Concurrent repeatability and reproducibility analyses of four marker placement protocols for the foot-ankle complex

Roberto Di Marco, Stefano Rossi, Vitomir Racic, Paolo Cappa, Claudia Mazzà

Research output: Contribution to journalArticlepeer-review


Multi-segment models of the foot have been proposed in the past years to overcome limitations imposed by oversimplified traditional approaches used to describe foot kinematics, but they have been only partially validated and never compared. This paper presents a unique comparative assessment of the four most widely adopted foot kinematic models and aims to provide a guidance for the clinical interpretation of their results. Sensitivity of the models to differences between treadmill and overground walking was tested in nine young healthy adults using a 1D paired t-test. Repeatability was assessed by investigating the joint kinematics obtained when the same operator placed the markers on thirteen young healthy adults in two occasions. Reproducibility was then assessed using data from three randomly selected participants, asking three operators to repeat the marker placement three times. The analyses were performed on sagittal kinematics using curve similarity and correlation indices (Linear Fit Method) and absolute differences between selected points. Differences between treadmill and overground gait were highlighted by all the investigated models. The two most repeatable and reproducible investigated models had average correlations higher than 0.70, with the lowest values (0.56) obtained for the midfoot. Averaged correlations were always higher than 0.74 for the former and 0.70 for the latter, with the lowest obtained for the midfoot (0.64 and 0.51). For all investigated models, foot kinematics generally showed low repeatability: normative bands must be adopted with caution when used for comparison with patient data.

Original languageEnglish
Pages (from-to)3168-3176
Number of pages9
JournalJournal of Biomechanics
Issue number14
Publication statusPublished - Oct 3 2016


  • Foot kinematics
  • Repeatability
  • Reproducibility
  • Statistical parametric mapping
  • Treadmill and overground walking

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Biomedical Engineering
  • Rehabilitation


Dive into the research topics of 'Concurrent repeatability and reproducibility analyses of four marker placement protocols for the foot-ankle complex'. Together they form a unique fingerprint.

Cite this