Factors influencing accuracy of screw displacement axis detection with a D.C.-based electromagnetic tracking system.

Recent technical improvements and cost reductions in electromagnetic motion tracking systems invite their application to motion axis determination in the surgical setting. After evaluation of the accuracy of a state-of-the-art D.C. electromagnetic tracking system, which generates complete three-dimensional kinematic outputs from just a single receiver, we calculated screw displacement axes (SDA's) from its source data. The accuracy of SDA determination from such source data was evaluated for various rotational increment sizes around a revolute joint. A novel smoothing procedure, customized for this type of source data, was developed, enabling SDA detection from incremental rotations of less than 1 deg, at an accuracy appropriate for intra-operative measurement of human joint motion. Examples of SDA determination are given for motion tracking of a ball joint and of the elbow articulation.     

The accuracy of joint surface models constructed from data obtained with an electromagnetic tracking device

Electromagnetic tracking devices are widely used in biomechanics. In this article a method is evaluated to construct models of articular surfaces using an electromagnetic tracking device. First, the accuracy of the space tracker was examined and optimised. Then, from several joint surfaces random points were measured and eighth degree polynomials were fitted to these measurements. To check if the fit converged well, plots of cross sections of the model with corresponding data points were examined. The accuracy of the models was determined by comparing them with computed tomography data and by reproducibility tests. All the fits converged well to the data. The root mean square (RMS) error of the models varied from 0.07 to 0. 18mm, and was proportional to the size and complexity of the surface. This was mainly due to systematic errors made by the space tracker, which were also proportional to the size and complexity of the surface.     

Evaluation of an electromagnetic position tracking device for measuring in vivo, dynamic joint kinematics

An electromagnetic position tracking device was evaluated to determine its static and dynamic accuracy and reliability for applications related to measuring in vivo joint kinematics. The device detected the position and orientation of small coiled sensors, maintained in an electromagnetic field. System output was measured against known translations or rotations throughout the measurement volume. Average translational errors during static testing were 0.1 +/- 0.04, 0.2 +/- 0.17, and 0.8 +/- 0.81 mm (mean+/-SD) for sensors 50, 300, and 550 mm away from the field generator, respectively. Average rotational errors were 0.4 +/- 0.31 degrees, 0.4 +/- 0.21 degrees, and 0.9 +/- 0.85 degrees (mean +/- SD) for sensors located at the same distances. Since we intended to use this system in an animal walking on a treadmill, we incrementally moved the sensors under various treadmill conditions. The effects of treadmill operation on translational accuracy were found to be negligible. The effects of dynamic motions on sensor-to-sensor distance were also assessed for future data collection in the animal. Sensor-to-sensor distance showed standard deviations of 2.6 mm and a range of 13 mm for the highest frequency tested (0.23 Hz). We conclude that this system is useful for static or slow dynamic motions, but is of limited use for obtaining gait kinematics at higher speeds.     

Direct comparison of kinematic data collected using an electromagnetic tracking system versus a digital optical system

The purpose of this study was to quantify the dynamic accuracy of kinematics measured by a digital optical motion analysis system in a gait analysis laboratory (capture volume approximately 20m(3)) compared to a standard range direct-current electromagnetic (EM) tracking device (capture volume approximately 1m(3)). This is a subset of a larger effort to establish an appropriate marker set for the optical system to quantify upperlimb kinematics simultaneously with gait, in comparison to previous studies of isolated upperlimb movements that have employed EM tracking devices. Rigid clusters of spherical reflective markers and EM sensors were attached to a mechanical articulator that mimicked three-dimensional joint rotations, similar to the elbow. As the articulator was moved through known ranges of motion (i.e. gold standard), kinematic data were collected simultaneously using both tracking systems. Both systems were tended to underestimate the range of motion; however, the application of post hoc smoothing and least-squares correction algorithms reduced these effects. When smoothing and correction algorithms were used, the magnitude of the mean difference between the gold standard and either the EM or optical system did not exceed 2 degrees for any of the compound motions performed. This level of agreement suggests that the measurements obtained from either system are clinically comparable, provided appropriate smoothing and correction algorithms are employed.     

Improvement of design of a surgical interface using an eye tracking device

Background

Surgical interfaces are used for helping surgeons in interpretation and quantification of the patient information, and for the presentation of an integrated workflow where all available data are combined to enable optimal treatments. Human factors research provides a systematic approach to design user interfaces with safety, accuracy, satisfaction and comfort. One of the human factors research called user-centered design approach is used to develop a surgical interface for kidney tumor cryoablation. An eye tracking device is used to obtain the best configuration of the developed surgical interface.

Methods

Surgical interface for kidney tumor cryoablation has been developed considering the four phases of user-centered design approach, which are analysis, design, implementation and deployment. Possible configurations of the surgical interface, which comprise various combinations of menu-based command controls, visual display of multi-modal medical images, 2D and 3D models of the surgical environment, graphical or tabulated information, visual alerts, etc., has been developed. Experiments of a simulated cryoablation of a tumor task have been performed with surgeons to evaluate the proposed surgical interface. Fixation durations and number of fixations at informative regions of the surgical interface have been analyzed, and these data are used to modify the surgical interface.

Results

Eye movement data has shown that participants concentrated their attention on informative regions more when the number of displayed Computer Tomography (CT) images has been reduced. Additionally, the time required to complete the kidney tumor cryoablation task by the participants had been decreased with the reduced number of CT images. Furthermore, the fixation durations obtained after the revision of the surgical interface are very close to what is observed in visual search and natural scene perception studies suggesting more efficient and comfortable interaction with the surgical interface. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Short Post-Assessment Situational Awareness (SPASA) questionnaire results have shown that overall mental workload of surgeons related with surgical interface has been low as it has been aimed, and overall situational awareness scores of surgeons have been considerably high.

Conclusions

This preliminary study highlights the improvement of a developed surgical interface using eye tracking technology to obtain the best SI configuration. The results presented here reveal that visual surgical interface design prepared according to eye movement characteristics may lead to improved usability.

     

Feasibility of using a magnetic tracking device for measuring carpal kinematics

While several different methods have been used to measure carpal kinematics, biplanar radiography is generally considered to be the most accurate and popular one. However, biplanar radiography is tedious and so only pseudo-dynamic kinematics can be measured. Recently, magnetic tracking system has been developed for the measurement of joint kinematics which is versatile and easy to use and so the possibility of measuring motions dynamically. In this study, the capability of a magnetic tracking device to accurately measure carpal kinematics was investigated by comparing it with biplanar radiography. The kinematics of the third metacarpal, scaphoid, and lunate in five fresh cadaveric specimens were measured using both methods as the wrists were placed in eight positions. The finite screw rotation of each bone with respect to the distal radius during selecting the seven wrist motions was calculated for both measuring techniques and compared. In general, the kinematics for all three bones measured by using either magnetic tracking device or biplanar radiography was identical and showed no statistical difference. The averaged differences ranged from 0.0 to 2.0°. These differences were due to the potential effect of the weight of the sensors and the interference of the attaching rod to the surrounding tissue. It is concluded that the application of the magnetic tracking device to carpal kinematics is warranted, if proper technical procedures as suggested are followed.     

Determining dual Euler angles of the ankle complex in vivo using "flock of birds" electromagnetic tracking device

The dual Euler angles method has been proposed as an alternative approach to describe the general spatial human joint motion. In this study, the dual Euler angles method was applied to study the three-dimensional motion of the ankle complex. The methodology for obtaining dual Euler angles of the ankle complex was developed by using a "Flock of Birds" electromagnetic tracking device. The repeatability of the methodology was studied based on the intertester and intratester variability analysis. Finally kinematic coupling characteristics of the ankle complex during dorsiflexion-plantarflexion, eversion-inversion, and abduction-adduction were analyzed according to the parameters of the dual Euler angles.     

A portable system for collecting anatomical joint angles during stair ascent: a comparison with an optical tracking device

Background

Assessments of stair climbing in real-life situations using an optical tracking system are lacking, as it is difficult to adapt the system for use in and around full flights of stairs. Alternatively, a portable system that consists of inertial measurement units (IMUs) can be used to collect anatomical joint angles during stair ascent. The purpose of this study was to compare the anatomical joint angles obtained by IMUs to those calculated from position data of an optical tracking device.

Methods

Anatomical joint angles of the thigh, knee and ankle, obtained using IMUs and an optical tracking device, were compared for fourteen healthy subjects. Joint kinematics obtained with the two measurement devices were evaluated by calculating the root mean square error (RMSE) and by calculating a two-tailed Pearson product-moment correlation coefficient (r) between the two signals.

Results

Strong mean correlations (range 0.93 to 0.99) were found for the angles between the two measurement devices, as well as an average root mean square error (RMSE) of 4 degrees over all the joint angles, showing that the IMUs are a satisfactory system for measuring anatomical joint angles.

Conclusion

These highly portable body-worn inertial sensors can be used by clinicians and researchers alike, to accurately collect data during stair climbing in complex real-life situations.

     

A new method for motion capture of the scapula using an optoelectronic tracking device: a feasibility study

Optoelectronic tracking systems are rarely used in 3D studies examining shoulder movements including the scapula. Among the reasons is the important slippage of skin markers with respect to scapula. Methods using electromagnetic tracking devices are validated and frequently applied. Thus, the aim of this study was to develop a new method for in vivo optoelectronic scapular capture dealing with the accepted accuracy issues of validated methods.

Eleven arm positions in three anatomical planes were examined using five subjects in static mode. The method was based on local optimisation, and recalculation procedures were made using a set of five scapular surface markers.

The scapular rotations derived from the recalculation-based method yielded RMS errors comparable with the frequently used electromagnetic scapular methods (RMS up to 12.6° for 150° arm elevation). The results indicate that the present method can be used under careful considerations for 3D kinematical studies examining different shoulder movements.     

Accuracy and repeatability of joint angles measured using a single camera markerless motion capture system

Markerless motion capture systems have developed in an effort to evaluate human movement in a natural setting. However, the accuracy and reliability of these systems remain understudied. Therefore, the goals of this study were to quantify the accuracy and repeatability of joint angles using a single camera markerless motion capture system and to compare the markerless system performance with that of a marker-based system. A jig was placed in multiple static postures with marker trajectories collected using a ten camera motion analysis system. Depth and color image data were simultaneously collected from a single Microsoft Kinect camera, which was subsequently used to calculate virtual marker trajectories. A digital inclinometer provided a measure of ground-truth for sagittal and frontal plane joint angles. Joint angles were calculated with marker data from both motion capture systems using successive body-fixed rotations. The sagittal and frontal plane joint angles calculated from the marker-based and markerless system agreed with inclinometer measurements by <0.5°. The systems agreed with each other by <0.5° for sagittal and frontal plane joint angles and <2° for transverse plane rotation. Both systems showed a coefficient of reliability <0.5° for all angles. These results illustrate the feasibility of a single camera markerless motion capture system to accurately measure lower extremity kinematics and provide a first step in using this technology to discern clinically relevant differences in the joint kinematics of patient populations.     

A novel device for long bone osteodistraction: description of device and case series

The purpose of this study was to present a novel intramedullary device (M-Bone; Phenix, Paris, France) that contains a mechanism for internal osteodistraction and bone transport in patients with segmental bone defects or limb length discrepancy after limb salvage operations. A total of five patients with primary bone tumors were enrolled in the study. After implantation, daily lengthening was performed in an outpatient setting either by the patient or with the help of a therapist, without the use of anesthesia. This unique device offers a totally new approach for the treatment of segmental bone defects or limb length discrepancy. It is designed to expand the remaining native bone by a magnetically activated drive system and induces new bone formation using osteodistraction and bone transport.     

Calibration of the "Flock of Birds" electromagnetic tracking device and its application in shoulder motion studies.

In this paper the applicability in terms of measurement accuracy of the "Flock of Birds" six D.O.F. electromagnetic tracking device in shoulder research is investigated. Position measurements in a workspace of approximately 1 m3 were performed using a stylus. The andom error at the stylus tip appeared to be 1.86, 1.98 and 2.54 mm for x-, y- and z-coordinate, respectively. The error caused by distortion of the magnetic field by metal in the concrete of especially the floor was 20.8, 22.2 and 20.4 mm for the x-, y- and z-coordinate, respectively. Calibration and leaving out the measurements closest to the floor lowered this error to 2.07, 2.38 and 2.35 mm. Orientation errors of the shoulder bones evolving from the measurement inaccuracy were estimated from repeated measurements of shoulder bony landmarks of ten subjects by means of the stylus. These errors were generally below 2 degrees. This is lower than found for the same measurements using a spatial linkage digitizer. It is concluded that the "Flock of Birds" is a useful tool for shoulder kinematic studies.     

In vivo tests of an improved method for functional location of the subtalar joint axis

The subtalar joint is important in frontal plane movement and posture of the hindfoot. Abnormal subtalar joint moments caused by muscle forces and the ground reaction force acting on the foot are thought to play a role in various foot deformities. Calculating joint moments typically requires knowledge of the location of the joint axis; however, location of the subtalar axis from measured movement is difficult because the talus cannot be tracked using skin-mounted markers. The accuracy of a novel technique for locating the subtalar axis was assessed in vivo using magnetic resonance imaging. The method was also tested with skin-mounted markers and video motion analysis. The technique involves applying forces to the foot that cause pure subtalar joint motion (with negligible talocrural joint motion), and then using helical axis decomposition of the resulting tibiocalcaneal motion. The resulting subtalar axis estimates differed by 6° on average from the true best-fit subtalar axes in the MRI tests. Motion was found to have been applied primarily about the subtalar joint with an average of only 3° of talocrural joint motion. The proposed method provides a potential means for obtaining subject-specific subtalar axis estimates which can then be used in inverse dynamic analyses and subject-specific musculoskeletal models.     

Reliability, repeatability and accuracy of the falling head method for hydraulic conductivity measurements under laboratory conditions

The aim of this study was to verify under lab conditions the reliability, repeatability and accuracy of the falling head method (FHM) for hydraulic conductivity measurements. The FHM is a reliable procedure that has slight variations (less than 10%) in repeated measurements and turns out to be a reliable technique to record the hydraulic conductivities typically described for clogged and unclogged subsurface-flow constructed wetlands (from 4 to ca. 360 m/day). The accuracy of the method is acceptable considering difficulties in the measurement of hydraulic conductivity in highly conductive media. Accordingly, results show measurement deviations of 20% when compared with a laboratory constant head method for highly conductive media (higher than 250 m/day), and 80% for media with low hydraulic conductivity (lower than 50 m/day). The main conclusion of the present paper is that of the FHM is a reliable and repeatable technique for hydraulic conductivity measurements and it is accurate enough for on-site clogging assessment in full-scale constructed wetlands.     

Quantitative measurements of force and displacement using an optical trap.

We combined a single-beam gradient optical trap with a high-resolution photodiode position detector to show that an optical trap can be used to make quantitative measurements of nanometer displacements and piconewton forces with millisecond resolution. When an external force is applied to a micron-sized bead held by an optical trap, the bead is displaced from the center of the trap by an amount proportional to the applied force. When the applied force is changed rapidly, the rise time of the displacement is on the millisecond time scale, and thus a trapped bead can be used as a force transducer. The performance can be enhanced by a feedback circuit so that the position of the trap moves by means of acousto-optic modulators to exert a force equal and opposite to the external force applied to the bead. In this case the position of the trap can be used to measure the applied force. We consider parameters of the trapped bead such as stiffness and response time as a function of bead diameter and laser beam power and compare the results with recent ray-optic calculations.     

Evidence for IHA migration during axial rotation of a lumbar spine segment by using a novel high-resolution 6D kinematic tracking system

The biomechanical properties of the lumbar spine have long been studied. However, despite its enormous importance, basic functional and morphological properties have been not well understood and require further experimental analysis since data concerning the spatial instantaneous segmental motions are hardly available. This study describes the theoretical background and the technical properties of an innovative method for tracking the instantaneous 3D motion of human spinal segments in vitro at high spatial resolution. This new acquisition system allows to scrutinise closely the location and alignment of the segmental instantaneous helical axis (IHA) and the respective screw pitch as functions of the absolute rotational angle. The required precision of the measuring device was attained (a) by six highly resolving linear inductive displacement sensors in a special spatially configuration (3-2-1), (b) by a method to apply torque and force independently of each other without counteraction, and (c) by suppression of vibrations. The validity and reliability of the experimental set-up and the numerical method of data analysis were tested by subjects of known mechanical properties. In vitro experiments with a human lumbar segment (L3/L4, autopsy material) demonstrated that (a) the IHA migrated during axial rotation from one segmental articulatio zygapophysialis to the other joint, (b) the IHA tilted medial-laterally, and (c) the pitch of the screw altered linearly as a function of the rotational angle. This phenomenon is traced back to the guidance of the articluationes zygapophysiales. The validation of the method allows to map segments of the entire vertebral column. The results can be used as benchmarks for future models of the human spine.     

Assessing the accuracy and precision of musculoskeletal motion tracking using cine-PC MRI on a 3.0T platform

The rising cost of musculoskeletal pathology, disease, and injury creates a pressing need for accurate and reliable methods to quantify 3D musculoskeletal motion, fostering a renewed interest in this area over the past few years. To date, cine-phase contrast (PC) MRI remains the only technique capable of non-invasively tracking in vivo 3D musculoskeletal motion during volitional activity, but current scan times are long on the 1.5T MR platform (～2.5 min or 75 movement cycles). With the clinical availability of higher field strength magnets (3.0T) that have increased signal-to-noise ratios, it is likely that scan times can be reduced while improving accuracy. Therefore, the purpose of this study is to validate cine-PC MRI on a 3.0T platform, in terms of accuracy, precision, and subject-repeatability, and to determine if scan time could be minimized. On the 3.0T platform it is possible to limit scan time to 2 min, with sub-millimeter accuracy (<0.33 mm/0.97°), excellent technique precision (<0.18°), and strong subject-repeatability (<0.73 mm/1.10°). This represents reduction in imaging time by 25% (42 s), a 50% improvement in accuracy, and a 72% improvement in technique precision over the original 1.5T platform. Scan time can be reduced to 1 min (30 movement cycles), but the improvements in accuracy are not as large.