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A Novel Device for Standardizing Marker Placement at the Calcaneus

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  • 1 Laboratory for Clinical Motion Analysis, University Hospital Pellenberg, Katholieke Universiteit, Leuven, Belgium. Dr. Deschamps is now with the Department of Rehabilitation Sciences – Research Center for Musculoskeletal Rehabilitation, Katholieke Universiteit, Leuven, Belgium.
  • | 2 Rehabilitation Sciences and Physical Therapy, Ghent University, Ghent, Belgium.
  • | 3 Community Services, Sheffield Teaching Hospitals NHS Foundation Trust, Hankham, East Sussex, England.
  • | 4 Faculty of Movement and Rehabilitaiton Sciences, Katholieke Universiteit, Leuven, Belgium.
  • | 5 Department of Mechanical Engineering, Katholieke Universiteit, Leuven, Belgium.
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Background

The determination of anatomical reference frames in the rearfoot during three-dimensional multisegment foot modeling has been hindered by a variety of factors. One of these factors is related to the difficulty in palpating, or the absence of, anatomical landmarks. A novel device (the Calcaneal Marker Device) aimed at standardizing marker placement at the calcaneus was, therefore, developed and evaluated for its reliability.

Methods

Throughout a random repeated-measures design, the repeatability of calcaneal marker placement was evaluated for two techniques: manual placement and placement using the Calcaneal Marker Device. Translational changes after marker placement and the clinical effect on intersegment angle calculation were quantified.

Results

Intraobserver variability was greater in therapist 2 (<5.3 mm) compared with therapist 1 (<2.9 mm). Intraobserver variability was also found to be less than 1.6 mm throughout use of the device. Interobserver variability was found to be significantly higher for the position of markers placed manually (5.8 mm), whereas with the Calcaneal Marker Device, the variability remained lower (<1.3 mm). The effect on the computed intersegment angles followed a similar trend, with variability of 0.4° to 4.0° and 1.0° to 8.7° for CMD and manual placement, respectively.

Conclusions

These findings suggest that variations in marker placement are considerably reduced when the novel Calcaneal Marker Device is used, possibly toward the limits dictated by the fine motor skills of therapists and tissue artifacts.

Corresponding author: Kevin Deschamps, MSc, Division of Musculoskeletal Disorders, University Hospital of Leuven, Weligerveld 1, Pellenberg, 3212, Belgium. (E-mail: kevin.deschamps@uz.kuleuven.ac.be)