健康老年人中无标记三维步态生物力学的结构效度。
Construct validity of markerless three-dimensional gait biomechanics in healthy older adults.
作者信息
Carvalho Andreia, Vanrenterghem Jos, Cabral Sílvia, M d'Assunção Ana, Carnide Filomena, Veloso António P, Moniz-Pereira Vera
机构信息
LBMF, CIPER, Faculdade de Motricidade Humana, Universidade Lisboa, Lisboa P-1499-002, Portugal; Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, Leuven KU, Belgium; Escola Superior de Tecnologias da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa 1990-096, Portugal.
Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, Leuven KU, Belgium.
出版信息
Gait Posture. 2025 Jul;120:217-225. doi: 10.1016/j.gaitpost.2025.04.022. Epub 2025 Apr 25.
BACKGROUND AND AIM
Gait changes due to aging can result in functional limitations and a higher risk of falls, with older adults showing alterations in joint angles and moments. Marker-based gait analysis is not widely used in clinical settings due to its complexity and discomfort, especially in older adults. Recent advances in markerless motion capture, such as Theia3D, offer a promising alternative. This study aims to assess the construct validity of a markerless motion capture system for gait analysis in healthy older adults.
METHODS
A cross-sectional study included 30 healthy community-dwelling older adults. Gait data was collected using marker-based and markerless motion capture systems in randomized order, with participants wearing tight-fitting minimal clothes plus 46 reflective markers attached, or their usual clothes, respectively. Joint kinematics (including range of motion) and kinetics were analyzed, and correlations between methods (Rxy) were assessed. Bland&Altman analysis was used to measure agreement. Root-mean-square differences (RMSD) were computed. Acceptable thresholds were set at ≤ 5º for kinematic and at ≤ 10 % of signal amplitude for kinetics.
RESULTS
Strong correlations (Rxy≥0.7) were found between the systems for sagittal plane kinematics (except for the pelvis), particularly for knee and ankle joints. A low agreement was detected in sagittal plane hip and pelvis kinematics, along with RMSD exceeding 5º. Weaker correlations and poor agreement were observed for transverse and frontal plane motions. Overall strong correlations were found for kinetics, except for the joint ankle inversion-eversion moment, and poor agreement for the frontal and transverse planes.
CONCLUSION
Overall markerless motion capture demonstrated good construct validity for measuring sagittal plane gait lower-limb gait kinematics (excluding pelvis) and kinetics in healthy older. However, considering the agreement between methods and the results for the other movement planes, further validation is required before markerless and marker-based systems can be used interchangeably in gait assessments.
背景与目的
衰老导致的步态变化会导致功能受限以及跌倒风险增加，老年人的关节角度和力矩会出现改变。基于标记的步态分析因其复杂性和不适感，在临床环境中并未得到广泛应用，尤其是在老年人中。无标记运动捕捉技术的最新进展，如Theia3D，提供了一种有前景的替代方案。本研究旨在评估一种无标记运动捕捉系统在健康老年人步态分析中的结构效度。
方法
一项横断面研究纳入了30名居住在社区的健康老年人。使用基于标记和无标记运动捕捉系统以随机顺序收集步态数据，参与者分别穿着紧身简约衣物并附着46个反光标记，或穿着日常服装。分析关节运动学（包括活动范围）和动力学，并评估两种方法之间的相关性（Rxy）。采用Bland&Altman分析来衡量一致性。计算均方根差异（RMSD）。运动学的可接受阈值设定为≤5°，动力学的可接受阈值设定为≤信号幅度的10%。
结果
在矢状面运动学方面（除骨盆外），两种系统之间发现了强相关性（Rxy≥0.7），尤其是膝关节和踝关节。在矢状面髋关节和骨盆运动学方面检测到一致性较低，同时RMSD超过5°。在横断面和额状面运动方面观察到相关性较弱且一致性较差。总体而言，在动力学方面发现了强相关性，但踝关节内翻 - 外翻力矩除外，在额状面和横断面方面一致性较差。
结论
总体而言，无标记运动捕捉在测量健康老年人矢状面步态下肢运动学（不包括骨盆）和动力学方面显示出良好的结构效度。然而，考虑到两种方法之间的一致性以及其他运动平面的结果，在无标记和基于标记的系统可在步态评估中互换使用之前，还需要进一步验证。
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