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Multi-segment foot motion in healthy individuals: Comparison of children and adults
Published posters / Gait & Posture 24S (2006) S98–S289
matic model) calculation of rotations around each of the axes using a series of simple four-point angle calculations. This enabled exploration of the performance and limitations of the kinematic model. The angles calculated from the wands were compared with the actual output of the arm angles obtained using the kinematic model. Data from over 200 static trails in which the PAM was positioned in different combinations of joint axis rotations were analysed and a disagreement of less than 5◦ achieved around all axes. The normative data set is based on over 160 gait cycles of 15 male subjects. The kinematic data (Fig. 1) are presented with respect to the contralateral limb initial contact to the next initial contact.
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motion, such as sagittal and coronal plane hindfoot motion and sagittal plane forefoot motion.
2. Introduction Little data has been documented on MSFM in children [1–4]. MacWilliams et al. reported on adolescents aged 7–16 (n = 18), however, they were not compared to adults. Henley et al. found differences between 5 years old (N = 2), 8 years old and adults (N = 2, N = 6, respectively). Longitudinal arch has been said to continue to develop and change through age 8, therefore differences in MSFM could be expected in younger children compared to adolescents and adults [5].
5. Results 3. Statement of clinical significance Fig. 1.
6. Discussion
Differences in MSFM over different age groups has not been previously described. It is hypothesized that there will be significant differences between the kids and the adults, as the foot complex and arch continue to develop.
The upper limb kinematics presented provide a useful quantitative description for reference. In many ways the work demonstrates the power of the tools that are readily available for kinematic modelling and of the flexibility available to end users to design models which best suit their needs.
4. Methods
References [1] Davis R, Ounpuu S, Tyburski, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Sci 1991;10:575–87. [2] Rau G, Disselhorst-Klug C, Schmidt R. Movement biomechanics goes upwards: from the leg to the arm. J Biomech 2000;33:1207–16. [3] Grood E, Suntay W. A joint co-ordinate system for the clinical description of three-dimensional motion: applications to the knee. J Biomech Eng 1983;105:136–44.
doi:10.1016/j.gaitpost.2006.11.150 PP-084 Multi-segment foot motion in healthy individuals: Comparison of children and adults Kirsten Tulchin ∗ , Lori Karol
Forty-five healthy children underwent gait analysis, with IRB approval, and were subdivided by age into three groups: kids (K, 6–9 years old, N = 15), pre-teens (PT, 10–12 years old, N = 15) and teens (T, 13–17 years, N = 15). In addition, 20 adults (Ad) were also evaluated. Demographics for the four groups are listed in Table 1. Patients were instrumented with a modified Helen Hayes marker set for lower extremity kinematics, which were processed with Vicon Clinical Manager (VCM, Oxford Metrics, England). MSFM were processed using the custom TSRH foot and ankle model in BodyBuilder for Biomechanics (Oxford Metrics, England) as previously described [4]. Kinematic data were collected at 120 Hz using a VICON 512 system (Oxford Metrics, England) at the subjects self-selecting walking speed. Lower extremity foot and ankle motion via the Helen Hayes marker set, and relative three-dimensional motion of the hindfoot to the tibia (HF) and the forefoot to the hindfoot (FF) were examined. Multivariate analysis (ANOVA) with Tukey post hoc tests were used to determine differences between groups across the gait cycle
Texas Scottish Rite Hospital for Children, Dallas, TX, USA
1. Summary/conclusions Multi-segment foot and ankle motion (MSFM) was compared across four age groups: kids, pre-teens, teens and adults. Significant differences were found between kids and adults in both typical lower extremity gait analysis measures, such as foot progression angle, as well as in multi-segment
Table 1 The average age, ratio of males to females (M/F), average self selected walking speed and cadence are listed for each of the four groups Group
Age (years)
M/F
Speed (m/s)
Cadence (steps/min)
K, N = 15 PT, N = 15 T, N = 15 A, N = 20
8.2 (1.0) 11.6 (0.9) 15.5 (1.5) 30.7 (5.9)
5/10 9/6 9/6 10/10
1.11 (0.35) 1.14 (0.16) 1.27 (0.18) 1.26 (0.10)
1.07 (0.09) 0.96 (0.04) 0.92 (0.08) 0.95 (0.07)
Mean (standard deviation).
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Published posters / Gait & Posture 24S (2006) S98–S289
Table 2 Significant differences seen in select gait variables did not correspond to low cross correlation between groups Group
Segment-plane
Variable(s) (p value)
Cross correlation
K vs. PT K vs. A
HF-Sag HF-Cor FF-Sag HF-Sag FP
Ave GC (p < 0.03), Max PF (p < 0.01) Ave GC (p < 0.03), Min GC (p < 0.05), Inv TO (p < 0.00), Max Inv (p < 0.01) Ave GC (p < 0.01), Max DF (p < 0.01), PF TO (p < 0.02) Min GC (p < 0.02), ROM GC (p < 0.02) Ave GC (p < 0.03), Max GC (p < 0.01), Min GC (p < 0.03), Ave ST (p < 0.04)
0.96 0.92 0.98 0.96 0.94
PT vs. T PT vs. A
ST, stance; TO, toeoff; GC, gait cycle; Inv, inversion; PF, plantarflexion; DF, dorsiflexion.
Fig. 1. Comparison of four age groups. Solid line: kids; dash line: pre-teens; dotted line: teens; gray band: adults. Kids are offset slightly in hindfoot PF and hindfoot eversion, with associated shifts in the forefoot.
for each kinematic variable. Correlation coefficients were used to determine similarity of the curves between groups.
5. Results Patient demographics and temporal parameters are listed in Table 1. Statistical analysis of specific portions or points of the gait cycle revealed significant differences between groups within four graphs: HF sagittal (HF-sag) plane and HF coronal (HF-cor) plane, FF sagittal (FF-sag) plane and foot progression angle (FPA). Despite these significant differences, the correlation coefficients of these variables between groups were above 0.90, indicating that the curve patterns were similar (Table 2). The lowest correlation coefficients were seen within HF-Cor between the PT group and K (0.84) and A (0.73). Gross examination of the graphs reveal that the K group has a slight plantarflexion shift in HF-Sag with a dorsiflexion shift in FF-Sag. In addition, there is a slight eversion shift in the K group in HF-Cor with corresponding inversion shift in FF-Cor. The PT group walked with slightly decreased external FPA compared to the other groups.
6. Discussion The combination of correlation analysis and ANOVA multivariate analysis determined that while the general shape of the kinematic variables were similar across groups, there were significant differences among several motions. As hypothesized, the kids did show significant differences compared to the adults, specifically in coronal plane hindfoot and sagittal plane forefoot motion. Based on these findings, it is suggested that pediatric patients with pathology are compared with age matched control data, particularly in children less than 10 years old (Fig. 1).
References [1] [2] [3] [4]
MacWilliams, et al. Gait Posture 2003;17:214–24. Henley, et al. In: Proceedings of GCMAS 6th Annual Meeting; 2001. Myers, et al. IEEE Trans Neural Syst Rehab Eng 2004;12:122–30. Tulchin, Haideri. In: Proceedings of 8th International Symposium 3D Analysis of Human Movement; 2001, p. 25–28. [5] Herring, editor. Tachdjian’s Pediatric Orthopedics, 3rd ed.; 2002, p. 891.
doi:10.1016/j.gaitpost.2006.11.151
matic model) calculation of rotations around each of the axes using a series of simple four-point angle calculations. This enabled exploration of the performance and limitations of the kinematic model. The angles calculated from the wands were compared with the actual output of the arm angles obtained using the kinematic model. Data from over 200 static trails in which the PAM was positioned in different combinations of joint axis rotations were analysed and a disagreement of less than 5◦ achieved around all axes. The normative data set is based on over 160 gait cycles of 15 male subjects. The kinematic data (Fig. 1) are presented with respect to the contralateral limb initial contact to the next initial contact.
S219
motion, such as sagittal and coronal plane hindfoot motion and sagittal plane forefoot motion.
2. Introduction Little data has been documented on MSFM in children [1–4]. MacWilliams et al. reported on adolescents aged 7–16 (n = 18), however, they were not compared to adults. Henley et al. found differences between 5 years old (N = 2), 8 years old and adults (N = 2, N = 6, respectively). Longitudinal arch has been said to continue to develop and change through age 8, therefore differences in MSFM could be expected in younger children compared to adolescents and adults [5].
5. Results 3. Statement of clinical significance Fig. 1.
6. Discussion
Differences in MSFM over different age groups has not been previously described. It is hypothesized that there will be significant differences between the kids and the adults, as the foot complex and arch continue to develop.
The upper limb kinematics presented provide a useful quantitative description for reference. In many ways the work demonstrates the power of the tools that are readily available for kinematic modelling and of the flexibility available to end users to design models which best suit their needs.
4. Methods
References [1] Davis R, Ounpuu S, Tyburski, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Sci 1991;10:575–87. [2] Rau G, Disselhorst-Klug C, Schmidt R. Movement biomechanics goes upwards: from the leg to the arm. J Biomech 2000;33:1207–16. [3] Grood E, Suntay W. A joint co-ordinate system for the clinical description of three-dimensional motion: applications to the knee. J Biomech Eng 1983;105:136–44.
doi:10.1016/j.gaitpost.2006.11.150 PP-084 Multi-segment foot motion in healthy individuals: Comparison of children and adults Kirsten Tulchin ∗ , Lori Karol
Forty-five healthy children underwent gait analysis, with IRB approval, and were subdivided by age into three groups: kids (K, 6–9 years old, N = 15), pre-teens (PT, 10–12 years old, N = 15) and teens (T, 13–17 years, N = 15). In addition, 20 adults (Ad) were also evaluated. Demographics for the four groups are listed in Table 1. Patients were instrumented with a modified Helen Hayes marker set for lower extremity kinematics, which were processed with Vicon Clinical Manager (VCM, Oxford Metrics, England). MSFM were processed using the custom TSRH foot and ankle model in BodyBuilder for Biomechanics (Oxford Metrics, England) as previously described [4]. Kinematic data were collected at 120 Hz using a VICON 512 system (Oxford Metrics, England) at the subjects self-selecting walking speed. Lower extremity foot and ankle motion via the Helen Hayes marker set, and relative three-dimensional motion of the hindfoot to the tibia (HF) and the forefoot to the hindfoot (FF) were examined. Multivariate analysis (ANOVA) with Tukey post hoc tests were used to determine differences between groups across the gait cycle
Texas Scottish Rite Hospital for Children, Dallas, TX, USA
1. Summary/conclusions Multi-segment foot and ankle motion (MSFM) was compared across four age groups: kids, pre-teens, teens and adults. Significant differences were found between kids and adults in both typical lower extremity gait analysis measures, such as foot progression angle, as well as in multi-segment
Table 1 The average age, ratio of males to females (M/F), average self selected walking speed and cadence are listed for each of the four groups Group
Age (years)
M/F
Speed (m/s)
Cadence (steps/min)
K, N = 15 PT, N = 15 T, N = 15 A, N = 20
8.2 (1.0) 11.6 (0.9) 15.5 (1.5) 30.7 (5.9)
5/10 9/6 9/6 10/10
1.11 (0.35) 1.14 (0.16) 1.27 (0.18) 1.26 (0.10)
1.07 (0.09) 0.96 (0.04) 0.92 (0.08) 0.95 (0.07)
Mean (standard deviation).
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Published posters / Gait & Posture 24S (2006) S98–S289
Table 2 Significant differences seen in select gait variables did not correspond to low cross correlation between groups Group
Segment-plane
Variable(s) (p value)
Cross correlation
K vs. PT K vs. A
HF-Sag HF-Cor FF-Sag HF-Sag FP
Ave GC (p < 0.03), Max PF (p < 0.01) Ave GC (p < 0.03), Min GC (p < 0.05), Inv TO (p < 0.00), Max Inv (p < 0.01) Ave GC (p < 0.01), Max DF (p < 0.01), PF TO (p < 0.02) Min GC (p < 0.02), ROM GC (p < 0.02) Ave GC (p < 0.03), Max GC (p < 0.01), Min GC (p < 0.03), Ave ST (p < 0.04)
0.96 0.92 0.98 0.96 0.94
PT vs. T PT vs. A
ST, stance; TO, toeoff; GC, gait cycle; Inv, inversion; PF, plantarflexion; DF, dorsiflexion.
Fig. 1. Comparison of four age groups. Solid line: kids; dash line: pre-teens; dotted line: teens; gray band: adults. Kids are offset slightly in hindfoot PF and hindfoot eversion, with associated shifts in the forefoot.
for each kinematic variable. Correlation coefficients were used to determine similarity of the curves between groups.
5. Results Patient demographics and temporal parameters are listed in Table 1. Statistical analysis of specific portions or points of the gait cycle revealed significant differences between groups within four graphs: HF sagittal (HF-sag) plane and HF coronal (HF-cor) plane, FF sagittal (FF-sag) plane and foot progression angle (FPA). Despite these significant differences, the correlation coefficients of these variables between groups were above 0.90, indicating that the curve patterns were similar (Table 2). The lowest correlation coefficients were seen within HF-Cor between the PT group and K (0.84) and A (0.73). Gross examination of the graphs reveal that the K group has a slight plantarflexion shift in HF-Sag with a dorsiflexion shift in FF-Sag. In addition, there is a slight eversion shift in the K group in HF-Cor with corresponding inversion shift in FF-Cor. The PT group walked with slightly decreased external FPA compared to the other groups.
6. Discussion The combination of correlation analysis and ANOVA multivariate analysis determined that while the general shape of the kinematic variables were similar across groups, there were significant differences among several motions. As hypothesized, the kids did show significant differences compared to the adults, specifically in coronal plane hindfoot and sagittal plane forefoot motion. Based on these findings, it is suggested that pediatric patients with pathology are compared with age matched control data, particularly in children less than 10 years old (Fig. 1).
References [1] [2] [3] [4]
MacWilliams, et al. Gait Posture 2003;17:214–24. Henley, et al. In: Proceedings of GCMAS 6th Annual Meeting; 2001. Myers, et al. IEEE Trans Neural Syst Rehab Eng 2004;12:122–30. Tulchin, Haideri. In: Proceedings of 8th International Symposium 3D Analysis of Human Movement; 2001, p. 25–28. [5] Herring, editor. Tachdjian’s Pediatric Orthopedics, 3rd ed.; 2002, p. 891.
doi:10.1016/j.gaitpost.2006.11.151