Enhanced anatomical calibration in human movement analysis

The representation of human movement requires knowledge of both movement and morphology of bony segments. The determination of subject-specific morphology data and their registration with movement data is accomplished through an anatomical calibration procedure (calibrated anatomical systems technique: CAST). This paper describes a novel approach to this calibration (UP-CAST) which, as compared with normally used techniques, achieves better repeatability, a shorter application time, and can be effectively performed by non-skilled examiners. Instead of the manual location of prominent bony anatomical landmarks, the description of which is affected by subjective interpretation, a large number of unlabelled points is acquired over prominent parts of the subject's bone, using a wand fitted with markers. A digital model of a template-bone is then submitted to isomorphic deformation and re-orientation to optimally match the above-mentioned points. The locations of anatomical landmarks are automatically made available. The UP-CAST was validated considering the femur as a paradigmatic case. Intra- and inter-examiner repeatability of the identification of anatomical landmarks was assessed both in vivo, using average weight subjects, and on bare bones. Accuracy of the identification was assessed using the anatomical landmark locations manually located on bare bones as reference. The repeatability of this method was markedly higher than that reported in the literature and obtained using the conventional palpation (ranges: 0.9-7.6 mm and 13.4-17.9, respectively). Accuracy resulted, on average, in a maximal error of 11 mm. Results suggest that the principal source of variability resides in the discrepancy between subject's and template bone morphology and not in the inter-examiner differences. The UP-CAST anatomical calibration could be considered a promising alternative to conventional calibration contributing to a more repeatable 3D human movement analysis.