Scalona Emilia, Di Marco Roberto, Castelli Enrico, Desloovere Kaat, Van Der Krogt Marjolein, Cappa Paolo, Rossi Stefano
Department of Mechanical and Aerospace Engineering (DIMA), "Sapienza" University of Rome, Rome, Italy.
Laboratory of Movement Analysis and Robotics (MARlab), "Bambino Gesù" Children Hospital, Passoscuro Fiumicuno (RM), Italy.
Int Biomech. 2019 Dec;6(1):19-33. doi: 10.1080/23335432.2019.1621205.
The intra-subject, the inter-operator, and the inter-laboratory variabilities are the main sources of uncertainties in gait analysis, and their effects have been partially described in the literature for adult populations. This study aimed to extend the repeatability and reproducibility analysis to a pediatric population, accounting for the effects induced by the intra-subject variations, the measurement setup, the marker set configuration, and the involved operators in placing markers and EMG electrodes. We evaluated kinematic, kinetic and EMG outputs collected from gait analyses performed on two healthy children in two laboratories, by two operators, and with two marker placement protocols. The two involved centers previously defined a common acquisition procedure based on their routine pipelines. The similarity of kinematic, kinetic, and EMG curves were evaluated by means of the coefficients of the Linear Fit Method, and the Mean Absolute Variability with and without the offset among curves. The inter-operator variability was found to be the main contribution to the overall reproducibility of kinematic and kinetic gait data. On the contrary, the main contribution to the variability of the EMG signals was the intra-subject repeatability that is due to the physiological stride to stride muscle activation variability.
受试者内、操作者间以及实验室间的变异性是步态分析中不确定性的主要来源，其影响在针对成年人群体的文献中已有部分描述。本研究旨在将重复性和再现性分析扩展至儿科人群，考虑受试者内变异、测量设置、标记集配置以及放置标记和肌电图电极的相关操作者所引起的影响。我们评估了在两个实验室由两名操作者采用两种标记放置方案对两名健康儿童进行步态分析时收集到的运动学、动力学和肌电图输出。两个参与中心先前根据其常规流程定义了一个通用的采集程序。通过线性拟合方法的系数以及曲线间有无偏移的平均绝对变异性来评估运动学、动力学和肌电图曲线的相似性。发现操作者间变异性是运动学和动力学步态数据总体再现性的主要贡献因素。相反，肌电图信号变异性的主要贡献因素是受试者内重复性，这是由于生理上步幅间肌肉激活的变异性所致。
