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Department of Human Movement and Sport Sciences Istituto Universitario di Scienze Motorie, Piazza Lauro de Bosis 6, 00194 Roma, Italy
b
Centro di Cura e Riabilitazione Santa Maria Bambina, Oristano, Italy
Received 15 October 2007; received in revised form 10 March 2008; accepted 7 April 2008
Abstract
Background and aims: In many applications, it is essential that the evaluation of a given motor task is not affected by the restrictions of the
laboratory environment. To accomplish this requirement, miniature triaxial inertial and magnetic sensors can be used. This paper describes an
anatomical calibration technique for wearable inertial and magnetic sensing modules based on the direct measure of the direction of
anatomical axes using palpable anatomical landmarks. An anatomical frame definition for the estimate of joint angular kinematics of the
lower limb is also proposed.
Methods: The performance of the methodology was evaluated in an upright posture and a walking trial of a single able-bodied subject. The
repeatability was assessed with six examiners performing the anatomical calibration, while its consistency was evaluated by comparing the
results with those obtained using stereophotogrammetry.
Results: Results relative to the up-right posture trial revealed an intra- and inter-examiner variability which is minimal in correspondence to
the flex-extension angles (0.22.98) and maximal to the internalexternal rotation (1.67.38). For the level walking, the root mean squared
error between the kinematics estimated with the two measurement techniques varied from 2.5% to 4.8% of the range of motion for the flexextension, whereas it ranged from 13.1% to 41.8% in correspondence of the internalexternal rotation.
Conclusion: The proposed methodology allowed for the estimate of lower limb joint angular kinematics in a repeatable and consistent
manner, enabling inertial and magnetic sensing based systems to be used especially for outdoor human movement analysis applications.
# 2008 Elsevier B.V. All rights reserved.
Keywords: Movement analysis; Anatomical calibration; Anatomical frame definition; Joint angular kinematics; Wearable devices; Inertial and magnetic
sensing
1. Introduction
The description of joint kinematics during the execution
of a physical exercise may be accomplished by tracking the
trajectory of active or passive point markers located on the
skin of the subject using optoelectronic stereophotogrammetry (SP). The reconstructed coordinates of these markers
in an arbitrarily defined global frame (GF) allow for the
determination of local frames (technical frame: TF)
associated with each bone of interest and, therefore, the
description of the relevant instantaneous pose (position and
* Corresponding author. Tel.: +39 06 36733506; fax: +39 06 36733517.
E-mail address: pietro.picerno@iusm.it (P. Picerno).
0966-6362/$ see front matter # 2008 Elsevier B.V. All rights reserved.
doi:10.1016/j.gaitpost.2008.04.003
589
Differently from motion analysis system based on stereophotogrammetry, electromagnetic or ultrasound technologies, using MARG sensors, the position of ALs cannot be
determined, while the orientation of axes is provided. The
axes of the AF can be assumed coinciding with the axes of
the TF by manually aligning the sensor module with the
anatomical axes. This approach is evidently unreliable
since it only approximates anatomical planes and is not
repeatable. A second solution, suggested by several authors
[20,21], is based on a functional approach: one of the axes of
the AF can be assumed as coinciding with the direction of
the 3D angular velocity vector measured by the MARG
sensor attached to the body segment while the segment is
rotated about a joints functional axis. A second axis of the
AF can be defined using the direction of gravity measured by
the MARG sensor module during resting posture. This
approach has the advantage of being quick to perform (so it
is ideal for virtual reality and entertainment applications),
but undergoes some limitations: movements planes and
postures are subjective and, thus, the determination of the
AFs may be not repeatable. Moreover, joint impairments
may produce axes that are not consistently related to bone
anatomy.
The purpose of this study is to present a novel anatomical
calibration procedure to be used in association with a
MARG based motion-tracking system. This procedure is
based on the identification of superficial ALs. The proposed
methodology can be used to compute 3D joint angular
kinematics by means of MARG sensors in a reliable manner.
The repeatability of the method and its consistency with
joint kinematics obtained using SP are assessed with
reference to the lower limb during posture and level walking.
2. Materials and methods
The anatomical calibration is carried out while the subject
assumes a suitable stationary posture with the body segments of
interest equipped with a movement tracking MARG sensor and
using a calibration device. The latter is equipped with two mobile
pointers that can be made to point two-selected ALs. The body of
the device carries a MARG sensor, an active axis of which is
aligned with the line joining the two pointers and, thus, two ALs. In
this way the orientation of this line relative to the GF can be
measured. For each bony segment, the orientation of a minimum of
two non-parallel lines must be determined in order to construct the
orthogonal axes of the AF through a given geometric rule. Calibration devices of different geometry may be required in order to fit
bones with different shapes (Fig. 1).
During the anatomical calibration procedure, the MARG sensor
module attached to the body segment provides the orientation
matrix (gRt(0)) of the TF while the MARG sensor module placed
on the calibration device measures the orientation of at least two
unit vectors (guk; k = 1, 2) of lines passing through couples of ALs,
all relative to the GF. The latter vectors are, thereafter, represented
in the TF through the rigid transformation
t
uk g RTt 0 g uk
(1)
590
Fig. 1. Calibration devices adopted to identify the lines connecting ALs (a and b). Calibration of the directions identified by GT and LE (c), and of the direction
identified by ME and LE with respect to the thigh TFMARG (d).
Ra i g Rt it Ra 0;
i 1; . . . ; N
(2)
591
Fig. 2. Right lower limb anatomical frame definitions. uk represents the oriented axes identified by pointing two ALs by means of the calibration devices. The
origins of the AFs are arbitrarily placed.
hip joint centre in the pelvis point marker cluster was also determined using the functional approach described in [13].
An experimental trial was carried out while the volunteer
assumed an upright posture. A second experimental trial was
performed during level walking at a self-selected speed. During
both trials the global orientation of the MARG sensor and the
global position of the point marker clusters were tracked simultaneously.
The joint angular kinematics of hip, knee and ankle, during
upright posture and during level walking, were estimated using
both SP and MARG sensor data. In both cases the Cardan angular
convention and the AF definitions reported in Fig. 2 were used.
Data from SP were also used to estimate the joint angular
kinematics according to commonly adopted AF definitions [12].
2.1. Data analysis
The intra- and inter-examiner repeatability of the MARG sensor
anatomical calibration procedure was evaluated in terms of root
mean square deviation (RMSD) from the mean of the joint angles
estimated during the up-right posture and generated by the six
relevant calibrations.
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Table 1
Intra- and inter-examiners repeatability (RMSD) of joint angles estimated
with MARG sensors during an upright posture
Joint
3. Results
Precision and consistency in estimating joint angles
during the up-right posture trial using the MARG sensors are
reported in Tables 1 and 2. On average, the intra-examiner
repeatability was higher than inter-examiner repeatability. In
particular, the internalexternal rotation (In/Ex rot) variability was the highest across all joints. The knee In/Ex rot
exhibited the highest intra- and inter-examiners RMSD, 4.98
and 7.38, respectively.
For all joints, the flexion-extension angle (Fl/Ex)
presented the smallest AE, with the mean values ranging
from 1.38 to 1.88 and standard deviation values below 0.98.
The largest AE was observed in correspondence with the In/
Ex rot and, in particular, the highest mean value of AE, equal
to 8.38, was found for the ankle, whereas the largest S.D.
value of AE, equal to 6.18, was observed in correspondence
with the hip.
For all joints, the MAE affecting the angular kinematics
estimated by the MARG sensors during one gait cycle was
minimal for the Fl/Ex angle and maximal for the In/Ex rot.
For Fl/Ex, it ranged from 1.28 at the ankle to 38 at the hip.
For the Ab/Ad, it ranged from 3.68 at the hip to 5.58 at the
ankle and finally for the In/Ex rot, it varied from 4.58 at the
hip to 21.78 at the ankle. The RMSE values varied from 0.88
to 3.68 and were minimal for the Fl/Ex and maximal for the
Hip
Knee
Ankle
Fl/Ex (8)
Ab/Ad (8)
Intra
Inter
Intra
Inter
Intra
Inter
2.9
0.2
0.4
1.8
2
1.5
1.2
1
1
2.4
1.1
1.5
3.5
4.9
1.6
6.6
7.3
1.6
Table 2
Mean (standard deviation) of the differences in absolute value (AE) between
joint angles estimated with SP and the MARG sensors during an upright
posture
Joint
Fl/Ex (8)
Ab/Ad (8)
Hip
Knee
Ankle
1.8 (0.7)
1.9 (0.7)
1.3 (0.9)
3 (2.2)
4.6 (1.1)
5.7 (1.5)
6.7 (6.1)
6.3 (3.9)
8.3 (1.6)
In/Ex rot, across all joints and angles. The Fl/Ex curves
estimated with the MARG sensors were very similar to those
estimated with SP (Fig. 3) and the RMSE were always lower
than 4.8% of the nominal RoM (Table 3). The largest
RMSE% value was the knee In/ex rot and was equal to
41.8% of the nominal RoM.
The joint kinematics obtained using the AF definitions
proposed in this study were highly correlated with those
estimated using the AF definitions suggested by [12].
The correlation coefficient for the Fl/Ex was equal to 1 for
all joints whereas the DRoM was less than 0.58. The
lowest R was the knee In/Ex rot, and it was equal to 0.942
Fig. 3. Ensemble plots of hip, knee and ankle joint angle waveforms. The solid black lines represent the joint kinematics obtained with SP and the dashed grey
lines represent the joint kinematics obtained with the MARG sensors as generated by the anatomical calibrations performed by the six examiners. The curves are
temporally normalized from initial right foot contact (0%) until subsequent foot contact (100%).
Angle
RMSE (8)
RMSE %
Hip
Fl/Ex
Ab/Ad
In/Ex rot
MAE (8)
3
3.6
4.5
0.8
1.5
1.8
2.5
13.3
13.1
Knee
Fl/Ex
Ab/Ad
In/Ex rot
2.4
4.8
9.4
1.9
2.8
3.6
3
21.1
41.8
Ankle
Fl/Ex
Ab/Ad
In/Ex rot
1.2
5.5
21.7
1.2
2.2
3.5
4.8
11.7
32.5
The offset was evaluated in terms of mean absolute error (MAE). The
waveform distortion was evaluated in terms of root mean square error
(RMSE) between joint angular kinematics curves aligned with respect to
their relative mean values, estimated with SP and the MARG sensors.
RMSE % represented the RMSE expressed as a percentage of the RoM
estimated with SP.
whereas the largest DRoM, equal to 28, was the knee Ab/
Ad (Fig. 4).
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of the Flex/Ex angles was the most reliable for all joints
both in terms of repeatability (RMSD < 2.98) and in
terms of consistency with the SP data (AE < 1.98 (0.78)).
The estimates of the Ab/Ad angles were repeatable
(RMSD < 2.48) but were associated to differences with
respect to the SP data up to 5.78 (1.58). The less reliable
angles estimate was for the In/Ex rot which exhibited both
the lowest repeatability (RMSD < 7.38) and consistency.
To exclude errors related to the uncertainties associated
with ALs identifications, their positions were identified by
an expert and then marked with a felt pen. Thanks to this,
two objectives were accomplished: all operators performed
the anatomical calibration exercise by pointing at the same
previously marked ALs; the AFs, determined using the
MARG sensors and SP, were defined using the same points,
thus allowing comparison between the results. Unfortunately, SP reconstructs the position of the geometrical centre
of the marker placed on the AL, which is different from the
palpable position of the AL on the skin. Hence, the direction
of the line connecting two ALs measured with a MARG
sensors (hosted in its specific calibration device) and with SP
is unavoidably different. This difference increases when the
distance between two ALs decreases (i.e. for epicondyles
and malleoli), resulting in an AF determined differently
from one anothers measurement system even if identical
ALs and axis definitions are used. This circumstance may
explain the greater errors found in correspondence with the
Ab/Ad and In/Ex rot.
It is important to note that the cluster of markers was
mounted on the MARG sensor case, and therefore, during the
walking trial, TFs obtained with MARG sensors and SP were
affected by the same soft tissue artefact and were related by a
Fig. 4. Ensemble plots of hip, knee and ankle joint angle waveforms. The solid lines represent the joint kinematics obtained using a commonly adopted AF
definition [12], while the dashed lines represent the joint kinematics obtained from the AF definition suggested in this study. The movement data have been
recorded using SP.
594
Acknowledgements
The authors would like to thank Andrea Mele for his
technical support. This study was funded by the Italian
Ministry of Health and the ISPESL.
Conflict of interest
None.
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