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Repeatability of a multi-segment foot model
with a 15-marker set in healthy children
Eo Jin Kim, MD1, Dong Yeon Lee, MD2,,Doo Jae Lee, MD2, Seong Hyun Kim, BS2, Hyo Jung Yoo, BS2, Won Jun Yoo, MD2, In Ho Choi, MD2
1Dept. of Orthopedic Surgery, Hanil General Hospital, Korea2Dept. of Orthopedic Surgery, Seoul National University Hospital, Korea
NO CONFLICT TO DISCLOSE
Repeatability of a multi-segment foot model with a
15-marker set in healthy children
Eo Jin Kim, MD, Dong Yeon Lee, MD, Doo Jae Lee, MD, Seong Hyun Kim, Hyo Jung Yoo, Won Jun Yoo, MD,
In Ho Choi, MD
Our disclosure is in the Final AOFAS Mobile App.
I have no potential conflicts with this presentation.
Introduction
• 3D multi-segment foot models (3D MFMs)
- Analysis of dynamic foot kinematics for diagnosis and
treatment
• 3D MFM using a 15 marker set
- Demonstrated intra-session and inter-session repeatability
comparable with other MFMs in the assessment of foot
motion in healthy adults
• Purpose
- To determine the reliability of the 3D MFM with a 15-
marker set in normal children
Material & Methods
• 40 feet of twenty healthy children
- 10 males, 10 females
- Age : 10-12 yrs
Group A (N=10) Group B (N=10)
1st visit 2nd visit 1st visit 2nd visit
Marker
placement
Operator A
(N=5)4wks
later
Operator A
(N=5)
Operator A
(N=5)4wks
later
Operator B
(N=5)
Operator B
(N=5)
Operator B
(N=5)
Operator B
(N=5)
Operator A
(N=5)
3D MFM using a 15 marker set
• Motion capture & analysis (Motion Analysis Co.)
-12 CCD cameras with a 3D optical motion system
- Eva Real-Time software
- Foot 3D Multi-Segment Software
• Coefficients of Multiple Correlation (CMC) and
Intra-Class Correlation (ICC) were calculated.
Results
• Repeatability of foot kinematics
Distance Map
Talar Navicular
Intra-session CMC Inter-session CMC Inter-rater CMC
Present study Healthy adults6 Present study Healthy adults6 Present study
HalluxFlex/Ext 0.962 0.971 0.859 0.796 0.880
Rot 0.874 0.970 0.955 0.951 0.746
Hind
Foot
Flex/Ext 0.913 0.931 0.923 0.837 0.913Pro/Sup 0.858 0.890 0.842 0.697 0.664
Rot 0.892 0.927 0.371 0.728 0.623
Arch
Height 0.954 0.959 0.788 0.798 0.862Length 0.980 0.909 0.975 0.980 0.971Index* 0.950 0.952 0.797 0.729 0.851
Fore
foot
Flex/Ext 0.956 0.978 0.943 0.840 0.888Pro/Sup 0.786 0.993 0.748 0.687 0.482
Rot 0.901 0.972 0.726 0.813 0.724
*Arch index = Arch height / Arch length
Results
• Difference of two sessions
Distance Map
Talar Navicular
Gap (mean)Standard error Range
Present study Healthy adults6
HalluxFlex/Ext 3.99 4.0 0.12 (1.65, 6.53)
Rot 2.58 3.6 0.06 (0.72, 8.07)
Hind
Foot
Flex/Ext 2.55 1.3 0.05 (1.32, 3.92)
Pro/Sup 3.85 4.3 0.04 (0.86, 10.22)
Rot 6.51 3.0 0.10 (1.31, 11.32)
Arch
Height 5.84 4.9 0.05 (0.41, 14.25)
Length 1.85 2.0 0.03 (0.57, 6.31)
Index* 0.03 0.03 0.00 (0.00, 0.08)
Fore
foot
Flex/Ext 2.26 2.6 0.04 (0.94, 4.95)
Pro/Sup 3.51 3.0 0.06 (1.39, 9.75)
Rot 4.27 3.9 0.09 (2.20, 7.53)
*Arch index = Arch height / Arch length
Comparison between 1st and 2nd visit
Discussion
• Inter-session CMC of hindfoot rotation, Inter-rater
CMC of hindfoot pronation/supination, rotation
and forefoot pronation/supination has significantly
lower CMC values.
• Considering lower repeatability in hindfoot
rotation and pronation/supination, hindfoot
markers would be the most critical markers for
reliability of foot motion analysis in children.
Conclusion
• The intra-session and inter-session repeatability of
3D Foot system in children were comparable to
those in healthy adults except hindfoot parameters.
• We think that 3D MFM using a 15 marker set might
be used for evaluation of inter-segemental foot
motion in children, with caution in interpretation
of hindfoot foot parameters.
References1. Stebbins, J. et al. (2006) Repeatability of a model for measuring multi-segment
foot kinematics in children. Gait & Posture, 23(4):401-10.
2. Carson, MC. et al. (2001) Kinematic analysis of a multi-segment foot model for
research and clinical applications: a repeatability analysis. Journal of Biomech,
34(10):1299-307.
3. Kidder, SM. et al. (1996) A system for the analysis of foot and ankle kinematics
during gait. IEEE Transactions on Rehabilitation Engineering, 4(1):25-32.
4. Henley, J. et al. (2008) Reliability of a clinically practical multisegment foot marker
set/model. Boca Raton, pp. 445–63.
5. Bruening, DA. et al. (2012) Analysis of a kinetic multi-segment foot model. Part I:
Model repeatability and kinematic validity. Gait & Posture, 35(4):529-34
6. Seo, SG. et al. (2014) Repeatability of a multi-segment foot model with a 15-
marker set in healthy adults Journal of foot and ankle research, 7:24.
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