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Table 3 Details of studies analyzed for the body segment inertial parameters (BSIPs) effect on the dynamics estimates

From: Methodological factors affecting joint moments estimation in clinical gait analysis: a systematic review

Study Experimental Simulation Differences Affect the dynamics (joint moments and powers)
[108] 1 RE [129] and 1 MI (MR) NA BSIPs were significantly different (exception: shank centre of mass, transverse—axis of radius of gyration about the knee) Statistically significant differences in sagittal-plane of hip and knee moments and powers. Maximum of 0.3 and 0.7% BW * H/s for moment and power at the hip
[130] 2 RE (linear multivariate and non-linear) [131] Variations up to 8%. NA Influence generally small. Propagation error at the hip joint due to errors at the knee and ankle
[26] 1 OM and 3 RE [14, 17, 22] NA BSIPs were significantly different (for the mass of the thigh Cheng closer to OM, for centre of mass Cheng and Dempster closer to OM, the moment of inertia no general results among body segment) Differences in the sagittal plane of hip, knee and ankle moments. Differences smaller in the stance phase with respect to the swing phase
[132] 5 RE [12, 16, 20, 22, 131] NA NA Appreciable differences on the sagittal plane of the hip moment. Some differences on frontal and coronal plane of the hip and knee moments (maximum 21.8% BW * H during stair descending). Larger during the swing phase
[114] 5 RE [12, 16, 20, 22, 131] NA NA Small differences between ex vivo and in vivo data, between data from different populations and among different modality of inertial parameters acquisition. The root mean square value was negligible at the ankle and increased as moving proximally among the joints (maximum 21.8% BW * H in the transverse plane at the hip moment)
[20] 1MI (DXA-derived), 1 RE cadaver based [14] NA BSIPs were significantly different (maximum differences were found for the foot: mass 36% lower, centre of mass 15% more proximally, moment of inertia 47% lower) Small effect during the stance phase, and more of an effect during the swing phase on joint moment on sagittal plane. Root mean square error increased moving proximally (at the hip 0.065 ± 0.043 Nm/kg body weight, corresponding approximatively to 0.4 ± 0.3% BW * H)
[21] 1MI (DXA-derived), 1 RE cadaver based [14] NA BSIPs were significantly different (maximum differences were found for moments of inertia 13–70%) Negligible effect on joint moments of three children (sagittal plane), higher at the hip during swing phase (ranging from 0.03 Nm/kg body weight in the 10 year-old to 0.06 Nm/kg body weight in the 7 year-old, corresponding approximatively to 0.2% BW * H in the 10 year-old and 0.5% BW * H in the 7 year-old)
[31] 3 RE [14, 21, 133] NA BSIPs were significantly different (mass, centre of mass, radius and moment of inertis) for each segment for both the cerebral palsy and control groups Negligible effect on joint moment for both groups (sagittal plane). Mean absolute variability between BSIP sets was low at the all three levels of the hip, knee and ankle (0.07, 0.04 and 0.01 Nm/kg respectively for the Control group and 0.04, 0.02 and 0.01 Nm/kg respectively for the CP group, corresponding approximatively to 0.5, 0.3 and 0.1% BW * H respectively for the control group and 0.3, 0.2 and 0.1% BW * H respectively for the CP group) No clinically meaningful difference between GDI-kinetic scores for the different BSIP protocols (maximum difference between BSIP sets was 2.4 and 2.8 points for Control and CP groups, respectively)
[47] NA Probabilistic analysis (advanced mean value, coefficients of variation: 0.12 for mass, 0.20 for moment of inertia, and 0.08 for centre-of-mass location ratio) NA Negligible effect of BSIPs on lower limb joint moments (stance phase, 3D), lower than the effect of anatomical landmarks definition. Variability in the magnitude of moments increased when moving from the ankle to the knee and hip
[111] 1 MI (DEXA), 4 RE [14, 22, 131, 134] NA BSIPs were significantly different: mass of the foot (up to 48.1%), centre of mass of thigh (8.3%), shank (9.7%) and foot, moment of inertia of shank and foot Negligible effect of BSIPs on lower limb joint moments (3D), higher in swing phase and for hip joint (absolute difference less than 0.09Nm/kg (0.5% BW * H)
[112] 1 GM [19], 1 RE [16] NA BSIPs were significantly different (mass and longitudinal moment of inertia of the thigh) Negligible effect of BSIPs on lower limb joint moments (root mean square difference 0.7 and 4.3% for the knee and hip, respectively. Difference lower than that caused by a 0.5 Hz adjustment in the cut-off frequency of the filter used to process the data
[117] NA Monte Carlo simulation (3000 iterations) NA BSIPs had a relatively small impact on lower limb joint moments compared to the impact of marker error (marker placement and soft tissue artifact). The only exception was hip flex/ext during the swing period
[110] 24 RE studies classified as: cadaveric, living (Caucasian), male living (Caucasian), female living (Caucasian), living (non-Caucasian) Monte Carlo simulation 2000 iterations (Latin Hypercube, Sampling method) BSIPs were significantly different between living subjects and cadaver studies (thigh, calf and foot masses up to 15.44%, centre of mass of the foot, and moment of inertia of thigh 36.65%), between Caucasian females and males (calf and foot masses, centre of mass of thigh and foot up to 15.05%, and moment of inertia of thigh 30.86%), and between Caucasian and non-Caucasian subjects (mass and moment of inertia of thigh 21.97%) Simulation results showed effect limited to the swing phase of the knee and hip. Experimental results showed little effect on joint moments, except for the swing phase. The magnitude of difference in the swing phase due to variability in BSIPs is not much greater than the inter-trial variability. Distal BSIPs have little effect on proximal joint moment
[34] NA Statistical analysis (sample of errors from a normal distribution, three different maximum errors: 5, 10 and 15%) NA The refinement of the BSIPs has little effect in gait analysis results (compared to kinematic data and ground reaction force). Higher effect during the swing phase
[109] 5 RE [14, 15, 134], 1 GM [134] BSIPs varied in steps over nine levels by a defined percentage (−40 to 40%) of the baseline value [14] Significant differences were found for the mass, centre of mass and moment of inertia for both the leg and thigh segments (more than 40%) BSIPS variations significantly affect most of the dynamic estimates (particularly the swing phase). The magnitude of these effects was generally less than 1% of body weight
[113] 5 RE [12, 14, 17, 131, 134], 1 GM [135] NA BSIPs were significantly different (from at least 9.73% up to 60%) BSIPs variation has no effect on knee and ankle joint moments. For the hip joint moments, the effect is significant at slow, preferred and fast cadence (deviations reaching 17.91% and 20.11%, during the swing phase)
[100] NA Two sets of Monte Carlo analyses with and without noise (variations of BSIP values, together or separately, within 25, 50, 75, and 100% of their allowable bounds obtained from OM) NA BSIPs variation had no significant effect on calculated lower-extremity inverse dynamics joint torques (worst average 0.25% BW * H)
[39] NA BSIPs varied ±30% of the baseline values [12] NA Top-down approach: segment mass has effect on the calculated GRF. No report on lower limb joint moment
[35] NA Two sets of accuracy (baseline value [12]: variation of 5% and [20, 130, 136] NA Regarding the BSIPs, the only main contributor of the uncertainty in the joint torques was the foot mass, the remaining secondary contributors were the other BSIPs
[116] NA Perturbation of BSIP from 60 to 140% in steps of 10% NA Limited effect of an individual parameter perturbation on the calculated moments (largest effect is found for shank centre of mass, with a ratio of absolute difference in torque and relative parameter perturbation maximally 7.81 Nm for hip flexion moment, corresponding approximatively to 0.6% BW * H). The additional influence of perturbing two parameters simultaneously is small
[115] 1RE [14, 137] Perturbation of mass and moment of inertia considering the uncertainty reported by Dempster [14]. Perturbation was performed considering the three segments (foot, shank, thigh) simultaneously and considering each segment independently NA Segment mass uncertainty has limited effect on the net joint moment. However, in case of adopted recursive method there is error propagation in proximal direction
  1. For the experimental studies the type of BPISs estimation was specified: regression analyses (RE), geometric models (GM), data provided by means of medical imaging technologies (MI), and data obtained solving the non- linear optimization problem (OM)