Reliability and Accuracy in Three-Dimensional Gait Analysis: A Comparison of Two Lower Body Protocols

Stief, Felix; Böhm, Harald; Michel, Katja; Schwirtz, Ansgar; Döderlein, Leonhard

doi:10.1123/jab.29.1.105

Cited by 96 publications

(54 citation statements)

References 18 publications

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“…Accurate and reliable placement of these wand marker is challenging [28] and errors in the definition of the knee flexion-extension axis can significantly impact on knee internal-external rotations [29]. Unlike the PiG-DK model, our 6-DoF-DK model defined ACS independently of the wand markers and showed on average smaller variations in joint kinematics (SD 2.7±2.0º) and kinetics (SD 0.033±0.016Nm/kg) than the PiG-DK model (SD 3.2±2.8º and 0.044±0.021Nm/kg), which confirmed the findings from [30].…”

Section: Discussionsupporting

confidence: 83%

Reliability of four models for clinical gait analysis

et al. 2017

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Three-dimensional gait analysis (3DGA) has become a common clinical tool for treatment planning in children with cerebral palsy (CP). Many clinical gait laboratories use the conventional gait analysis model (e.g. Plug-in-Gait model), which uses Direct Kinematics (DK) for joint kinematic calculations, whereas, musculoskeletal models, mainly used for research, use Inverse Kinematics (IK). Musculoskeletal IK models have the advantage of enabling additional analyses which might improve the clinical decision-making in children with CP. Before any new model can be used in a clinical setting, its reliability has to be evaluated and compared to a commonly used clinical gait model (e.g. Plug-in-Gait model) which was the purpose of this study. Two testers performed 3DGA in eleven CP and seven typically developing participants on two occasions. Intra- and inter-tester standard deviations (SD) and standard error of measurement (SEM) were used to compare the reliability of two DK models (Plug-in-Gait and a six degrees-of-freedom model solved using Vicon software) and two IK models (two modifications of 'gait2392' solved using OpenSim). All models showed good reliability (mean SEM of 3.0° over all analysed models and joint angles). Variations in joint kinetics were less in typically developed than in CP participants. The modified 'gait2392' model which included all the joint rotations commonly reported in clinical 3DGA, showed reasonable reliable joint kinematic and kinetic estimates, and allows additional musculoskeletal analysis on surgically adjustable parameters, e.g. muscle-tendon lengths, and, therefore, is a suitable model for clinical gait analysis.

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Section: Discussionsupporting

confidence: 83%

Reliability of four models for clinical gait analysis

et al. 2017

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“…In this study, we used the biomechanical model PlugInGait for calculating kinematic parameters. Although this model has some limitations that may lead to notable small but not significant differences between groups, McGinley et al and Stief et al have shown that when accurately used, this model is applicable for clinical purposes. An experienced tester places the skin markers to minimize potential measurements errors.…”

Section: Discussionmentioning

confidence: 99%

Stair dimension affects knee kinematics and kinetics in patients with good outcome after TKA similarly as in healthy subjects

Trinler

Baty

Mündermann

et al. 2016

Journal Orthopaedic Research

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Joint biomechanics during stair walking may contain important information on functional deficits in patients with orthopaedic conditions but depend on the stair dimension. The goal of this study was to compare knee kinematics and kinetics between patients with good outcome 2 years after total knee arthroplasty (TKA) and age-matched controls during stair ascent and descent at two different stair heights. Principal component analysis was used to detect differences in gait mechanics between 15 patients and 15 controls at different stair conditions. Linear mixed models showed differences in knee kinematic and kinetic patterns (in flexion/extension and abduction/adduction) between stair heights. The knee adduction angle was more affected by stair heights in stair ascending whereas knee adduction moment and knee power were more affected during stair descent. Some stair by height and subject effects were small but not significant. Overall, good outcome after TKA is reflected in close-to-normal knee biomechanics during stair walking. Specific stair configuration must be considered when comparing joint biomechanics between subject groups and studies.

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“…Ground reaction forces were recorded synchronously at 1,000 Hz using two AMTI force plates (Advanced Mechanical Technology, Inc., Watertown, MA) situated at the mid‐point of the 15 m long level walkway. To improve the reliability and accuracy when analyzing frontal plane gait data, a lower body protocol (called MA), described in a previous investigation, was used . In addition to the standardized Plug‐in‐Gait marker set, reflective markers on the medial malleolus, medial femoral condyle, and greater trochanter were applied to determine the joint centers of rotation for the ankle, knee, and hip.…”

Section: Methodsmentioning

confidence: 99%

Abnormal loading of the hip and knee joints in unilateral hip osteoarthritis persists two years after total hip replacement

Stief

Schmidt

Drongelen³

et al. 2018

Journal Orthopaedic Research

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A total hip replacement (THR) is a common and routine procedure to reduce pain and restore normal activity. Gait analysis can provide insights into functional characteristics and dynamic joint loading situation not identifiable by clinical examination or static radiographic measures. The present prospective longitudinal study tested whether 2 years after surgery a THR would restore dynamic loading of the knee and hip joints in the frontal plane to normal. Instrumented gait analysis was performed shortly before surgery and approximately 2 years after THR on 15 unilateral hip osteoarthritis (OA) patients. 15 asymptomatic matched individuals were recruited as healthy controls. Results showed that abnormal joint loading persisted 2 years after THR. The 2nd external knee adduction moment in terminal stance in the affected (-34%, p = 0.002, d = 1.22) and non-affected limb (-25%, p = 0.035, d = 0.81) was lower compared to controls and thus indicated a shift in the knee joint load distribution from medial to lateral. A correlation analysis revealed that a smaller hip range of motion explained 46% of 2nd knee adduction moment alterations. In contrast, the 2nd external hip adduction moment in terminal stance was postoperatively higher in the affected (+22%, p = 0.007, d = 1.04) and non-affected limb (+22%, p = 0.005, d = 1.05). Here, 51% of 2nd hip adduction moment alterations can be explained with a greater hip adduction angle. Patients with a THR may therefore be at higher risk for abnormal joint loading and thus for the development of OA in other joints of the lower extremities. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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Reliability and Accuracy in Three-Dimensional Gait Analysis: A Comparison of Two Lower Body Protocols

Cited by 96 publications

References 18 publications

Reliability of four models for clinical gait analysis

Reliability of four models for clinical gait analysis

Stair dimension affects knee kinematics and kinetics in patients with good outcome after TKA similarly as in healthy subjects

Abnormal loading of the hip and knee joints in unilateral hip osteoarthritis persists two years after total hip replacement

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