Multi-Segmented Foot and Ankle Model

Sensitivity to Marker Placement in the TSRHC Foot Model

Multi-segmented foot and ankle (FandA) models provide more information regarding intrinsic foot motion compared to rigid-body models due to additional markers on bony landmarks of the foot. Marker placement sensitivity is a concern, especially in patients with bony abnormalities, because kinematics vary with marker placement deviations. PURPOSE: Assess kinematic changes due to marker placement error using the TSRHC multi-segmented FandA model. METHODS: Our participant was an 18yo female lacking any prior orthopedic conditions. The Plug-in-Gait model was used with the TSRHC model. An experienced clinician executed all marker placements, systematically moving each marker approximately 2.5mm within two planes. Three dynamic trials were collected for each condition, and static trials were used to calculate exact distances markers moved. Six force plates (AMTI) were utilized to confirm a consistent walking pattern. Graphs analyzed included: 1)PIG–ankle dorsiflexion, foot rotation, foot progression angle, 2)TSRHC–hindfoot, forefoot, FF-tibia. For each condition, the peaks of affected kinematic graphs were compared to assess correlations. Intra-trial error was determined by the maximum difference across walking trials. CONCLUSION: The hindfoot was most sensitive to transverse plane marker placement errors. Markers on metatarsals periodically rose vertically when moved laterally due to foot curvature causing errors in the sagittal plane as well. The forefoot also had transverse plane errors when metatarsal markers were moved. This case study illustrates the importance of proper marker placement training when utilizing a multi-segmented foot model. A thorough understanding of a utilized model is imperative, including how sensitive the model is to marker placement.
Listed In: Biomechanics, Gait, Orthopedic Research