A. Hannover Medical School, Hannover, hosted by Ann-Kathrin Einfeldt and Negin Tschalaki (22.10.2025)
B. Waldkliniken Eisenberg, Eisenberg, hosted by Dr. Leandra Bauer (23.10.2025)
C. BG Klinik Ludwigshafen, Ludwigshafen, hosted by Dr. Ursula Trinler (19.11.2025)
D. University of Stuttgart, Stuttgart, hosted by Anja Seeger (20.11.2025)
E. ETH Zurich, Zurich, hosted by Dr. Ariana Ortigas-Vásquez and Angela Frautschi (21.11.2025)
Description
This project investigates the repeatability and reproducibility of marker-based motion capture across five gait laboratories in Germany and Switzerland. Standardised treadmill walking trials at 4 km/h will be captured for two researchers using optical motion analysis with the MiKneeSoTA marker approach (Einfeldt et al.) in combination with the REFRAME harmonisation technique (Ortigas-Vásquez et al.). To assess inter- and intra-examiner variability, markers will be placed by each researcher on each other, as well as by local laboratory staff. The study aims to quantify sources of variability in marker placement and data capture across sites, contributing to improved standardisation and comparability in gait analysis research.
Specific Aims
1) Assess repeatability of marker placement within laboratories
> Quantify intra- and inter-examiner variability in applying the MiKneeSoTA marker set when performed by the two researchers and by local lab staff.
2) Evaluate reproducibility across laboratories
> Compare kinematic outcomes of standardised treadmill gait trials across five different gait laboratories in Germany and Switzerland.
3) Investigate the effectiveness of the REFRAME harmonisation technique
> Determine to what extent REFRAME reduces variability in motion capture data introduced by differences in marker placement and laboratory setups.
4) Identify sources of variability in marker-based motion capture
> Characterise the relative contributions of examiner-dependent factors, laboratory specific setups, and inter-site methodological differences.
5) Contribute to standardisation in gait analysis
> Provide evidence-based recommendations to improve consistency, reproducibility, and comparability of marker-based gait data across research and clinical contexts.
MiKneeSoTA is a new method developed by Einfeldt et al. (2024) to minimize knee soft-tissue artifacts in kinematic analysis during gait studies. The approach addresses a critical limitation in marker-based optical motion capture systems used for joint kinematics estimation. The primary challenge MiKneeSoTA tackles is soft-tissue-induced motion artifacts (STIMA), which is a major source of error in biomechanical analysis. These artifacts occur when skin and soft tissue move relative to the underlying bones during movement, causing inaccurate measurements of joint angles and motion patterns. While traditional approaches to soft tissue artifact compensation often rely on anatomical simplifications or require complex multi-body optimization methods, MiKneeSoTA offer a novel computational solution specifically tailored for knee joint analysis. The development of MiKneeSoTA is particularly significant for clinical gait analysis, where accurate kinematic measurements are essential for diagnostic and treatment decisions, as well as for research applications involving musculoskeletal modeling where precise joint kinematics are crucial for estimating muscle and joint forces.
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REFRAME is an approach developed by Ortigas-Vásquez et al. to minimize cross-talk between axes of movement and provide kinematic patterns that can be reliably compared without requiring direct knowledge of the relative poses of different local segment frames. The method addresses a fundamental challenge in clinical movement biomechanics, where kinematic signals may appear different not because they represent different underlying joint movements, but due to inconsistent local reference frame orientations used during data collection and analysis. By using a self-contained optimization approach to systematically re-align the position and orientation of reference frames, REFRAME allows researchers to better assess whether two kinematic signals represent fundamentally similar or different underlying knee motion. This standardization is particularly valuable for comparing kinematic data across different studies, marker sets, or measurement systems, enabling more consistent interpretation and analysis of joint kinematics in both clinical and research settings.
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