Abstract
Background Technical development lead to an enhancement of clinical movement analysis in the
last few decades and expanded its research and clinical applications. Since the mid
20th century, human movement analysis has made its way into clinical practice, e.g.
in treating poliomyelitis and infantile cerebral palsy. Today, it has a wide range
of applications in various clinical areas. The aim of this narrative review is to
illustrate the variety of camera-based systems for human movement analysis and their
clinical applications, specifically in the field of orthopaedics and trauma surgery
(O/U). Benefits and limitations of each system are shown. Future development and necessary
improvements are discussed.
Material and Methods A selective literature review was undertaken with the databases PubMed and Google
Scholar using keywords related to clinical human movement analysis in the field of
orthopaedics and trauma surgery. Furthermore standard book references were included.
Results Common video camera systems (VS) are used for basic visual movement analysis. Instrumented
movement analysis systems include marker-based systems (MBS), markerless optical systems
(MLS) and rasterstereographic analysis systems (VRS). VS, MBS and MLS have clinical
use for dynamic examination of patients with various disorders in movement and gait.
Among such are e.g. neuro-orthopaedic disorders, muscular insufficiencies, degenerative
and post-trauma deficiencies with e.g. resultant pathologic leg axis. Besides the
measurement of kinematic data by MBS and MLS, the combination with kinetic measurements
to detect abnormal loading patterns as well as the combination with electromyography
(EMG) to detect abnormal muscle function is a great advantage. Validity and reliability
of kinematic measurements depend on the camera systems (MBS, MLS), the applied marker
models, the joints of interest and the observed movement plane. Movements in the sagittal
plane of the hip and knee joint, pelvic rotation and tilt as well as hip abduction
are generally measured with high reliability. In the frontal and transverse planes
of the knee and ankle joint substantial angular variabilities were noted due to the
small range of motion of the joints in these planes. Soft tissue artefacts and marker
placement are the biggest sources of errors. So far MLS did not improve these limitations.
MBS are most accurate and remain the gold-standard in clinical and scientific movement
analysis. VRS is used clinically for static 3D-analysis of the trunk posture and spine
deformities. Current systems allow the dynamic measurement and visualisation of trunk
and spine movement in 3D during gait and running. Planar x-ray-imaging (Cobbʼs angle)
and to some extent cross sectional imaging with CT-scan or MRI are commonly used for
the evaluation of patients with spinal deformities. VRS offers functional 3D data
of trunk and spine deformities without radiation exposure, thus allowing safer clinical
monitoring of the mainly infantile and adolescent patients. The accuracy, validity
and reliability of measurements of different VRS-systems for the clinical use has
been proven by several studies.
Conclusion The instrumented movement analysis is an additional tool that aids clinical practitioners
of O/U in the dynamic assessment of pathologic movement and loading patterns. In conjunction
with common radiologic imaging it aids in the planning of type and extent of corrective
surgical interventions. In the field of orthopaedics and trauma surgery movement analysis
can help as an additional diagnostic tool to develop therapeutic strategies and evaluate
clinical outcomes.
Key words
motion analysis - orthopaedic surgery - rasterstereography - infrared cameras - gait
analysis
