Article

Marker-based gait analysis of the lower limb that uses assumptions of generic
anatomical morphology can be susceptible to errors, particularly in subjects with
high levels of soft tissue coverage. We hypothesize that a functional approach
for assessing skeletal kinematics, based on the application of techniques to
reduce soft tissue artefact and functionally identify joint centres and axes, can
more reliably (repeatably and reproducibly) assess the skeletal kinematics than a
standard generic regression approach. Six healthy adults each performed 100
repetitions of a standardized motion, measured on four different days and by five
different observers. Using OSSCA, a combination of functional approaches to
reduce soft tissue artefact and identify joint centres and axes, the lengths of
the femora and tibiae were determined to assess the inter-day and inter-observer
reliability, and compared against a standard generic regression approach. The
results indicate that the OSSCA was repeatable and reproducible (ICC lowest bound
0.87), but also provided an improvement over the regression approach (ICC lowest
bound 0.69). Furthermore, the analysis of variance revealed a statistically
significant variance for the factor "observers" (p<0.01; low-reproducibility)
when using the regression approach for determining the femoral lengths. Here,
this non-invasive, rapid and robust approach has been demonstrated to allow the
repeatable and reproducible identification of skeletal landmarks, which is
insensitive to marker placement and measurement session. The reliability of the
OSSCA thus allows its application in clinical studies for reducing the
uncertainty of approach-induced systematic errors.
CI - Copyright 2010 Elsevier B.V. All rights reserved.

Langue : ANGLAIS