Validation of a new model-based tracking technique for measuring three-dimensional, in vivo glenohumeral joint kinematics

Shoulder motion is complex and significant research efforts have focused on measuring glenohumeral joint motion. Unfortunately, conventional motion measurement techniques are unable to measure glenohumeral joint kinematics during dynamic shoulder motion to clinically significant levels of accuracy. The purpose of this study was to validate the accuracy of a new model-based tracking technique for measuring three-dimensional, in vivo glenohumeral joint kinematics. We have developed a model-based tracking technique for accurately measuring in vivo joint motion from biplane radiographic images that tracks the position of bones based on their three-dimensional shape and texture. To validate this technique, we implanted tantalum beads into the humerus and scapula of both shoulders from three cadaver specimens and then recorded biplane radiographic images of the shoulder while manually moving each specimen's arm. The position of the humerus and scapula were measured using the model-based tracking system and with a previously validated dynamic radiostereometric analysis (RSA) technique. Accuracy was reported in terms of measurement bias, measurement precision, and overall dynamic accuracy by comparing the model-based tracking results to the dynamic RSA results. The model-based tracking technique produced results that were in excellent agreement with the RSA technique. Measurement bias ranged from -0.126 to 0.199 mm for the scapula and ranged from -0.022 to 0.079 mm for the humerus. Dynamic measurement precision was better than 0.130 mm for the scapula and 0.095 mm for the humerus. Overall dynamic accuracy indicated that rms errors in any one direction were less than 0.385 mm for the scapula and less than 0.374 mm for the humerus. These errors correspond to rotational inaccuracies of approximately 0.25 deg for the scapula and 0.47 deg for the humerus. This new model-based tracking approach represents a non-invasive technique for accurately measuring dynamic glenohumeral joint motion under in vivo conditions. The model-based technique achieves accuracy levels that far surpass all previously reported non-invasive techniques for measuring in vivo glenohumeral joint motion. This technique is supported by a rigorous validation study that provides a realistic simulation of in vivo conditions and we fully expect to achieve these levels of accuracy with in vivo human testing. Future research will use this technique to analyze shoulder motion under a variety of testing conditions and to investigate the effects of conservative and surgical treatment of rotator cuff tears on dynamic joint stability.     

The effect of decreasing computed tomography dosage on radiostereometric analysis (RSA) accuracy at the glenohumeral joint

Standard, beaded radiostereometric analysis (RSA) and markerless RSA often use computed tomography (CT) scans to create three-dimensional (3D) bone models. However, ethical concerns exist due to risks associated with CT radiation exposure. Therefore, the aim of this study was to investigate the effect of decreasing CT dosage on RSA accuracy. Four cadaveric shoulder specimens were scanned using a normal-dose CT protocol and two low-dose protocols, where the dosage was decreased by 89% and 98%. 3D computer models of the humerus and scapula were created using each CT protocol. Bi-planar fluoroscopy was used to image five different static glenohumeral positions and two dynamic glenohumeral movements, of which a total of five static and four dynamic poses were selected for analysis. For standard RSA, negligible differences were found in bead (0.21±0.31mm) and bony landmark (2.31±1.90mm) locations when the CT dosage was decreased by 98% (p-values>0.167). For markerless RSA kinematic results, excellent agreement was found between the normal-dose and lowest-dose protocol, with all Spearman rank correlation coefficients greater than 0.95. Average root mean squared errors of 1.04±0.68mm and 2.42±0.81° were also found at this reduced dosage for static positions. In summary, CT dosage can be markedly reduced when performing shoulder RSA to minimize the risks of radiation exposure. Standard RSA accuracy was negligibly affected by the 98% CT dose reduction and for markerless RSA, the benefits of decreasing CT dosage to the subject outweigh the introduced errors.     

Measuring dynamic in-vivo glenohumeral joint kinematics: technique and preliminary results

Rotator cuff tears are a common injury that affect a significant percentage of the population over age 60. Although it is widely believed that the rotator cuff's primary function is to stabilize the humerus against the glenoid during shoulder motion, accurately measuring the three-dimensional (3D) motion of the shoulder's glenohumeral joint under in-vivo conditions has been a challenging endeavor. In particular, conventional motion measurement techniques have frequently been limited to static or two-dimensional (2D) analyses, and have suffered from limited or unknown in-vivo accuracy. We have recently developed and validated a new model-based tracking technique that is capable of accurately measuring the 3D position and orientation of the scapula and humerus from biplane X-ray images. Herein we demonstrate the in-vivo application of this technique for accurately measuring glenohumeral joint translations during shoulder motion in the repaired and contralateral shoulders of patients following rotator cuff repair. Five male subjects were tested at 3-4 months following arthroscopic rotator cuff repair. Superior-inferior humeral translation was measured during elevation, and anterior-posterior humeral translation was measured during external rotation in both the repaired and contralateral shoulders. The data failed to detect statistically significant differences between the repaired and contralateral shoulders in superior-inferior translation (p=0.74) or anterior-posterior translation (p=0.77). The measurement technique overcomes the limitations of conventional motion measurement techniques by providing accurate, 3D, in-vivo measures of glenohumeral joint motion during dynamic activities. On-going research is using this technique to assess the effects of conservative and surgical treatment of rotator cuff tears.     

Validation of a non-invasive fluoroscopic imaging technique for the measurement of dynamic knee joint motion

The accurate measurement of the in vivo knee joint kinematics in six degrees-of-freedom (6DOF) remains a challenge in biomedical engineering. We have adapted a dual fluoroscopic imaging system (DFIS) to investigate the various in vivo dynamic knee joint motions. This paper presents a thorough validation of the accuracy and repeatability of the DFIS system when used to measure 6DOF dynamic knee kinematics. First, the validation utilized standard geometric spheres made from different materials to demonstrate the capability of the DFIS technique to determine the object positions under changing speeds. The translational pose of the spheres could be recreated to less than 0.15±0.09 mm for velocities below 300 mm/s. Next, tantalum beads were inserted into the femur and tibia of two fresh frozen cadaver knees to compare the dynamic kinematics measured by matching knee models to the kinematics from the tantalum bead matching—a technique similar to Roentgen stereophotogrammetric analysis (RSA). Each cadaveric knee was attached to the crosshead of a tensile testing machine and vertically translated at a rate of 16.66 mm/s while images were captured with the DFIS. Subsequently, the tibia was held fixed and the femur manually flexed from full extension to 90° of flexion, as the DFIS acquired images. In vitro translation of the cadaver knee using the tensile testing machine deviated from predicted values by 0.08±0.14 mm for the matched knee models. The difference between matching the knee and tantalum bead models during the dynamic flexion–extension motion of the knee was 0.1±0.65°/s in flexion speed; 0.24±0.16 mm in posterior femoral translation; and 0.16±0.61° in internal–external tibial rotation. Finally, we applied the method to investigate the knee kinematics of a living subject during a step ascent and treadmill gait. High repeatability was demonstrated for the in vivo application. Thus, the DFIS provides an easy and powerful tool for accurately determining 6DOF positions of the knee when performing daily functional activities.     

Static and dynamic error of a biplanar videoradiography system using marker-based and markerless tracking techniques

The use of biplanar videoradiography technology has become increasingly popular for evaluating joint function in vivo. Two fundamentally different methods are currently employed to reconstruct 3D bone motions captured using this technology. Marker-based tracking requires at least three radio-opaque markers to be implanted in the bone of interest. Markerless tracking makes use of algorithms designed to match 3D bone shapes to biplanar videoradiography data. In order to reliably quantify in vivo bone motion, the systematic error of these tracking techniques should be evaluated. Herein, we present new markerless tracking software that makes use of modern GPU technology, describe a versatile method for quantifying the systematic error of a biplanar videoradiography motion capture system using independent gold standard instrumentation, and evaluate the systematic error of the W.M. Keck XROMM Facility's biplanar videoradiography system using both marker-based and markerless tracking algorithms under static and dynamic motion conditions. A polycarbonate flag embedded with 12 radio-opaque markers was used to evaluate the systematic error of the marker-based tracking algorithm. Three human cadaveric bones (distal femur, distal radius, and distal ulna) were used to evaluate the systematic error of the markerless tracking algorithm. The systematic error was evaluated by comparing motions to independent gold standard instrumentation. Static motions were compared to high accuracy linear and rotary stages while dynamic motions were compared to a high accuracy angular displacement transducer. Marker-based tracking was shown to effectively track motion to within 0.1?mm and 0.1 deg under static and dynamic conditions. Furthermore, the presented results indicate that markerless tracking can be used to effectively track rapid bone motions to within 0.15 deg for the distal aspects of the femur, radius, and ulna. Both marker-based and markerless tracking techniques were in excellent agreement with the gold standard instrumentation for both static and dynamic testing protocols. Future research will employ these techniques to quantify in vivo joint motion for high-speed upper and lower extremity impacts such as jumping, landing, and hammering.     

Validation of imaging-based quantification of glenohumeral joint kinematics using an unmodified clinical biplane fluoroscopy system

Model-based tracking, using CT and biplane fluoroscopy, allows highly accurate quantification of glenohumeral motion and changes in the subacromial space. Previous investigators have used custom-built biplane fluoroscopes designed specifically for kinematic applications, which are available at few institutions and require FDA approval prior to clinical use. The aim of this study was to demonstrate the utility of an off-the-shelf clinical biplane fluoroscope for kinematic applications by validating model-based tracking for measurement of glenohumeral motion using an unmodified clinical system. Biplane images of each shoulder of a cadaver torso were acquired at various joint positions and during simulated movements along anatomical planes of motion. The pose of each humerus and scapula was determined using model-based tracking and compared to a bead-based gold standard. Error due to a temporal-offset between corresponding biplane images, characteristic of clinical biplane systems, was determined by comparison of measured and known relative position of 2 bead clusters of a phantom that was imaged while moved throughout the fluoroscopy image volume. Model-based tracking had global kinematic mean absolute errors of 0.27 mm and 0.29° (static), and 0.22–0.32 mm and 0.12–0.45° (dynamic). Glenohumeral mean absolute errors were 0.39 mm and 0.45° (static), and 0.36–0.42 mm and 0.41–0.48° (dynamic). The temporal-offset was predicted to add errors of 0.06–0.85 mm and 0.05–0.28° for cadaveric trials for the speeds examined. For defined speeds, sub-millimeter and sub-degree kinematic accuracy and precision were achieved using an unmodified clinical biplane fluoroscope for quantification of glenohumeral motion.     

A regression-based 3-D shoulder rhythm

In biomechanical modeling of the shoulder, it is important to know the orientation of each bone in the shoulder girdle when estimating the loads on each musculoskeletal element. However, because of the soft tissue overlying the bones, it is difficult to accurately derive the orientation of the clavicle and scapula using surface markers during dynamic movement. The purpose of this study is to develop two regression models which predict the orientation of the clavicle and the scapula. The first regression model uses humerus orientation and individual factors such as age, gender, and anthropometry data as the predictors. The second regression model includes only the humerus orientation as the predictor. Thirty-eight participants performed 118 static postures covering the volume of the right hand reach. The orientation of the thorax, clavicle, scapula and humerus were measured with a motion tracking system. Regression analysis was performed on the Euler angles decomposed from the orientation of each bone from 26 randomly selected participants. The regression models were then validated with the remaining 12 participants. The results indicate that for the first model, the r² of the predicted orientation of the clavicle and the scapula ranged between 0.31 and 0.65, and the RMSE obtained from the validation dataset ranged from 6.92° to 10.39°. For the second model, the r² ranged between 0.19 and 0.57, and the RMSE obtained from the validation dataset ranged from 6.62° and 11.13°. The derived regression-based shoulder rhythm could be useful in future biomechanical modeling of the shoulder.     

Markerless Roentgen Stereophotogrammetric Analysis for in vivo implant migration measurement using three dimensional surface models to represent bone

Recent studies have shown that model-based RSA using implant surface models to detect in vivo migration is as accurate as the classical marker-based RSA method. Use of bone surface models would be a further advancement of the model-based method by decreasing complications arising from marker insertion. The aim of this pilot investigation was to assess the feasibility of a "completely markerless" model-based RSA in detecting migration of an implant using bone surface models instead of bone markers. A total knee arthroplasty (TKA) was performed on a human cadaver knee, which was subsequently investigated by repeated RSA measurements performed by one observer. The cadaver knee was CT scanned prior to implantation of the TKA. Tibia-fibular surface models were created using two different commercially available software packages to investigate the effect of segmentation software on the accuracy of repeated migration measures of zero displacement by one observer. Reverse engineered surface models of the TKA tibial component were created. The analysis of the RSA images was repeated 10 times by one individual observer. For the markerless method, the greatest apparent migration observed about the three anatomical axes investigated was between -2.08 and 1.35 mm (SD ≤ 0.88) for z-axis translation, and -4.57° to 7.86° (SD ≤ 3.17) for R(y)-axis rotation, which were well beyond out of the range of what is typically considered adequate for clinically relevant RSA measurements. Use of tibia-fibular surface models of the bone instead of markers could provide practical advantages in evaluating implant migration. However, we found the accuracy and precision of the markerless approach to be lower than that of marker-based RSA, to a degree which precludes the use of this method for measuring implant migration in its present form.     

Validation of radiostereometric analysis in six degrees of freedom for use with reverse total shoulder arthroplasty

A phantom study was conducted to determine bias in motion and bias at zero motion of radiostereometric analysis (RSA) for evaluating implant relative displacement in reverse total shoulder arthroplasty (RTSA). A Sawbones shoulder phantom was fitted with a RTSA implant set and 13 tantalum markers. The model was fixed to a manual micrometer, providing controlled movements though fifteen known increments in translation and twelve increments in rotation (0.02–5.00 mm and 0.1–6.0°), along each translation and rotation axis. Movement between the glenoid and humerus was assessed using beads vs. beads (B/B), model vs. beads (M/B), and model vs. model (M/M) measurement methods in a model-based RSA environment. Bias in motion and bias at zero motion were defined as the difference between measured and accepted reference values, and the difference between double examinations with a theoretical displacement of zero, respectively. Bias in motion ranged from 0.054 ± 0.010 to 0.129 ± 0.014 mm and 0.076 ± 0.025 to 0.126 ± 0.025° (B/B), 0.023 ± 0.009 to 0.126 ± 0.016 mm and 0.111 ± 0.033 to 0.794 ± 0.251° (M/B), and 0.029 ± 0.010 to 0.135 ± 0.030 mm and 0.243 ± 0.088 to 0.384 ± 0.153° (M/M). Bias at zero motion ranged from 0.120 to 0.156 mm and 0.075 to 0.206° (B/B), 0.074 to 0.149 mm and 0.067 to 1.953° (M/B), and 0.069 to 0.259 mm and 0.284 to 1.273° (M/M). This is the first RSA for RTSA study, with results comparable to those validating the use of RSA for hip and knee arthroplasties (accepted as 0.05–0.50 mm and 0.15–1.15°), justifying the potential use of RSA as a tool for measuring implant displacement in the shoulder.     

Evaluation of regression-based 3-D shoulder rhythms

The movements of the humerus, the clavicle, and the scapula are not completely independent. The coupled pattern of movement of these bones is called the shoulder rhythm. To date, multiple studies have focused on providing regression-based 3-D shoulder rhythms, in which the orientations of the clavicle and the scapula are estimated by the orientation of the humerus. In this study, six existing regression-based shoulder rhythms were evaluated by an independent dataset in terms of their predictability. The datasets include the measured orientations of the humerus, the clavicle, and the scapula of 14 participants over 118 different upper arm postures. The predicted orientations of the clavicle and the scapula were derived from applying those regression-based shoulder rhythms to the humerus orientation. The results indicated that none of those regression-based shoulder rhythms provides consistently more accurate results than the others. For all the joint angles and all the shoulder rhythms, the RMSE are all greater than 5°. Among those shoulder rhythms, the scapula lateral/medial rotation has the strongest correlation between the predicted and the measured angles, while the other thoracoclavicular and thoracoscapular bone orientation angles only showed a weak to moderate correlation. Since the regression-based shoulder rhythm has been adopted for shoulder biomechanical models to estimate shoulder muscle activities and structure loads, there needs to be further investigation on how the predicted error from the shoulder rhythm affects the output of the biomechanical model.     

Measuring humeral head translation using fluoroscopy: A validation study

Numerous techniques have been employed to monitor humeral head translation due to its involvement with several shoulder pathologies. However, most of the techniques were not validated. The objective of this study is to compare the accuracy of manual digitization and contour registration in measuring superior translation of the humeral head. Eight pairs of cadaver scapulae and humerii bones were harvested for this study. Each scapula and humerus was secured in a customized jig that allowed for control of humeral head translations and a vise that permitted rotations of the scapula about three axes. Fluoroscopy was used to take images of the shoulder bones. Scapular orientation was manipulated in different positions while the humerus was at 90° of humeral elevation in the scapular plane. Humeral head translation was measured using the two methods and was compared to the known translation. Additionally, accuracy of the contour registration method to measure 2-D scapular rotations was assessed. The range for the root mean square (RMS) error for manual digitization method was 0.27 mm - 0.43 mm and the contour registration method had a RMS error ranging from 0.18 mm - 0.40 mm. In addition, the RMS error for the scapular angle rotation using the contour registration method was 2.4°. Both methods showed acceptable errors. However, on average, the contour registration method showed lesser measurement error compared to the manual digitization method. In addition, the contour registration method was able to show good accuracy in measuring rotation that is useful in 2-D image analysis.     

In-vivo 6 degrees-of-freedom kinematics of metal-on-polyethylene total hip arthroplasty during gait

Knowledge of accurate in-vivo 6 degree-of-freedom (6-DOF) kinematics of total hip arthroplasty (THA) during daily activities is critical for improvement of longevity of the components. Previous studies assessed in-vivo THA kinematics using skin marker-based motion analysis. However, skin markers are prone to move with respect to the underlying bones. A non-invasive dual fluoroscopic imaging system (DFIS) based tracking technique has been used to avoid skin artifacts and provide accurate 6-DOF kinematic measurement. This study aimed to quantify in-vivo 6-DOF THA kinematics during gait using DFIS. Twenty eight well-functioning THAs were evaluated during treadmill gait under DFIS surveillance. The maximum translations of the femoral head were 0.46±0.10 mm and 0.45±0.10 mm during the stance and swing phases (p=0.57), respectively. The range of hip flexion was from 8.7° to 47.6°, adduction from 3.0° to 12.5° and external rotation from 19.2° to 29.7°. The THA was flexed, externally rotated and adducted throughout the gait. The magnitudes of the femoral head translations were found to be within the manufacture tolerance of the components, suggesting that in-vivo hip “pistoning” during gait cycle may be minimal in well-functioning THAs. The 6-DOF kinematics could be used as the baseline knowledge for further improvement of wear-testing of hip implant, implants manufacturing and implant positioning during surgery.     

Shoulder joint kinematics during elevation measured by ultrasound-based measuring system.

In order to analyze shoulder joint movements, the authors use a ZEBRIS CMS-HS ultrasound-based movement analysis system. In essence, the measurement involves the determination of the spatial position of the 16 anatomical points, which are specified on the basis of the coordinates of ultrasound-based triplets positioned on the upper limb, the scapula, and the thorax; their spatial position is measured in the course of motion. Kinematic characteristics of 74 shoulder joints of 50 healthy persons were identified during elevation in the plane of the scapula. Kinematic characteristics of motion were identified by scapulothoracic, glenohumeral, and humeral elevation angles; range of angles; scapulothoracis and glenohumeral rhythm; scapulothoracic, glenohumeral, and scapuloglenoid ratios; and the relative displacement between the rotation centers of the humerus and the scapula. Motion of the humerus and the scapula relative to each other was characterized by their rotation as well as the relative displacement between the rotation centers of scapula and humerus. The biomechanical model of the shoulder joint during elevation can be described by analyzing the results of the measurements performed.     

Simulated four-dimensional CT for markerless tumor tracking using a deep learning network with multi-task learning

IntroductionOur markerless tumor tracking algorithm requires 4DCT data to train models. 4DCT cannot be used for markerless tracking for respiratory-gated treatment due to inaccuracies and a high radiation dose. We developed a deep neural network (DNN) to generate 4DCT from 3DCT data.MethodsWe used 2420 thoracic 4DCT datasets from 436 patients to train a DNN, designed to export 9 deformation vector fields (each field representing one-ninth of the respiratory cycle) from each CT dataset based on a 3D convolutional autoencoder with shortcut connections using deformable image registration. Then 3DCT data at exhale were transformed using the predicted deformation vector fields to obtain simulated 4DCT data. We compared markerless tracking accuracy between original and simulated 4DCT datasets for 20 patients. Our tracking algorithm used a machine learning approach with patient-specific model parameters. For the training stage, a pair of digitally reconstructed radiography images was generated using 4DCT for each patient. For the prediction stage, the tracking algorithm calculated tumor position using incoming fluoroscopic image data.ResultsDiaphragmatic displacement averaged over 40 cases for the original 4DCT were slightly higher (<1.3 mm) than those for the simulated 4DCT. Tracking positional errors (95th percentile of the absolute value of displacement, “simulated 4DCT” minus “original 4DCT”) averaged over the 20 cases were 0.56 mm, 0.65 mm, and 0.96 mm in the X, Y and Z directions, respectively.ConclusionsWe developed a DNN to generate simulated 4DCT data that are useful for markerless tumor tracking when original 4DCT is not available. Using this DNN would accelerate markerless tumor tracking and increase treatment accuracy in thoracoabdominal treatment.     

An optimized image matching method for determining in-vivo TKA kinematics with a dual-orthogonal fluoroscopic imaging system

This study presents an optimized matching algorithm for a dual-orthogonal fluoroscopic image system used to determine six degrees-of-freedom total knee arthroplasty (TKA) kinematics in-vivo. The algorithm was evaluated using controlled conditions and standard geometries. Results of the validation demonstrate the algorithm's robustness and capability of realizing a pose from a variety of initial poses. Under idealized conditions, poses of a TKA system were recreated to within 0.02+/-0.01 mm and 0.02+/-0.03 deg for the femoral component and 0.07+/-0.09 mm and 0.16+/-0.18 deg for the tibial component. By employing a standardized geometry with spheres, the translational accuracy and repeatability under actual conditions was found to be 0.01+/-0.06 mm. Application of the optimized matching algorithm to a TKA patient showed that the pose of in-vivo TKA components can be repeatedly located, with standard deviations less than +/-0.12 mm and +/-0.12 deg for the femoral component and +/-0.29 mm and +/-0.25 deg for the tibial component. This methodology presents a useful tool that can be readily applied to the investigation of in-vivo motion of TKA kinematics.     

Predicting the shapes of bones at a joint: application to the shoulder

This paper presents a novel method to explore the intrinsic morphological correlation between the bones of a shoulder joint (humerus and scapula). To model this correlation, canonical correlation analysis (CCA) is used. We also propose a technique to predict a three-dimensional (3D) bone shape from its adjoining segment at a joint based on partial least squares regression (PLS). The high dimensional 3D surface information of a bone is represented by a few variables using principal component analysis, which also captures the pattern of variability of the shapes in our datasets. Our results show that the humerus set and scapula set have highly linear morphological relationship and that the correlation information can be used as a classifier. In this study, primate shoulder bone datasets were categorised into two clusters: great apes (including humans) and monkeys. A leave one out experiment was performed to test the robustness of this prediction method. The prediction behaviour using this method shows statistically significantly better results than using the mean shape from the training set.     

In-vivo measurement of dynamic joint motion using high speed biplane radiography and CT: application to canine ACL deficiency

Dynamic assessment of three-dimensional (3D) skeletal kinematics is essential for understanding normal joint function as well as the effects of injury or disease. This paper presents a novel technique for measuring in-vivo skeletal kinematics that combines data collected from high-speed biplane radiography and static computed tomography (CT). The goals of the present study were to demonstrate that highly precise measurements can be obtained during dynamic movement studies employing high frame-rate biplane video-radiography, to develop a method for expressing joint kinematics in an anatomically relevant coordinate system and to demonstrate the application of this technique by calculating canine tibio-femoral kinematics during dynamic motion. The method consists of four components: the generation and acquisition of high frame rate biplane radiographs, identification and 3D tracking of implanted bone markers, CT-based coordinate system determination, and kinematic analysis routines for determining joint motion in anatomically based coordinates. Results from dynamic tracking of markers inserted in a phantom object showed the system bias was insignificant (-0.02 mm). The average precision in tracking implanted markers in-vivo was 0.064 mm for the distance between markers and 0.31 degree for the angles between markers. Across-trial standard deviations for tibio-femoral translations were similar for all three motion directions, averaging 0.14 mm (range 0.08 to 0.20 mm). Variability in tibio-femoral rotations was more dependent on rotation axis, with across-trial standard deviations averaging 1.71 degrees for flexion/extension, 0.90 degree for internal/external rotation, and 0.40 degree for varus/valgus rotation. Advantages of this technique over traditional motion analysis methods include the elimination of skin motion artifacts, improved tracking precision and the ability to present results in a consistent anatomical reference frame.     

Growth of the pectoral girdle of the Leopard frog, Rana pipiens (Anura: Ranidae)

This article describes the growth of the anuran pectoral girdle of Rana pipiens and compares skeletal development of the shoulder to that of long bones. The pectoral girdle chondrifies as two halves, each adjacent to a developing humerus. In each, the scapula and coracoid form as single foci of condensed chondrocytes that fuse, creating a cartilaginous glenoid bridge articulating with the humerus. Based on histological sections, both the dermal clavicle and cleithrum begin to ossify at approximately the same time as the periosteum forms around the endochondral bones. The dermal and endochondral bones of the girdle form immobile joints with neighboring girdle elements; however, the cellular organization and growth pattern of the scapula and coracoid closely resemble those of a long bone. Similar to a long bone epiphysis, distal margins of both endochondral elements have zones of hyaline, stratified, and hypertrophic cartilages. As a result, fused elements of the girdle can grow without altering the glenoid articulation with the humerus. Comparisons of anuran long bone and pectoral girdle growth suggest that different bones can have similar histology and development regardless of adult morphology.     

Comparative accuracy of radiostereometric and optical tracking systems

This study aims to quantify and compare the accuracy of traditional radiostereometric analysis (RSA), fluoroscopic RSA (fRSA), and optical tracking systems. Three phantoms were constructed, each having three stainless steel spheres and three reflective markers. One phantom was mounted to the base of a precision cross-slide table, one to the base of a precision rotation table, and the third was mounted to each moveable tabletop. Two dial-gauges, rigidly mounted to the cross-slide table and rotation table, quantified translations and rotations. Two fluoroscopy units placed orthogonally tracked the steel spheres while a four-camera optical motion capture system tracked the reflective markers in three-dimensional space. RSA was performed with both digital radiography and fluoroscopy. Three axes of translation were tested: parallel to one fluoroscopy image, parallel to the other fluoroscopy image, and at approximately 45° to each image. One axis of rotation was tested. Intraclass correlation coefficients indicated excellent agreement between the actual (dial-gauge) and measured translations for all modalities (ICCs>0.99) and excellent agreement between actual and measured rotations for RSA and fRSA (ICCs>0.99). Standard errors of measurement ranged from 0.032 mm and 0.121° for RSA, to 0.040 mm and 0.229° for fRSA, and to 0.109 mm and 0.613° for optical tracking. Differences between actual and measured translations along the 45° axis were significantly smaller than the two parallel axes. These findings suggest that under ideal conditions, accuracy of fRSA is comparable to traditional RSA, and superior to optical tracking. Accuracy is highest when measured at 45° to the fluoroscopy units.     

Markerless analysis of front crawl swimming

Research on motion analysis of swimmers is commonly based on video recordings of the subject's motion, which are analyzed by manual digitization of feature points by an operator. This procedure has two main drawbacks: it is time-consuming, and it is affected by low repeatability. Therefore, the application of video-based, automatic approaches to motion analysis was investigated. A video-based, markerless system for the analysis of arm movements during front crawl swimming was developed. The method proposed by Corazza et al. (2010) was modified in order to be used into water environment. Three dimensional coordinates of shoulder, elbow and wrist joints centers of 5 sprint swimmers performing front crawl swimming were determined. Wrist joint velocity was also calculated. Accuracy and reliability of the proposed technique were evaluated by means of comparison with traditional manual digitization (SIMI Reality Motion Systems GmbH). Root mean square distance (RMSD) values between trajectories estimated with the two techniques were determined. Results show good accuracy for wrist joint (RMSD<56mm), and reliability, evaluated on one subject, comparable to the inter-operator variability associated with the manual digitization procedure. The proposed technique is therefore very promising for quantitative, wide-scale studies on swimmers' motion.