Wand-mounted lateral markers are less prone to misplacement and soft-tissue artefacts than skin-mounted markers when using the conventional gait model

Abstract

BackgroundThe conventional gait model (CGM1) is extensively used for 3D clinical gait analysis. It uses lateral wand-mounted markers for the thigh and shank segments to avoid colinearity of the tracking markers. However, gait analysts may be tempted to use skin-mounted markers instead. Research question:Does it matter if the lateral markers for the thigh and shank segments are mounted on wands or directly taped to the skin when using the CGM1? MethodsGait sessions from 147 and 73 patients equipped with wand-mounted and skin-mounted markers, respectively, were extracted from the database of a single clinical gait laboratory. The marker trajectories were reprocessed with the CGM1. The risk of marker colinearity was assessed from the planar angle constructed from the proximal joint center, the lateral joint marker and the lateral segmental marker (i.e. skin or wand). We assessed the effect of marker misplacement and soft-tissue artefact on kinematics. Results:The averaged planar angles calculated from static ranged from 10° to 30° and 7° to 21° for the skin-mounted thigh and shank markers respectively, while planar angles were always larger than 25° with wand-mounted markers. One cm misplacement of the thigh marker altered hip rotation by 10° if skin-mounted against 5° if wand-mounted. Soft tissue artefact led to 7.6° or 4.3° depending if it was skin- or wand-mounted, respectively. Significance:Our analysis showed moderate risk of collinearity, increased effect of STA, and larger potential effect of marker misplacement with the use of skin- rather than wand-mounted markers.