Cross-Talk Correction Method for Knee Kinematics in Gait Analysis Using Principal Component Analysis (PCA): A New Proposal

Background In 3D gait analysis, the knee joint is usually described by the Eulerian way. It consists in breaking down the motion between the articulating bones of the knee into three rotations around three axes: flexion/extension, abduction/adduction and internal/external rotation. However, the definition of these axes is prone to error, such as the “cross-talk” effect, due to difficult positioning of anatomical landmarks. This paper proposes a correction method, principal component analysis (PCA), based on an objective kinematic criterion for standardization, in order to improve knee joint kinematic analysis. Methods The method was applied to the 3D gait data of two different groups (twenty healthy subjects and four with knee osteoarthritis). Then, this method was evaluated with respect to three main criteria: (1) the deletion of knee joint angle cross-talk (2) the reduction of variance in the varus/valgus kinematic profile (3) the posture trial varus/valgus deformation matching the X-ray value for patients with knee osteoarthritis. The effect of the correction method was tested statistically on variabilities and cross-talk during gait. Results Cross-talk was lower (p<0.05) after correction (the correlation between the flexion-extension and varus-valgus kinematic profiles being annihilated). Additionally, the variance in the kinematic profile for knee varus/valgus and knee flexion/extension was found to be lower and higher (p<0.05), respectively, after correction for both the left and right side. Moreover, after correction, the posture trial varus/valgus angles were much closer to x-ray grading. Conclusion The results show that the PCA correction applied to the knee joint eliminates the cross-talk effect, and does not alter the radiological varus/valgus deformation for patients with knee osteoarthritis. These findings suggest that the proposed correction method produces new rotational axes that better fit true knee motion.

[1]  W. Skalli,et al.  Which method of hip joint centre localisation should be used in gait analysis? , 2014, Gait & posture.

[2]  H. Hotelling.  Analysis of a complex of statistical variables into principal components. , 1933 .

[3]  Won-Sook Lee,et al.  Survey of Formal Methods of Hip Joint Center Calculation in Human Studies , 2013 .

[4]  A Leardini,et al.  Position and orientation in space of bones during movement: anatomical frame definition and determination. , 1995, Clinical biomechanics.

[5]  A Cappozzo,et al.  Femoral anatomical frame: assessment of various definitions. , 2003, Medical engineering & physics.

[6]  Dan K Ramsey,et al.  Biomechanics of the knee: methodological considerations in the in vivo kinematic analysis of the tibiofemoral and patellofemoral joint. , 1999, Clinical biomechanics.

[7]  R. B. Davis,et al.  A gait analysis data collection and reduction technique , 1991 .

[8]  L. Chèze,et al.  Comparison of different calculations of three-dimensional joint kinematics from video-based system data. , 2000, Journal of biomechanics.

[9]  J S Higginson,et al.  Two simple methods for determining gait events during treadmill and overground walking using kinematic data. , 2008, Gait & posture.

[10]  P R Cavanagh,et al.  Three-dimensional kinematics of the human knee during walking. , 1992, Journal of biomechanics.

[11]  M. Schwartz,et al.  A new method for estimating joint parameters from motion data. , 2004, Journal of biomechanics.

[12]  H. Woltring.  3-D attitude representation of human joints: a standardization proposal. , 1994, Journal of biomechanics.

[13]  L. Blankevoort,et al.  The envelope of passive knee joint motion. , 1988, Journal of biomechanics.

[14]  M P Kadaba,et al.  Measurement of lower extremity kinematics during level walking , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[15]  S. Piazza,et al.  Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment. , 2000, Journal of biomechanics.

[16]  P. Ornetti,et al.  Test-retest reliability of 3D kinematic gait variables in hip osteoarthritis patients. , 2011, Osteoarthritis and cartilage.

[17]  Heng Tao Shen,et al.  Principal Component Analysis , 2009, Encyclopedia of Biometrics.

[18]  Alberto Leardini,et al.  Quantitative comparison of five current protocols in gait analysis. , 2008, Gait & posture.

[19]  Joyce P Trost,et al.  Measurement and management of errors in quantitative gait data. , 2004, Gait & posture.

[20]  M P Kadaba,et al.  On the estimation of joint kinematics during gait. , 1991, Journal of biomechanics.

[21]  P R Cavanagh,et al.  ISB recommendations for standardization in the reporting of kinematic data. , 1995, Journal of biomechanics.

[22]  Jos Vanrenterghem,et al.  An evaluation of anatomical and functional knee axis definition in the context of side-cutting. , 2012, Journal of biomechanics.

[23]  V Pinskerova,et al.  The movement of the normal tibio-femoral joint. , 2005, Journal of biomechanics.

[24]  Y. Ishii,et al.  Three-dimensional kinematics of the human knee with intracortical pin fixation. , 1997, Clinical orthopaedics and related research.

[25]  E S Grood,et al.  A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. , 1983, Journal of biomechanical engineering.

[26]  Anthony G Schache,et al.  Defining the knee joint flexion-extension axis for purposes of quantitative gait analysis: an evaluation of methods. , 2006, Gait & posture.

[27]  Kevin A. Ball,et al.  On the problems of describing joint axis alignment. , 2008, Journal of biomechanics.

[28]  A. Cappozzo,et al.  Pelvis and lower limb anatomical landmark calibration precision and its propagation to bone geometry and joint angles , 1999, Medical & Biological Engineering & Computing.

[29]  Louis-Paul Rivest.  A correction for axis misalignment in the joint angle curves representing knee movement in gait analysis. , 2005, Journal of biomechanics.

[30]  L Claes,et al.  Correction of axis misalignment in the analysis of knee rotations. , 2003, Human movement science.

[31]  Suzanne Halliday,et al.  Interobserver Variability of Gait Analysis in Patients With Cerebral Palsy , 2003, Journal of pediatric orthopedics.

[32]  Aurelio Cappozzo,et al.  Enhanced anatomical calibration in human movement analysis. , 2007, Gait & posture.

[33]  B. Nigg,et al.  Tibiofemoral and tibiocalcaneal motion during walking: external vs. skeletal markers , 1997 .

[34]  Herman J. Woltring,et al.  A fortran package for generalized, cross-validatory spline smoothing and differentiation , 1986 .

[35]  William R Taylor,et al.  A survey of formal methods for determining functional joint axes. , 2007, Journal of biomechanics.

[36]  Richard Baker,et al.  A new approach to determine the hip rotation profile from clinical gait analysis data , 1999 .

[37]  S. J. Tupling,et al.  Use of cardan angles to locate rigid bodies in three-dimensional space , 1987, Medical and Biological Engineering and Computing.

[38]  Ewa Szczerbik,et al.  The influence of knee marker placement error on evaluation of gait kinematic parameters. , 2011, Acta of bioengineering and biomechanics.

[39]  Karl Pearson F.R.S..  LIII. On lines and planes of closest fit to systems of points in space , 1901 .

[40]  A. Shirazi-Adl,et al.  Cruciate coupling and screw-home mechanism in passive knee joint during extension--flexion. , 2005, Journal of biomechanics.

[41]  I. Charlton,et al.  Repeatability of an optimised lower body model. , 2004, Gait & posture.

[42]  M. Morris,et al.  The reliability of three-dimensional kinematic gait measurements: a systematic review. , 2009, Gait & posture.

[43]  H. Rubash,et al.  Sensitivity of the knee joint kinematics calculation to selection of flexion axes. , 2004, Journal of biomechanics.