Non-invasive assessment of superficial soft tissue local displacements during movement: a feasibility study.

In the movement analysts community, the assessment of the displacement of skin photogrammetric markers relative to the underlying bone (soft tissue displacement, STD) is considered to be a priority. The aim of this study is to present a non-invasive method that allows for the characterization of STD for any marker location, subject, and motor task. In particular, this method provides an estimate of the STD vector in a bone-embedded frame. The body segment under analysis is endowed with the largest possible number of skin markers located over all areas of interest. Any given STD vector is observed from all the marker cluster frames that can be built by suitably combining all the available markers. A subset of the latter frames is identified that is made of frames endowed with uncorrelated local movements. The estimate of a given STD vector is determined through the coherent average of the vectors reconstructed using the above-mentioned independent frames. This estimate is affected by a 180 degrees phase indeterminacy. The proposed method and the underlying hypotheses were validated using markers located on the thighs of two female subjects treated for a total knee replacement. The relevant STD estimates, STDm, were compared with those directly observed using photogrammetry combined with 2D fluoroscopic projections and the prosthesis CAD model (STDf). Recordings were made while the volunteers performed step up/down motor tasks. The root mean square value of STDm was found in the range 2.5-23.0 mm and was consistent with the RMS values of STDf and with other results reported in the literature and obtained in similarly unconstrained conditions. Moreover, STDm and STDf showed a pattern similarity measured by a correlation coefficient equal to 0.83 (+/-0.13) and by a normalised root mean square distance equal to 27% (+/-16%). The described estimate of the STD pattern and magnitude, even with the above-mentioned indeterminacies, constitutes valuable information when aiming at optimal marker placement and is an indispensable prerequisite for bone pose estimator design and assessment.