Effect of tibia marker placement on knee joint kinematic analysis

Variability of kinematic measures determined by different marker sets among sites participating in a collaborative study is necessary for determining the reliability of a multi-site gait analysis research. We compared knee kinematics based on different marker sets on the tibia, calculating by segmental optimization (SO) and multi-body optimization (MBO) methods respectively, in order to assess the effect of marker locations on the methods. 11 healthy subjects participated in the study with 33 markers attached to the lower extremity segments, and 4 groups were identified according to markers on the tibia. Knee joint kinematics during level walking were measured and then compared among the 4 groups using statistical parametric mapping. For SO method, the results showed that there were no significant differences in the knee joint angles when used different marker sets on the tibia. However, significant differences were found in the transverse plane kinematics for MBO method. It was concluded that MBO method was more likely to be influenced by different marker sets. More attention should be paid to marker sets, specifically for MBO method, when three-dimensional gait analysis data are shared and interpreted among sites for clinical decision-making.