Skin movement errors in measurement of sagittal lumbar and hip angles in young and elderly subjects

Errors in measurement of sagittal lumbar and hip angles due to skin movement on the pelvis and/or lateral thigh were measured in young (n = 21, age = 18.6 +/- 2.1 years) and older (n = 23, age = 70.9 +/- 6.4 years) age groups. Skin reference markers were attached over specific landmarks of healthy young and elderly subjects, who were videotaped in three static positions of hip flexion using the 2D PEAK Motus video analysis system. Sagittal lumbar and hip angles were calculated from skin reference markers and manually palpated landmarks. The elderly subjects demonstrated greater errors in lumbar angle due to skin movement on the pelvis only in the maximal hip flexion position. The traditional model (ASIS-PSIS-GT-LFE) underestimated sagittal hip angle and the revised model (ASIS-PSIS-2/3Th-1/4Th) provided more accurate measurement of sagittal hip angle throughout the full available range of hip flexion. Skin movement on the pelvis had a small counterbalancing effect on the larger errors from lateral thigh markers (GT-LFE), thereby decreasing hip angle error.