Deschamps Kevin, Roosen Philip, Birch Ivan, Dingenen Bart, Bruyninckx Herman, Desloovere Kaat, Aertbelien Erwin, Staes Filip
Laboratory for Clinical Motion Analysis, University Hospital Pellenberg, Katholieke Universiteit, Leuven, Belgium. Dr. Deschamps is now with the Department of Rehabilitation Sciences - Research Center for Musculoskeletal Rehabilitation, Katholieke Universiteit, Leuven, Belgium.
J Am Podiatr Med Assoc. 2014 Jan-Feb;104(1):43-9. doi: 10.7547/0003-0538-104.1.43.
The determination of anatomical reference frames in the rearfoot during three-dimensional multisegment foot modeling has been hindered by a variety of factors. One of these factors is related to the difficulty in palpating, or the absence of, anatomical landmarks. A novel device (the Calcaneal Marker Device) aimed at standardizing marker placement at the calcaneus was, therefore, developed and evaluated for its reliability.
Throughout a random repeated-measures design, the repeatability of calcaneal marker placement was evaluated for two techniques: manual placement and placement using the Calcaneal Marker Device. Translational changes after marker placement and the clinical effect on intersegment angle calculation were quantified.
Intraobserver variability was greater in therapist 2 (<5.3 mm) compared with therapist 1 (<2.9 mm). Intraobserver variability was also found to be less than 1.6 mm throughout use of the device. Interobserver variability was found to be significantly higher for the position of markers placed manually (5.8 mm), whereas with the Calcaneal Marker Device, the variability remained lower (<1.3 mm). The effect on the computed intersegment angles followed a similar trend, with variability of 0.4° to 4.0° and 1.0° to 8.7° for CMD and manual placement, respectively.
These findings suggest that variations in marker placement are considerably reduced when the novel Calcaneal Marker Device is used, possibly toward the limits dictated by the fine motor skills of therapists and tissue artifacts.
在三维多节段足部建模过程中，后足解剖参考系的确定受到多种因素的阻碍。其中一个因素与触诊解剖标志点的困难或解剖标志点的缺失有关。因此，开发了一种旨在标准化跟骨标志点放置的新型装置（跟骨标记装置），并对其可靠性进行了评估。
在整个随机重复测量设计中，对两种技术的跟骨标志点放置重复性进行了评估：手动放置和使用跟骨标记装置放置。量化了标志点放置后的平移变化以及对节段间角度计算的临床影响。
与治疗师1（<2.9mm）相比，治疗师2的观察者内变异性更大（<5.3mm）。在整个装置使用过程中，观察者内变异性也被发现小于1.6mm。手动放置标志点的观察者间变异性显著更高（5.8mm），而使用跟骨标记装置时，变异性仍然较低（<1.3mm）。对计算出的节段间角度的影响遵循类似趋势，跟骨标记装置和手动放置的变异性分别为0.4°至4.0°和1.0°至8.7°。
这些发现表明，使用新型跟骨标记装置时，标志点放置的变化显著减少，可能接近治疗师精细运动技能和组织伪影所规定的极限。
