A six degrees-of-freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set

Kinematic gait analysis is limited by simplified marker sets and related models. The majority of sets in clinical use were developed with low resolution imaging systems so required various assumptions about body behaviour. Further major limitations include soft tissue artefact and ambiguity in landmark identification. An alternative is the use of sets based on six degrees-of-freedom (DOF) principles, primarily using marker clusters for tracking. This study evaluates performance of a 6DOF set, based largely on CAST/ISB recommendations, through comparison with a conventional set and assessment of repeatability. Ten healthy subjects were assessed in treadmill walking, with both sets applied simultaneously on two occasions. Data were analysed using repeatability coefficients, correlation of key features, and comparison of joint angle curves and difference curves with confidence bands. Apart from pelvic tilt all segment and joint angles from both sets showed high within and between session repeatability (CMC>0.80). Hip rotations showed clear differences between the two sets with indications in support of the 6DOF set. Knee coronal angles showed evidence of cross-talk in the conventional set, highlighting difficulties with anatomical identification despite control measures such as a foot alignment template. Knee transverse angles showed inconsistent patterns for both sets. At the ankle the conventional set only allowed true measurement in two planes so with high repeatability the 6DOF set is preferable. The 6DOF set showed comparable performance to the conventional set and overcomes a number of theoretical limitations, however further development is needed prior to clinical implementation.