The reliability, accuracy and minimal detectable difference of a multi-segment kinematic model of the foot-shoe complex.

Kinematic models are commonly used to quantify foot and ankle kinematics, yet no marker sets or models have been proven reliable or accurate when wearing shoes. Further, the minimal detectable difference of a developed model is often not reported. We present a kinematic model that is reliable, accurate and sensitive to describe the kinematics of the foot-shoe complex and lower leg during walking gait. In order to achieve this, a new marker set was established, consisting of 25 markers applied on the shoe and skin surface, which informed a four segment kinematic model of the foot-shoe complex and lower leg. Three independent experiments were conducted to determine the reliability, accuracy and minimal detectable difference of the marker set and model. Inter-rater reliability of marker placement on the shoe was proven to be good to excellent (ICC=0.75-0.98) indicating that markers could be applied reliably between raters. Intra-rater reliability was better for the experienced rater (ICC=0.68-0.99) than the inexperienced rater (ICC=0.38-0.97). The accuracy of marker placement along each axis was <6.7 mm for all markers studied. Minimal detectable difference (MDD90) thresholds were defined for each joint; tibiocalcaneal joint--MDD90=2.17-9.36°, tarsometatarsal joint--MDD90=1.03-9.29° and the metatarsophalangeal joint--MDD90=1.75-9.12°. These thresholds proposed are specific for the description of shod motion, and can be used in future research designed at comparing between different footwear.

[1]  Christiane,et al.  World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. , 2004, Journal international de bioethique = International journal of bioethics.

[2]  A. Leardini,et al.  Rear-foot, mid-foot and fore-foot motion during the stance phase of gait. , 2007, Gait & posture.

[3]  D. Winter,et al.  Talocrural and talocalcaneal joint kinematics and kinetics during the stance phase of walking. , 1991, Journal of biomechanics.

[4]  A Leardini,et al.  Repeatability of a multi-segment foot protocol in adult subjects. , 2011, Gait & posture.

[5]  Jason T Long,et al.  Repeatability and sources of variability in multi-center assessment of segmental foot kinematics in normal adults. , 2010, Gait & posture.

[6]  Dominic Thewlis,et al.  A radiological method to determine the accuracy of motion capture marker placement on palpable anatomical landmarks through a shoe , 2011 .

[7]  P. Pidcoe,et al.  Repeatability of the modified Oxford foot model during gait in healthy adults. , 2011, Gait & posture.

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

[9]  Hartmut Witte,et al.  ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion--part I: ankle, hip, and spine. International Society of Biomechanics. , 2002, Journal of biomechanics.

[10]  Rebecca Shultz,et al.  Determining the maximum diameter for holes in the shoe without compromising shoe integrity when using a multi-segment foot model. , 2012, Medical engineering & physics.

[11]  J J O'Connor,et al.  Kinematic analysis of a multi-segment foot model for research and clinical applications: a repeatability analysis. , 2001, Journal of biomechanics.

[12]  D Brunt,et al.  The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. , 1993, The Journal of orthopaedic and sports physical therapy.

[13]  A. J. van den Bogert,et al.  Effects of shoe sole construction on skeletal motion during running. , 2001, Medicine and science in sports and exercise.

[14]  Wolzt,et al.  World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. , 2003, The Journal of the American College of Dentists.

[15]  Hylton B Menz,et al.  A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements , 2009, Journal of foot and ankle research.

[16]  Thomas D. Collins,et al.  A six degrees-of-freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set. , 2009, Gait & posture.

[17]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[18]  Leslie G. Portney Dpt PhD Fapta,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

[19]  S. Jan.  Color Atlas of Skeletal landmark definitions. Guidelines for reproducible manual and virtual palpations. , 2007 .

[20]  J J O'Connor,et al.  Bone position estimation from skin marker co-ordinates using global optimisation with joint constraints. , 1999, Journal of biomechanics.

[21]  G F Harris,et al.  A system for the analysis of foot and ankle kinematics during gait. , 1996, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

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

[23]  L. Portney,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

[24]  Kaat Desloovere,et al.  Body of evidence supporting the clinical use of 3D multisegment foot models: a systematic review. , 2011, Gait & posture.