Nicholson Kristen, Church Chris, Takata Colton, Niiler Tim, Chen Brian Po-Jung, Lennon Nancy, Sees Julie P, Henley John, Miller Freeman
Gait Analysis Laboratory, Nemours/A.I. duPont Hospital for Children, Wilmington, DE, USA.
Gait Analysis Laboratory, Nemours/A.I. duPont Hospital for Children, Wilmington, DE, USA.
Gait Posture. 2018 Jun;63:236-241. doi: 10.1016/j.gaitpost.2018.05.013. Epub 2018 May 16.
Many skin-mounted three-dimensional multi-segmented foot models are currently in use for gait analysis. Evidence regarding the repeatability of models, including between trial and between assessors, is mixed, and there are no between model comparisons of kinematic results.
This study explores differences in kinematics and repeatability between five three-dimensional multi-segmented foot models. The five models include duPont, Heidelberg, Oxford Child, Leardini, and Utah.
Hind foot, forefoot, and hallux angles were calculated with each model for ten individuals. Two physical therapists applied markers three times to each individual to assess within and between therapist variability. Standard deviations were used to evaluate marker placement variability. Locally weighted regression smoothing with alpha-adjusted serial T tests analysis was used to assess kinematic similarities.
All five models had similar variability, however, the Leardini model showed high standard deviations in plantarflexion/dorsiflexion angles. P-value curves for the gait cycle were used to assess kinematic similarities. The duPont and Oxford models had the most similar kinematics.
All models demonstrated similar marker placement variability. Lower variability was noted in the sagittal and coronal planes compared to rotation in the transverse plane, suggesting a higher minimal detectable change when clinically considering rotation and a need for additional research. Between the five models, the duPont and Oxford shared the most kinematic similarities. While patterns of movement were very similar between all models, offsets were often present and need to be considered when evaluating published data.
目前许多用于步态分析的皮肤贴合式三维多节段足部模型正在使用。关于模型重复性的证据，包括试验间和评估者间的证据，好坏参半，并且没有对运动学结果进行模型间比较。
本研究探讨了五种三维多节段足部模型在运动学和重复性方面的差异。这五种模型包括杜邦模型、海德堡模型、牛津儿童模型、莱迪尼模型和犹他模型。
对十名个体使用每种模型计算后足、前足和拇趾角度。两名物理治疗师对每个个体进行三次标记物涂抹，以评估治疗师内部和治疗师之间的变异性。使用标准差评估标记物放置的变异性。采用α调整序列T检验分析的局部加权回归平滑法评估运动学相似性。
所有五种模型的变异性相似，然而，莱迪尼模型在跖屈/背屈角度上显示出较高的标准差。步态周期的P值曲线用于评估运动学相似性。杜邦模型和牛津模型的运动学最为相似。
所有模型均显示出相似的标记物放置变异性。与横断面旋转相比，矢状面和冠状面的变异性较低，这表明在临床考虑旋转时最小可检测变化更高，需要进一步研究。在这五种模型中，杜邦模型和牛津模型的运动学相似性最高。虽然所有模型之间的运动模式非常相似，但偏移量经常存在，在评估已发表的数据时需要考虑。
