot and a static standing trial was collected. Each marker was replaced ± 10 mm in steps of 1 mm over the three axes of a foot coordinate system. For each replacement the change in segment orientation (tibia, hindfoot, midfoot, forefoot) was calculated with respect to the reference pose in which no markers were replaced. A linear fit was made to calculate the sensitivity of segment orientation to marker misplacement in °/mm. Additionally, the effect of foot size on the sensitivity was determined using linear regressions. For every foot segment of both models, at least one marker had a sensitivity ≥ 1.0°/mm. Highest values were found for the markers at the posterior aspect of the calcaneus in OFM (1.5°/mm) and the basis of the second metatarsal in RFM (1.4°/mm). Foot size had a small effect on 40% of the sensitivity values. This study identified markers of which consistent placement is critical to prevent clinically relevant errors (>5°). For more repeatable multi-segment models, the role of these markers within the models’ definitions needs to be reconsidered.

Highlights

Foot and ankle problems during gait are regularly assessed with 3dimensional (3D) marker-based gait analyses
The nine sensitivity values for each marker of Oxford Foot Model (OFM) and Rizzoli Foot Model (RFM) and the corresponding effect of foot size on these values are shown in Table 2 and 3
69% of the sensitivity values were ≤ 0.2◦/mm, indicating that the segment orientation changed < 0.2◦ when a marker was mis placed one mm

Summary

Introduction

Foot and ankle problems during gait are regularly assessed with 3dimensional (3D) marker-based gait analyses. In multi-segment foot models, the repeatability between days or testers is primarily subject to variability of marker placement (Carson et al, 2001). This variability is reported to be around 5 mm, with outliers up to 13 mm between testers (Bishop et al, 2013; Deschamps et al, 2014). The repeatability of OFM and RFM kinematics has been assessed frequently in both healthy and pathological pop ulations (Caravaggi et al, 2011; Deschamps et al, 2012; Di Marco et al, 2016; Mahaffey et al, 2013; McCahill et al, 2018; Stebbins et al, 2006)

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