Sensitivity of intersegmental angles of the spinal column to errors due to marker misplacement

The ranges of angular motion measured using multisegmented spinal column models are typically small, meaning that minor experimental errors can potentially affect the reliability of these measures. This study aimed to investigate the sensitivity of the 3D intersegmental angles, measured using a multisegmented spinal column model, to errors due to marker misplacement. Eleven healthy subjects performed trunk bending in five directions. Six cameras recorded the trajectory of 22 markers, representing seven spinal column segments. Misplacement error for each marker was modeled as a Gaussian function with a standard deviation of 6 mm, and constrained to a maximum value of 12 mm in each coordinate across the skin. The sensitivity of 3D intersegmental angles to these marker misplacement errors, added to the measured data, was evaluated. The errors in sagittal plane motions resulting from marker misplacement were small (RMS error less than 3.2 deg and relative error in the angular range less than 15%) during the five trunk bending direction. The errors in the frontal and transverse plane motions, induced by marker misplacement, however, were large (RMS error up to 10.2 deg and relative error in the range up to 58%), especially during trunk bending in anterior, anterior-left, and anterior-right directions, and were often comparable in size to the intersubject variability for those motions. The induced errors in the frontal and transverse plane motions tended to be the greatest at the intersegmental levels in the lower lumbar region. These observations questioned reliability of angle measures in the frontal and transverse planes particularly in the lower lumbar region during trunk bending in anterior direction, and thus did not recommend interpreting these measures for clinical evaluation and decision-making.