Repeatability Analysis of the OrthoTrak 3D Multi-Segment Foot Model: Kinematic Analysis

Dong Yeon Lee, MD, Sang Gyo Seo, MD, Kyoung Min Lee, MD, Hey Sun Park, MS, and In Ho Choi, MD

Dept. of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea

2012 AOFAS Annual Summer Meeting

Repeatability Analysis of the OrthoTrak 3D Multi-Segment Foot Model: Kinematic Analysis

Dong Yeon Lee, MD, Sang Gyo Seo, MD, Kyoung Min Lee, MD, Hey Sun Park, MS, and In Ho Choi, MD

My disclosure is in the

Final AOFAS Program Book.

I have no potential conflicts with

this presentation.

3D Multi-Segment Foot Models • To measure in vivo foot kinematics

• Increasing evidences for published models…

Name of Model Methodological Study Clinical Study

Milwaukee Foot Model Kidder et al. (1996), Meyer

et al. (2004)

Khazzam et al. (2007) for RA Canseco K et al. (2008) for Hallux

rigidus

Oxford Foot Model Carson et al. (2001) Thelologis et al. (2003) for Clubfoot

Turner et al. (2006, 2008) for RA

Heidelberg Foot Measurement Method

Simon et al. (2006) Wolf et al. (2008) for Footwear

Model by Leardini Leardini et al. (2007)

Deschamps et al. (2012)

Model by Jenkyn Jenkyn & Nicol (2007,

2009)

OrthoTrak Foot3D (-)

OrthoTrak Foot3D Model • OrthoTrak Software (Motion Analysis Co., Santa

Rosa, CA)

• 6 segments: Lower leg, Hindfoot, Lateral forefoot, Medial forefoot, Whole forefoot, Hallux

• 10 markers on foot & ankle

Materials & Methods • Twenty volunteers (Korean)

• 10 males & 10 females

• 3 strides from 5 separate trials

• Retest at interval of 4 weeks

• 12 cameras, 3D optical motion capture system (Motion Analysis Co., Santa Rosa. CA)

• Eva Real-Time software (EVaRT, Motion Analysis Co.)

Demographic Features

Average (Range)

Age 28.9 yrs (20~35)

Weight 66.5 kg

(44.9 ~ 105.5)

Height 168.5 cm

(154.3 ~ 181.5)

BMI 23.3 kg/m2

(16.8 ~ 32.2)

SMD 86.0 cm

(76.7 ~ 96)

Foot length 24.5 cm

(21.5 ~ 26.9)

Foot width 9.7 cm

(8.6 ~11.0)

Results

1st visit(N=20) 2nd visit(N=20)

-20

-10

0

10

20

30

40

0 20 40 60 80

Dorsiflextion

…

Flex/Extension

-20

-10

0

10

0 20 40 60 80

Varus

…

HalluxRotation

15

25

35

45

55

0 20 40 60 80

Arch Height

100 110 120 130 140 150 160 170 180 190 200 210

0 20 40 60 80

Arch Length

-10

0

10

20

0 20 40 60 80

Supinated

…

Pro/Supination

0.1

0.2

0.3

0 20 40 60 80

Arch Index

-10

0

10

20

0 20 40 60 80

Internal

…

HindFoot Rotaion

-20

-10

0

10

0 20 40 60 80

Int

…

Foot Progression

-20

-10

0

10

20

0 20 40 60 80

Dorsiflextion

…

Flex/Extension

-10

0

10

20

0 20 40 60 80

Supinated

…

Pro/Supination

• Similar range & pattern between session

Hallux

Hindfoot

Arch

Results

1st visit(N=20) 2nd visit(N=20)

• Similar range & pattern between session

Forefoot

Medial Forefoot

Lateral Forefoot

-20

-10

0

10

0 20 40 60 80

Dorsiflextion

…

Flex/Extension

-10

0

10

20

0 20 40 60 80

Supinated

…

Pro/Supination

-10

0

10

0 20 40 60 80

Dorsiflextion

…

Flex/Extension

-20

-10

0

10

0 20 40 60 80

Dorsiflextion

…

Flex/Extension

-10

0

10

20

30

0 20 40 60 80

Supinated

…

Pro/Supination

-10

0

10

20

0 20 40 60 80

Supinated

…

Pro/Supination

-20

-10

0

10

0 20 40 60 80

Adduction

…

ForeFoot Rotation

-20

-10

0

10

0 20 40 60 80

Adduction

…

ForeFoot Rotation

-20

-10

0

10

0 20 40 60 80

Adduction

…

ForeFoot Rotation

Results

Inter-trial Inter-session

CMC ICC ICC

Hallux Flex/Ext 0.971 0.990 0.880

Hallux Rotation 0.970 0.990 0.974

HindFoot Flex/Ext 0.931 0.976 0.911

Hindfoot Pro/Sup 0.890 0.961 0.838

Hindfoot Rotation 0.927 0.974 0.820

ArchHeight 0.959 0.992 0.883

ArchLength 0.909 0.998 0.840

ArchIndex 0.952 0.972 0.989

ForeFoot Flex/Ext 0.978 0.986 0.913

ForeFoot Pro/Sup 0.993 0.968 0.814

ForeFoot Rotation 0.972 0.983 0.890

MedForeFoot Flex/Ext 0.956 0.984 0.909

MedForeFoot Pro/Sup 0.916 0.975 0.892

MedForeFoot Rotation 0.949 0.985 0.893

LatForeFoot Flex/Ext 0.957 0.985 0.866

LatForeFoot Pro/Sup 0.929 0.970 0.865

LatForeFoot Rotation 0.954 0.983 0.877

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

1.00

Moderate Good

Very good

Excellent

Inter-trial repeatability (CMC)

• High inter-trial & Inter-session repeatability, especially in sagittal plane motion

Summary

• Inter-trial & inter-session repeatability of OrthoTrak

Foot3D Multi-Segment Foot Model is comparable

to that of previously reported 3D MFMs.

• OrthoTrak Foot3D MFM can be used for objective

foot measurement in gait analysis for both research

and clinical applications.

Hallux Arch Hindfoot

Case of Residual Clubfoot Pt. (s/p PMLR)

References Carson MC et al. Kinematic analysis of a multi-segment foot model for research and

clinical applications : a repeatability analysis. J Biomech. 2001;34: 1299-1307.

Deschamps K et al. Repeatability in the assessment of multi-segment foot kinematics. Gait Posture. 2012;35:255-260.

Garofalo P et al. Interoperator reliability and prediction band of a novel protocol to measure the coordinated movements of shoulder-girdle and humerus in clinical settings Med Biol Eng Comput 2009; 47:475-486

Motion Analysis. Foot3D Multi-Segment User’s Manual version 1.1

Wright CJ et al. Repeatability of the modified Oxford foot model during gait in healthy adults. Gait Posture. 2011;33:108-112.