X-ray motion analysis is a technique used to track the movement of objects using X-rays. This is done by placing the subject to be imaged in the center of the X-ray beam and recording the motion using an image intensifier and a high-speed camera, allowing for high quality videos sampled many times per second. Depending on the settings of the X-rays, this technique can visualize specific structures in an object, such as bones or cartilage. X-ray motion analysis can be used to perform gait analysis, analyze joint movement, or record the motion of bones obscured by soft tissue. The ability to measure skeletal motions is a key aspect to one's understanding of vertebrate biomechanics, energetics, and motor control. [1]
Many X-ray studies are performed with a single X-ray emitter and camera. This type of imaging allows for tracking movements in the two-dimensional plane of the X-ray. Movements are performed parallel to the camera's imaging plane in order for the motion to be accurately tracked. [2] In gait analysis, planar X-ray studies are done in the sagittal plane to allow for highly accurate tracking of large movements. [3] Methods have been developed to allow for estimating all six degrees of freedom of movement from a planar X-ray and a model of the tracked object. [4] [5]
Few movements are truly planar; [2] planar X-ray imaging can capture the majority of movement, but not all of it. Accurately capturing and quantifying all three dimensions of movement requires a biplanar imaging system. [2] Biplanar imaging is difficult to perform because many facilities have access to only one X-ray emitter. [1] With the addition of a second X-ray and camera system, the 2-D plane of imaging expands to a 3-D volume of imaging at the intersection of the X-ray beams. Because the volume of imaging is at the intersection of two X-ray beams, the overall size of it is limited by the area of the X-ray emitters.
Motion capture techniques often use reflective markers for the image capturing. In X-ray imaging, markers that appear opaque in the X-ray images are utilized. [2] This frequently involves using radio-opaque spheres attached to the subject. Markers can be implanted in the subject's bones, which would then appear visible in the X-ray images. [6] This method requires surgical procedures for implanting and a healing period before the subject can undergo a motion analysis. For accurate 3-D tracking, at least three markers need to be implanted onto each bone to be tracked. [7] Markers can also be placed on the subject's skin to track the motion of the underlying bones, though markers placed on the skin are sensitive to skin movement artifacts. These are errors in the measurement of the location of a skin-placed marker compared to a bone-implanted marker. This occurs at locations where soft tissue moves more freely than the overlaying skin. [2] [4] [6] [8] The markers are then tracked relative to the X-ray camera(s) and the motions are mapped to the local anatomical bodies.
Emerging techniques and software are allowing for motion to be tracked without the need for radio-opaque markers. By using a 3-D model of the object being tracked, the object can be overlaid on the images of the X-ray video at each frame. [7] The translations and rotations of the model, as opposed to a set of markers, are then tracked relative to the X-ray camera(s). [7] Using a local coordinate system, these translations and rotations can then be mapped to standard anatomical movements. The 3-D model of the object is generated from any 3-D imaging technique, such as an MRI or CT scan. Markerless tracking has the benefit of being a non-invasive tracking method, avoiding any complications due to surgeries. One difficulty comes from generating the 3-D model in animal studies, as the animals are required to be sedated or sacrificed for the scan.
In planar X-ray imaging, the motions of the markers or bodies are tracked in a specialized software. An initial location guess is supplied by the user for the markers or bodies. The software, depending on its capabilities, requires the user to manually locate the markers or bodies for each frame of the video, or can automatically track the locations throughout the video. The automatic tracking has to be monitored for accuracy and may require manually relocating the markers or bodies. After the tracking data is generated for each marker or body of interest, the tracking is applied to the local anatomical bodies. For example, markers placed at the hip and knee would track the motion of the femur. Using knowledge of the local anatomy, these motions can then be translated into anatomical terms of motion in the plane of the X-ray. [2]
In biplanar X-ray imaging, the motions are also tracked in a specialized software. Similar to planar analysis, the user provides an initial location guess and either tracks the markers or bodies manually or the software can automatically track them. However, biplanar analysis requires that all tracking be done on both video frames at the same time, positioning the object in free space. Both X-ray cameras have to be calibrated using an object of known volume. This allows the software to locate the cameras' positions relative to each other and then allows the user to position the 3-D model of the object in line with both video frames. The tracking data is generated for each marker or body and then applied to the local anatomical bodies. The tracking data is then further defined as anatomical terms of motion in free space. [7]
X-ray motion analysis can be used in human gait analysis to measure the kinematics of the lower limbs. Treadmill gait or overground gait [9] can be measured depending on the mobility of the X-ray system. Other types of movements, such as a jump-cut maneuver, [10] have also been recorded. By combining X-ray motion analysis with force platforms, a joint torque analysis can be performed. [10] [11] Rehabilitation is an important application of X-ray motion analysis. X-ray imaging has been used for medical diagnostic purposes since shortly after its discovery in 1895. [12] X-ray motion analysis can be utilized in joint imaging or analyzing joint-related diseases. It has been used to quantify osteoarthritis in the knee, [13] estimate knee cartilage contact areas, [14] and analyze the results of rotator cuff repair by imaging the shoulder joint, [15] among other applications.
Animal locomotion can also be analyzed with X-ray imaging. As long as the animal can be placed between the X-ray emitter and the camera, the subject can be imaged. Examples of gaits that have been studied are rats, [8] [16] guineafowl, [17] horses, [6] bipedal birds, [18] and frogs, [11] among others. Aside from locomotion, X-ray motion analysis has been utilized in the study and research of other moving morphology analyses, such as pig mastication [2] and movement of the temporomandibular joint in rabbits. [19]
Running is a method of terrestrial locomotion allowing humans and other animals to move rapidly on foot. Running is a type of gait characterized by an aerial phase in which all feet are above the ground. This is in contrast to walking, where one foot is always in contact with the ground, the legs are kept mostly straight and the center of gravity vaults over the stance leg or legs in an inverted pendulum fashion. A feature of a running body from the viewpoint of spring-mass mechanics is that changes in kinetic and potential energy within a stride occur simultaneously, with energy storage accomplished by springy tendons and passive muscle elasticity. The term running can refer to any of a variety of speeds ranging from jogging to sprinting.
Fluoroscopy is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. There are two main sub-category of Fluoroscopy. Larger, typically Floor, Wall or Ceiling mounted device often called Cath Lab, and Smaller Mobile C-Arm. In its primary application of medical imaging, a fluoroscope allows a surgeon to see the internal structure and function of a patient mainly during surgery so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery.
Gait analysis is the systematic study of animal locomotion, more specifically the study of human motion, using the eye and the brain of observers, augmented by instrumentation for measuring body movements, body mechanics, and the activity of the muscles. Gait analysis is used to assess and treat individuals with conditions affecting their ability to walk. It is also commonly used in sports biomechanics to help athletes run more efficiently and to identify posture-related or movement-related problems in people with injuries.
The posterior cruciate ligament (PCL) is a ligament in each knee of humans and various other animals. It works as a counterpart to the anterior cruciate ligament (ACL). It connects the posterior intercondylar area of the tibia to the medial condyle of the femur. This configuration allows the PCL to resist forces pushing the tibia posteriorly relative to the femur.
A gait is a pattern of limb movements made during locomotion. Human gaits are the various ways in which humans can move, either naturally or as a result of specialized training. Human gait is defined as bipedal, biphasic forward propulsion of the center of gravity of the human body, in which there are alternate sinuous movements of different segments of the body with least expenditure of energy. Gait patterns are characterized by differences in limb-movement patterns, overall velocity, forces, kinetic and potential energy cycles, and changes in contact with the ground.
The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is strong, supporting the entire weight of the upper body. It is a synovial plane joint with irregular elevations and depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one on the right, that often match each other but are highly variable from person to person.
Genu varum is a varus deformity marked by (outward) bowing at the knee, which means that the lower leg is angled inward (medially) in relation to the thigh's axis, giving the limb overall the appearance of an archer's bow. Usually medial angulation of both lower limb bones is involved.
Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine its size, shape, firmness, or location.
Inverse dynamics is an inverse problem. It commonly refers to either inverse rigid body dynamics or inverse structural dynamics. Inverse rigid-body dynamics is a method for computing forces and/or moments of force (torques) based on the kinematics (motion) of a body and the body's inertial properties. Typically it uses link-segment models to represent the mechanical behaviour of interconnected segments, such as the limbs of humans or animals or the joint extensions of robots, where given the kinematics of the various parts, inverse dynamics derives the minimum forces and moments responsible for the individual movements. In practice, inverse dynamics computes these internal moments and forces from measurements of the motion of limbs and external forces such as ground reaction forces, under a special set of assumptions.
Computer-assisted orthopedic surgery or computer-assisted orthopaedic surgery is a discipline where computer technology is applied pre-, intra- and/or post-operatively to improve the outcome of orthopedic surgical procedures. Although records show that it has been implemented since the 1990s, CAOS is still an active research discipline which brings together orthopedic practitioners with traditionally technical disciplines, such as engineering, computer science and robotics.
Motion analysis is used in computer vision, image processing, high-speed photography and machine vision that studies methods and applications in which two or more consecutive images from an image sequences, e.g., produced by a video camera or high-speed camera, are processed to produce information based on the apparent motion in the images. In some applications, the camera is fixed relative to the scene and objects are moving around in the scene, in some applications the scene is more or less fixed and the camera is moving, and in some cases both the camera and the scene are moving.
Digital motion X-ray
Ankle replacement, or ankle arthroplasty, is a surgical procedure to replace the damaged articular surfaces of the human ankle joint with prosthetic components. This procedure is becoming the treatment of choice for patients requiring arthroplasty, replacing the conventional use of arthrodesis, i.e. fusion of the bones. The restoration of range of motion is the key feature in favor of ankle replacement with respect to arthrodesis. However, clinical evidence of the superiority of the former has only been demonstrated for particular isolated implant designs.
Roentgen stereophotogrammetry (RSA) is a highly accurate technique for the assessment of three-dimensional migration and micromotion of a joint replacement prosthesis relative to the bone it is attached to. It was introduced in 1974 by Göran Selvik.
Orthotics is a medical specialty that focuses on the design and application of orthoses, or braces. An orthosis is "an externally applied device used to influence the structural and functional characteristics of the neuromuscular and skeletal system".
Cone beam computed tomography is a medical imaging technique consisting of X-ray computed tomography where the X-rays are divergent, forming a cone.
G-arm medical imaging systems are based on fluoroscopic X-ray and are used for a variety of diagnostic imaging and minimally invasive surgical procedures. The name is derived from the G-shaped arm used to connect two X-ray generators and two X-ray detectors, image intensifiers or digital flat panel detectors, to one another. The main advantage of the G-arm, compared to a conventional C-arm system, is that it combines a pair of X-ray chains facilitating simultaneous views in two perpendicular planes, also called G-arm imaging.
Robotic prosthesis control is a method for controlling a prosthesis in such a way that the controlled robotic prosthesis restores a biologically accurate gait to a person with a loss of limb. This is a special branch of control that has an emphasis on the interaction between humans and robotics.
Gait deviations are nominally referred to as any variation of standard human gait, typically manifesting as a coping mechanism in response to an anatomical impairment. Lower-limb amputees are unable to maintain the characteristic walking patterns of an able-bodied individual due to the removal of some portion of the impaired leg. Without the anatomical structure and neuromechanical control of the removed leg segment, amputees must use alternative compensatory strategies to walk efficiently. Prosthetic limbs provide support to the user and more advanced models attempt to mimic the function of the missing anatomy, including biomechanically controlled ankle and knee joints. However, amputees still display quantifiable differences in many measures of ambulation when compared to able-bodied individuals. Several common observations are whole-body movements, slower and wider steps, shorter strides, and increased sway.
The study of animal locomotion is a branch of biology that investigates and quantifies how animals move.