Method for the estimation of a double hinge kinematic model for the trapeziometacarpal joint using MR imaging

In this paper, we propose a method to estimate the parameters of a double hinge model of the trapeziometacarpal joint (TMC) by MRI-based motion analysis. The model includes two non-orthogonal and non-intersecting rotation axes accounting for flexion–extension (F–E) and adduction–abduction (A–A). We evaluated the quality of the estimated model parameters in the prediction of the relative motion of the first metacarpal bone with respect to the trapezium. As a result, we obtained that: (a) the estimated location and orientation of the F–E and A–A axes were in agreement with previous in vitro studies, (b) the motion of the first metacarpal predicted by the 2 degrees of freedom (2DoF) model exhibits a maximum surface distance error in the range of about 2 mm and (c) four thumb postures at the boundary of the TMC range of motion are sufficient to provide a good estimation of the 2DoF TMC kinematic model and good reproducibility (～1.7 mm) of the real thumb motion at TMC level.     

In vivo kinematic behavior of the radio-capitate joint during wrist flexion-extension and radio-ulnar deviation.

The capitate is often considered the "keystone" of the carpus, not simply because of its central and prominent position in the wrist, but also because of its mechanical interactions with neighboring bones. The purpose of this study was to determine in vivo three-dimensional capitate kinematics. Twenty uninjured wrists were investigated using a recently developed, non-invasive markerless bone registration (MBR) technique. Surface contours of the capitate, third metacarpal and radius were extracted from computed tomography images of seven wrist positions and the three-dimensional motions of the capitate and third metacarpal were calculated with respect to the radius in wrist flexion-extension and radio-ulnar deviation. We found that in vivo capitate motion does not simply occur about a single pivot point like a universal joint, as demonstrated by non-intersecting rotation axes for different capitate motions. The distance between flexion and ulnar deviation axes was 3.9+/-2.0 mm, and the distance between extension and ulnar deviation axes was 3.9+/-1.4 mm. Furthermore, capitate axes for males tended to be located more distally than axes for females. However, we believe that this result is related to subject size and not to gender. We also found that there is minimal relative motion between the capitate and third metacarpal during these in vivo wrist motions. These findings demonstrate the complexity of capitate kinematics, as well as the different mechanisms through which wrist flexion, extension, radial deviation and ulnar deviation occur.     

Soft tissue displacement over pelvic anatomical landmarks during 3-D hip movements

The position, in a pelvis-embedded anatomical coordinate system, of skin points located over the following anatomical landmarks (AL) was determined while the hip assumed different spatial postures: right and left anterior superior and posterior superior iliac spines, and the sacrum. Postures were selected as occurring during walking and during a flexion–extension and circumduction movement, as used to determine the hip joint centre position (star-arc movement). Five volunteers, characterised by a wide range of body mass indices (22–37), were investigated. Subject-specific MRI pelvis digital bone models were obtained. For each posture, the pose of the pelvis-embedded anatomical coordinate system was determined by registering this bone model with points digitised over bony prominences of the pelvis, using a wand carrying a marker-cluster and stereophotogrammetry. The knowledge of how the position of the skin points varies as a function of the hip posture provided information regarding the soft tissue artefact (STA) that would affect skin markers located over those points during stereophotogrammetric movement analysis. The STA was described in terms of amplitude (relative to the position of the AL during an orthostatic posture), diameter (distance between the positions of the AL which were farthest away from each other), and pelvis orientation. The STA amplitude, exhibited, over all postures, a median [inter-quartile] value of 9[6] and 16[11] mm, for normal and overweight volunteers, respectively. STA diameters were larger for the star-arc than for the walking postures, and the direction was predominantly upwards. Consequent errors in pelvic orientation were in the range 1–9 and 4–11 degrees, for the two groups respectively.     

In situ comparison of A-mode ultrasound tracking system and skin-mounted markers for measuring kinematics of the lower extremity

Skin-mounted marker based motion capture systems are widely used in measuring the movement of human joints. Kinematic measurements associated with skin-mounted markers are subject to soft tissue artifacts (STA), since the markers follow skin movement, thus generating errors when used to represent motions of underlying bone segments. We present a novel ultrasound tracking system that is capable of directly measuring tibial and femoral bone surfaces during dynamic motions, and subsequently measuring six-degree-of-freedom (6-DOF) tibiofemoral kinematics. The aim of this study is to quantitatively compare the accuracy of tibiofemoral kinematics estimated by the ultrasound tracking system and by a conventional skin-mounted marker based motion capture system in a cadaveric experimental scenario. Two typical tibiofemoral joint models (spherical and hinge models) were used to derive relevant kinematic outcomes. Intra-cortical bone pins equipped with optical markers were inserted in the tibial and femoral bones to serve as a reference to provide ground truth kinematics. The ultrasound tracking system resulted in lower kinematic errors than the skin-mounted markers (the ultrasound tracking system: maximum root-mean-square (RMS) error 3.44° for rotations and 4.88 mm for translations, skin-mounted markers with the spherical joint model: 6.32° and 6.26 mm, the hinge model: 6.38° and 6.52 mm). Our proposed ultrasound tracking system has the potential of measuring direct bone kinematics, thereby mitigating the influence and propagation of STA. Consequently, this technique could be considered as an alternative method for measuring 6-DOF tibiofemoral kinematics, which may be adopted in gait analysis and clinical practice.     

Motion analysis of an articulated locomotion model by video and telemetric data.

Traditional techniques of human motion analysis use markers located on body articulations. The position of each marker is extracted from each image. Temporal and kinematic analysis is given by matching these data with a reference model of the human body. However, as human skin is not rigidly linked with the skeleton, each movement causes displacements of the markers and induces uncertainty in results. Moreover, the experiments are mostly conducted in restricted laboratory conditions. The aim of our project was to develop a new method for human motion analysis which needs non-sophisticated recording devices, avoids constraints to the subject studied, and can be used in various surroundings such as stadiums or gymnasiums. Our approach consisted of identifying and locating body parts in image, without markers, by using a multi-sensory sensor. This sensor exploits both data given by a video camera delivering intensity images, and data given by a 3D sensor delivering in-depth images. Our goal, in this design, was to show up the feasibility of our approach. In any case the hardware we used could facilitate an automated motion analysis. We used a linked segment model which referred to Winter's model, and we applied our method not on a human subject but on a life size articulated locomotion model. Our approach consists of finding the posture of this articulated locomotion model in the image. By performing a telemetric image segmentation, we obtained an approximate correspondence between linked segment model position and locomotion model position. This posture was then improved by injecting segmentation results in an intensity image segmentation algorithm. Several tests were conducted with video/telemetric images taken in an outdoor surrounding with the articulated model. This real life-size model was equipped with movable joints which, in static positions, described two strides of a runner. With our fusion method, we obtained relevant limbs identification and location for most postures.     

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.     

Osteocutaneous posterior interosseous flap for reconstruction of the metacarpal bone and soft-tissue defects in the hand

A vascularized bone segment of the ulna together with a posterior interosseous fasciocutaneous flap is harvested, including a cuff of the extensor pollicis longus muscle. The authors treated five male patients with metacarpal bone and soft-tissue defects of the hand using a distally based island osteocutaneous posterior interosseous flap. Their ages at the time of surgery ranged from 15 to 37 years (mean, 24 years). The bone defects were in the first metacarpal in three cases, the fourth metacarpal in one, and the fifth metacarpal in one. The length of the donated ulna ranged from 3 to 7 cm (mean, 5 cm). The follow-up period ranged from 5 to 92 months (mean, 39 months). All flaps survived completely. The posterior interosseous flap provides thin skin of good texture, together with vascularized bone, for a one-stage reconstruction of the metacarpal bone and soft-tissue defects in the hand.     

Measurement of in vivo anterior cruciate ligament strain during dynamic jump landing

Despite recent attention in the literature, anterior cruciate ligament (ACL) injury mechanisms are controversial and incidence rates remain high. One explanation is limited data on in vivo ACL strain during high-risk, dynamic movements. The objective of this study was to quantify ACL strain during jump landing. Marker-based motion analysis techniques were integrated with fluoroscopic and magnetic resonance (MR) imaging techniques to measure dynamic ACL strain non-invasively. First, eight subjects' knees were imaged using MR. From these images, the cortical bone and ACL attachment sites of the tibia and femur were outlined to create 3D models. Subjects underwent motion analysis while jump landing using reflective markers placed directly on the skin around the knee. Next, biplanar fluoroscopic images were taken with the markers in place so that the relative positions of each marker to the underlying bone could be quantified. Numerical optimization allowed jumping kinematics to be superimposed on the knee model, thus reproducing the dynamic in vivo joint motion. ACL length, knee flexion, and ground reaction force were measured. During jump landing, average ACL strain peaked 55±14 ms (mean and 95% confidence interval) prior to ground impact, when knee flexion angles were lowest. The peak ACL strain, measured relative to its length during MR imaging, was 12±7%. The observed trends were consistent with previously described neuromuscular patterns. Unrestricted by field of view or low sampling rate, this novel approach provides a means to measure kinematic patterns that elevate ACL strains and that provide new insights into ACL injury mechanisms.     

Knee joint secondary motion accuracy improved by quaternion-based optimizer with bony landmark constraints

Skin marker-based motion analysis has been widely used in biomechanical studies and clinical applications. Unfortunately, the accuracy of knee joint secondary motions is largely limited by the nonrigidity nature of human body segments. Numerous studies have investigated the characteristics of soft tissue movement. Utilizing these characteristics, we may improve the accuracy of knee joint motion measurement. An optimizer was developed by incorporating the soft tissue movement patterns at special bony landmarks into constraint functions. Bony landmark constraints were assigned to the skin markers at femur epicondyles, tibial plateau edges, and tibial tuberosity in a motion analysis algorithm by limiting their allowed position space relative to the underlying bone. The rotation matrix was represented by quaternion, and the constrained optimization problem was solved by Fletcher's version of the Levenberg-Marquardt optimization technique. The algorithm was validated by using motion data from both skin-based markers and bone-mounted markers attached to fresh cadavers. By comparing the results with the ground truth bone motion generated from the bone-mounted markers, the new algorithm had a significantly higher accuracy (root-mean-square (RMS) error: 0.7 ± 0.1 deg in axial rotation and 0.4 ± 0.1 deg in varus-valgus) in estimating the knee joint secondary rotations than algorithms without bony landmark constraints (RMS error: 1.7 ± 0.4 deg in axial rotation and 0.7 ± 0.1 deg in varus-valgus). Also, it predicts a more accurate medial-lateral translation (RMS error: 0.4 ± 0.1 mm) than the conventional techniques (RMS error: 1.2 ± 0.2 mm). The new algorithm, using bony landmark constrains, estimates more accurate secondary rotations and medial-lateral translation of the underlying bone.     

A protocol for monitoring soft tissue motion under compression garments during drop landings

This study used a single-subject design to establish a valid and reliable protocol for monitoring soft tissue motion under compression garments during drop landings. One male participant performed six 40 cm drop landings onto a force platform, in three compression conditions (none, medium high). Five reflective markers placed on the thigh under the compression garment and five over the garment were filmed using two cameras (1000 Hz). Following manual digitisation, marker coordinates were reconstructed and their resultant displacements and maximum change in separation distance between skin and garment markers were calculated. To determine reliability of marker application, 35 markers were attached to the thigh over the high compression garment and filmed. Markers were then removed and re-applied on three occasions; marker separation and distance to thigh centre of gravity were calculated. Results showed similar ground reaction forces during landing trials. Significant reductions in the maximum change in separation distance between markers from no compression to high compression landings were reported. Typical errors in marker movement under and over the garment were 0.1mm in medium and high compression landings. Re-application of markers showed mean typical errors of 1mm in marker separation and <3mm relative to thigh centre of gravity. This paper presents a novel protocol that demonstrates sufficient sensitivity to detect reductions in soft tissue motion during landings in high compression garments compared to no compression. Additionally, markers placed under or over the garment demonstrate low variance in movement, and the protocol reports good reliability in marker re-application.     

Accuracy of an optical active-marker system to track the relative motion of rigid bodies

The measurement of relative motion between two moving bones is commonly accomplished for in vitro studies by attaching to each bone a series of either passive or active markers in a fixed orientation to create a rigid body (RB). This work determined the accuracy of motion between two RBs using an Optotrak optical motion capture system with active infrared LEDs. The stationary noise in the system was quantified by recording the apparent change in position with the RBs stationary and found to be 0.04 degrees and 0.03 mm. Incremental 10 degrees rotations and 10-mm translations were made using a more precise tool than the Optotrak. Increasing camera distance decreased the precision or increased the range of values observed for a set motion and increased the error in rotation or bias between the measured and actual rotation. The relative positions of the RBs with respect to the camera-viewing plane had a minimal effect on the kinematics and, therefore, for a given distance in the volume less than or close to the precalibrated camera distance, any motion was similarly reliable. For a typical operating set-up, a 10 degrees rotation showed a bias of 0.05 degrees and a 95% repeatability limit of 0.67 degrees. A 10-mm translation showed a bias of 0.03 mm and a 95% repeatability limit of 0.29 mm. To achieve a high level of accuracy it is important to keep the distance between the cameras and the markers near the distance the cameras are focused to during calibration.     

Eustachian tube cartilage and medial movement of lateral pharyngeal wall on phonation

Several authors have demonstrated the importance of medial movement of the lateral pharyngeal wall in velopharyngeal closure upon phonation. However, it remains controversial what muscle is responsible for lateral pharyngeal wall movement and where is the main site of this movement. The purpose of this study was to address the above two unanswered questions. In 22 subjects (12 normal volunteers, 10 patients with cleft palate), lateral pharyngeal wall movement upon phonation was evaluated by using rapid magnetic resonance imaging (MRI). Before rapid MRI, their lateral pharyngeal wall movements were classified into three groups: the poor, moderate, and good, according to the findings of nasopharyngoscopy. Inward displacement of the eustachian tube cartilages upon phonation, which was quantified as distance ratio in the transverse plane of MR images, was compared with nasopharyngoscopic findings. In addition, the level of lateral pharyngeal wall movement was observed in the plane 5 mm lateral to the mid-sagittal plane of MR images. Inward displacement of the eustachian tube cartilage in the transverse plane of MR images was coincident with medial movement of lateral pharyngeal wall observed by nasopharyngoscopy in all 22 subjects. By using one-way analysis of variance, a statistically significant correlation was found between nasopharyngoscopic classification and distance ratio. The sagittal plane of MR images revealed that the main site of movement occurred at the level of the hard palate and above. It is concluded that medial movement of the lateral pharyngeal wall consists of inward displacement of the eustachian tube cartilage, which is caused by contraction of the levator veli palatini muscle, and that the primary site of this movement is at the level of the hard palate and above, where the eustachian tube, but not the superior constrictor muscle, exists.     

Kinematic accuracy of three surface registration methods in a three-dimensional wrist bone study

The use of registration techniques to determine motion transformations noninvasively has become more widespread with the increased availability of the necessary software. In this study, three surface registration techniques were used to generate carpal bone kinematic results from a single cadaveric wrist specimen. Surface contours were extracted from specimen computed tomography volume images of the forearm, carpal, and metacarpal bones in four arbitrary positions. Kinematic results from each of three registration techniques were compared with results derived from multiple spherical markers fixed to the specimen. Kinematic accuracy was found to depend on the registration method and bone size and shape. In general, rotation errors of the capitate and scaphoid were less than 0.5 deg for all three techniques. Rotation errors for the other bones were generally less than 2 deg, although error for the trapezoid was greater than 2 deg in one technique. Translation errors of the bones were generally less than 1 mm, although errors of the trapezoid and trapezium were greater than 1 mm for two techniques. Tradeoffs existed in each registration method between image processing time and overall kinematic accuracy. Markerless bone registration (MBR) can provide accurate measurements of carpal kinematics and can be used to study the noninvasive, three-dimensional in vivo kinematics of the wrist and other skeletal joints.     

Kinematic models of the upper limb joints for multibody kinematics optimisation: An overview

Soft tissue artefact (STA), i.e. the motion of the skin, fat and muscles gliding on the underlying bone, may lead to a marker position error reaching up to 8.7 cm for the particular case of the scapula. Multibody kinematics optimisation (MKO) is one of the most efficient approaches used to reduce STA. It consists in minimising the distance between the positions of experimental markers on a subject skin and the simulated positions of the same markers embedded on a kinematic model. However, the efficiency of MKO directly relies on the chosen kinematic model. This paper proposes an overview of the different upper limb models available in the literature and a discussion about their applicability to MKO.The advantages of each joint model with respect to its biofidelity to functional anatomy are detailed both for the shoulder and the forearm areas. Models capabilities of personalisation and of adaptation to pathological cases are also discussed. Concerning model efficiency in terms of STA reduction in MKO algorithms, a lack of quantitative assessment in the literature is noted. In priority, future studies should concern the evaluation and quantification of STA reduction depending on upper limb joint constraints.     

Metacarpal head biomechanics: a comparative backscattered electron image analysis of trabecular bone mineral density in Pan troglodytes, Pongo pygmaeus, and Homo sapiens

Great apes and humans use their hands in fundamentally different ways, but little is known about joint biomechanics and internal bone variation. This study examines the distribution of mineral density in the third metacarpal heads in three hominoid species that differ in their habitual joint postures and loading histories. We test the hypothesis that micro-architectural properties relating to bone mineral density reflect habitual joint use. The third metacarpal heads of Pan troglodytes, Pongo pygmaeus, and Homo sapiens were sectioned in a sagittal plane and imaged using backscattered electron microscopy (BSE-SEM). For each individual, 72 areas of subarticular cortical (subchondral) and trabecular bone were sampled from within 12 consecutive regions of the BSE-SEM images. In each area, gray levels (representing relative mineralization density) were quantified.Results show that chimpanzee, orangutan, and human metacarpal III heads have different gray level distributions. Weighted mean gray levels (WMGLs) in the chimpanzee showed a distinct pattern in which the ‘knuckle-walking’ regions (dorsal) and ‘climbing’ regions (palmar) are less mineralized, interpreted to reflect elevated remodeling rates, than the distal regions. Pongo pygmaeus exhibited the lowest WMGLs in the distal region, suggesting elevated remodeling rates in this region, which is loaded during hook grip hand postures associated with suspension and climbing. Differences among regions within metacarpal heads of the chimpanzee and orangutan specimens are significant (Kruskal–Wallis, p < 0.001). In humans, whose hands are used for manipulation as opposed to locomotion, mineralization density is much more uniform throughout the metacarpal head. WMGLs were significantly (p < 0.05) lower in subchondral compared to trabecular regions in all samples except humans. This micro-architectural approach offers a means of investigating joint loading patterns in primates and shows significant differences in metacarpal joint biomechanics among great apes and humans.     

Predicting Missing Marker Trajectories in Human Motion Data Using Marker Intercorrelations

Missing information in motion capture data caused by occlusion or detachment of markers is a common problem that is difficult to avoid entirely. The aim of this study was to develop and test an algorithm for reconstruction of corrupted marker trajectories in datasets representing human gait. The reconstruction was facilitated using information of marker inter-correlations obtained from a principal component analysis, combined with a novel weighting procedure. The method was completely data-driven, and did not require any training data. We tested the algorithm on datasets with movement patterns that can be considered both well suited (healthy subject walking on a treadmill) and less suited (transitioning from walking to running and the gait of a subject with cerebral palsy) to reconstruct. Specifically, we created 50 copies of each dataset, and corrupted them with gaps in multiple markers at random temporal and spatial positions. Reconstruction errors, quantified by the average Euclidian distance between predicted and measured marker positions, was ≤ 3 mm for the well suited dataset, even when there were gaps in up to 70% of all time frames. For the less suited datasets, median reconstruction errors were in the range 5–6 mm. However, a few reconstructions had substantially larger errors (up to 29 mm). Our results suggest that the proposed algorithm is a viable alternative both to conventional gap-filling algorithms and state-of-the-art reconstruction algorithms developed for motion capture systems. The strengths of the proposed algorithm are that it can fill gaps anywhere in the dataset, and that the gaps can be considerably longer than when using conventional interpolation techniques. Limitations are that it does not enforce musculoskeletal constraints, and that the reconstruction accuracy declines if applied to datasets with less predictable movement patterns.     

Tibiocalcaneal kinematics of barefoot versus shod running

Barefoot running kinematics has been described to vary considerably from shod running. However, previous investigations were typically based on externally mounted shoe and/or skin markers, which have been shown to overestimate skeletal movements. Thus, the purpose of this study was to compare calcaneal and tibial movements of barefoot versus shod running using skeletal markers. Intracortical bone pins with reflective marker triads were inserted under standard local anesthetic into the calcaneus and tibia of five healthy male subjects. The subjects ran barefoot, with a normal shoe, with three shoe soles and two orthotic modifications. The three-dimensional tibiocalcaneal rotations were determined using a joint coordinate system approach. Test variables were defined for eversion and tibial rotation. The results showed that the differences in bone movements between barefoot and shod running were small and unsystematic (mean effects being less than 2 degrees ) compared with the differences between the subjects (up to 10 degrees ). However, differences may occur during midstance when extreme shoe modifications (i.e. posterior orthosis) are used. It is concluded that calcaneal and tibial movement patterns do not differ substantially between barefoot and shod running, and that the effects of these interventions are subject specific. The result of this in vivo study contrasts with previous investigations using skin and shoe mounted markers and suggests that these discrepancies may be the result of the overestimation with externally mounted markers.     

Inter-individual variation in vertebral kinematics affects predictions of neck musculoskeletal models

Experimental studies have found significant variation in cervical intervertebral kinematics (IVK) among healthy subjects, but the effect of this variation on biomechanical properties, such as neck strength, has not been explored. The goal of this study was to quantify variation in model predictions of extension strength, flexion strength and gravitational demand (the ratio of gravitational load from the weight of the head to neck muscle extension strength), due to inter-subject variation in IVK. IVK were measured from sagittal radiographs of 24 subjects (14F, 10M) in five postures: maximal extension, mid-extension, neutral, mid-flexion, and maximal flexion. IVK were defined by the position (anterior-posterior and superior-inferior) of each cervical vertebra with respect to T1 and its angle with respect to horizontal, and fit with a cubic polynomial over the range of motion. The IVK of each subject were scaled and incorporated into musculoskeletal models to create models that were identical in muscle force- and moment-generating properties but had subject-specific kinematics. The effect of inter-subject variation in IVK was quantified using the coefficient of variation (COV), the ratio of the standard deviation to the mean. COV of extension strength ranged from 8% to 15% over the range of motion, but COV of flexion strength was 20–80%. Moreover, the COV of gravitational demand was 80–90%, because the gravitational demand is affected by head position as well as neck strength. These results indicate that including inter-individual variation in models is important for evaluating neck musculoskeletal biomechanical properties.     

In vivo pons motion within the skull

Finite element (FE) models are used to identify head injury mechanisms and design new and improved injury prevention schemes. Although brain-skull boundary conditions strongly influence the model mechanical responses, limited experimental data are available to develop an informed representation. We hypothesize that the spinal cord tension and gravity contribute to the pons displacement in vivo. Static high-resolution T1-weighted sagittal MR images of the inferior portion of the head in neutral and flexion positions were acquired in 15 human volunteers in both supine and prone postures. Boundaries of the pons and clivus were extracted with a gradient-based algorithm, and the pontes were fitted into ellipses. Assuming rigid body motion of the skull, image pairs in different postures were co-registered with an autocorrelation technique. By comparing images before and after the motion, we found that while the rotation of the pons is negligible relative to the skull, the pons displaces significantly at the foramen magnum, on the order of approximately 2 mm. When the spinal cord tension and gravity act in concert, the pons moves caudally; when opposed, superiorly, such that the influence of gravity on the pons is six times that of the spinal cord tension. Based on these findings, we recommend that the brainstem-skull interface be treated as a sliding (with or without friction) boundary condition in FE models of the human head.     

Non-invasive assessment of soft-tissue artifact and its effect on knee joint kinematics during functional activity

The soft-tissue interface between skin-mounted markers and the underlying bones poses a major limitation to accurate, non-invasive measurement of joint kinematics. The aim of this study was twofold: first, to quantify lower limb soft-tissue artifact in young healthy subjects during functional activity; and second, to determine the effect of soft-tissue artifact on the calculation of knee joint kinematics. Subject-specific bone models generated from magnetic resonance imaging (MRI) were used in conjunction with X-ray images obtained from single-plane fluoroscopy to determine three-dimensional knee joint kinematics for four separate tasks: open-chain knee flexion, hip axial rotation, level walking, and a step-up. Knee joint kinematics was derived using the anatomical frames from the MRI-based, 3D bone models together with the data from video motion capture and X-ray fluoroscopy. Soft-tissue artifact was defined as the degree of movement of each marker in the anteroposterior, proximodistal and mediolateral directions of the corresponding anatomical frame. A number of different skin-marker clusters (total of 180) were used to calculate knee joint rotations, and the results were compared against those obtained from fluoroscopy. Although a consistent pattern of soft-tissue artifact was found for each task across all subjects, the magnitudes of soft-tissue artifact were subject-, task- and location-dependent. Soft-tissue artifact for the thigh markers was substantially greater than that for the shank markers. Markers positioned in the vicinity of the knee joint showed considerable movement, with root mean square errors as high as 29.3 mm. The maximum root mean square errors for calculating knee joint rotations occurred for the open-chain knee flexion task and were 24.3°, 17.8° and 14.5° for flexion, internal–external rotation and abduction–adduction, respectively. The present results on soft-tissue artifact, based on fluoroscopic measurements in healthy adult subjects, may be helpful in developing location- and direction-specific weighting factors for use in global optimization algorithms aimed at minimizing the effects of soft-tissue artifact on calculations of knee joint rotations.