WITHIN- AND BETWEEN-SESSION RELIABILITY OF PELVIC MARKER PLACEMENT AND POSTURE IN LOWER-LIMB AMPUTEES

Alex Withey; Dario Cazzola; Abby Tabor; Elena Seminati

doi:10.33137/cpoj.v8i2.46063

WITHIN- AND BETWEEN-SESSION RELIABILITY OF PELVIC MARKER PLACEMENT AND POSTURE IN LOWER-LIMB AMPUTEES

University of West of England

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Accurate placement of anatomical markers is essential for valid three-dimensional (3D) gait analysis, yet individuals with lower-limb amputation (LLA) pose unique challenges due to altered anatomy, prosthetic interfaces, and increased adiposity. OBJECTIVE: This study assessed within- and between-session reliability of pelvis marker placement and static posture kinematics in adults with unilateral LLA. METHODOLOGY: Fourteen adults with unilateral LLA (age: 58 ± 15 years, height: 174.6 ± 7.5 cm, body mass: 91.1 ± 27.7 kg, BMI: 29.6 ± 7.5 kg/m ^2; eleven transtibial, three transfemoral) participated in two sessions spaced 3–13 months apart. Reliability of marker distances and static posture kinematics were assessed using intraclass correlation coefficients (ICC) and standard error of measurement (SEM). FINDINGS: Within-session reliability of pelvis marker distances was good to excellent (ICC ≥ 0.78), whereas between-session reliability was lower (ICC as low as 0.14), particularly for posterior superior iliac spine markers. Pelvis kinematics demonstrated moderate reliability within sessions (average ICC ≈ 0.71), but trunk kinematics showed poor reliability. SEM values were low (<5°), suggesting acceptable absolute consistency despite variable ICCs, likely driven by postural changes and prosthetic factors. CONCLUSION: Findings support reliable pelvis marker placement within sessions but highlight challenges for longitudinal consistency. Multiple trial collections and standardised posture protocols are recommended to improve long-term reliability.

Original language	English
Pages (from-to)	1-12
Number of pages	12
Journal	Canadian Prosthetics & Orthotics Journal
Volume	8
Issue number	2
DOIs	https://doi.org/10.33137/cpoj.v8i2.46063
Publication status	Published - 20 Oct 2025

Acknowledgements

We thank the clinicians Dr Shigong Gou and Helen Harvey (Bristol Centre for Enablement), and Chantel Ostler (Portsmouth Enablement Centre) for their feedback developing the inclusion/exclusion criteria for the study. We also thank the physiotherapists AnneHarrill (Bristol Centre for Enablement) and Matthias Wright (Portsmouth Enablement Centre) for their help with identifying patients who meet the inclusion criteria and coordinating patient bookings, and all the patients who took part in the study

Funding

This study has funding through the University Research Studentship Award (URSA) awarded by the University of Bath. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Keywords

Gait Analysis
Kinematics
Longitudinal Consistency
Lower-Limb Amputation
Marker Placement Reliability
Posture

ASJC Scopus subject areas

Rehabilitation

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10.33137/cpoj.v8i2.46063Licence: CC BY

Cite this

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title = "WITHIN- AND BETWEEN-SESSION RELIABILITY OF PELVIC MARKER PLACEMENT AND POSTURE IN LOWER-LIMB AMPUTEES",

abstract = "BACKGROUND: Accurate placement of anatomical markers is essential for valid three-dimensional (3D) gait analysis, yet individuals with lower-limb amputation (LLA) pose unique challenges due to altered anatomy, prosthetic interfaces, and increased adiposity. OBJECTIVE: This study assessed within- and between-session reliability of pelvis marker placement and static posture kinematics in adults with unilateral LLA. METHODOLOGY: Fourteen adults with unilateral LLA (age: 58 ± 15 years, height: 174.6 ± 7.5 cm, body mass: 91.1 ± 27.7 kg, BMI: 29.6 ± 7.5 kg/m 2; eleven transtibial, three transfemoral) participated in two sessions spaced 3–13 months apart. Reliability of marker distances and static posture kinematics were assessed using intraclass correlation coefficients (ICC) and standard error of measurement (SEM). FINDINGS: Within-session reliability of pelvis marker distances was good to excellent (ICC ≥ 0.78), whereas between-session reliability was lower (ICC as low as 0.14), particularly for posterior superior iliac spine markers. Pelvis kinematics demonstrated moderate reliability within sessions (average ICC ≈ 0.71), but trunk kinematics showed poor reliability. SEM values were low (<5°), suggesting acceptable absolute consistency despite variable ICCs, likely driven by postural changes and prosthetic factors. CONCLUSION: Findings support reliable pelvis marker placement within sessions but highlight challenges for longitudinal consistency. Multiple trial collections and standardised posture protocols are recommended to improve long-term reliability.",

keywords = "Gait Analysis, Kinematics, Longitudinal Consistency, Lower-Limb Amputation, Marker Placement Reliability, Posture",

author = "Alex Withey and Dario Cazzola and Abby Tabor and Elena Seminati",

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N2 - BACKGROUND: Accurate placement of anatomical markers is essential for valid three-dimensional (3D) gait analysis, yet individuals with lower-limb amputation (LLA) pose unique challenges due to altered anatomy, prosthetic interfaces, and increased adiposity. OBJECTIVE: This study assessed within- and between-session reliability of pelvis marker placement and static posture kinematics in adults with unilateral LLA. METHODOLOGY: Fourteen adults with unilateral LLA (age: 58 ± 15 years, height: 174.6 ± 7.5 cm, body mass: 91.1 ± 27.7 kg, BMI: 29.6 ± 7.5 kg/m 2; eleven transtibial, three transfemoral) participated in two sessions spaced 3–13 months apart. Reliability of marker distances and static posture kinematics were assessed using intraclass correlation coefficients (ICC) and standard error of measurement (SEM). FINDINGS: Within-session reliability of pelvis marker distances was good to excellent (ICC ≥ 0.78), whereas between-session reliability was lower (ICC as low as 0.14), particularly for posterior superior iliac spine markers. Pelvis kinematics demonstrated moderate reliability within sessions (average ICC ≈ 0.71), but trunk kinematics showed poor reliability. SEM values were low (<5°), suggesting acceptable absolute consistency despite variable ICCs, likely driven by postural changes and prosthetic factors. CONCLUSION: Findings support reliable pelvis marker placement within sessions but highlight challenges for longitudinal consistency. Multiple trial collections and standardised posture protocols are recommended to improve long-term reliability.

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WITHIN- AND BETWEEN-SESSION RELIABILITY OF PELVIC MARKER PLACEMENT AND POSTURE IN LOWER-LIMB AMPUTEES

Abstract

Acknowledgements

Funding

Keywords

ASJC Scopus subject areas

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