An objective evaluation of a segmented foot model

Segmented foot and ankle models divide the foot into multiple segments in order to obtain more meaningful information about its functional behavior in health and disease. The goal of this research was to objectively evaluate the fidelity of a generalized three-segment foot and ankle model defined using externally mounted markers. An established apparatus that reproduces the kinematics and kinetics of gait in cadaver lower extremities was used to independently examine the validity of the rigid body assumption and the magnitude of soft tissue artifact induced by skin-mounted markers. Stance phase simulations were conducted on ten donated limbs while recording the three-dimensional kinematic trajectories of skin-mounted and then bone-mounted marker constructs. Segment kinematics were compared to underlying bone kinematics to examine the rigid body assumption. Virtual markers were calculated from the bone mounted marker set and then compared to the skin-mounted markers to examine soft tissue artifact. The shank and hindfoot segments behaved as rigid bodies. The forefoot segment violated the rigid body assumption, as evidenced by significant differences between motions of the first metatarsal and the forefoot segment, and relative motion between the first and fifth metatarsals. Motion vectors of the external skin markers relative to their virtual counterparts were no more than 3 mm in each direction, and 3–7 mm overall. Artifactual marker motion had mild affects on inter-segmental kinematics. Despite errors, the segmented model appeared to perform reasonably well overall. The data presented here enable more informed interpretations of clinical findings using the segmented model approach.