IORFoot Paper

This tutorial describes the 2007 publication. For the updated 2014 IOR foot model see here.

Sample Data

Sample data can be downloaded here.

Once the zip file has been downloaded, you can find a static C3D and three dynamic trials in the SampleFiles folder. These files will be used to complete the tutorial.

The model, planar angles and joint angles for the right side were defined and plotted in the Leardini_2007_Angles.cmo. Once the left side angles have been defined, the report template will graph both the left and right angles.

Introduction

Visual3D is a general tool capable of implementing many different foot models.

This tutorial describes the IOR Foot analysis as it was published in the ORIGINAL paper (shown below):

Leardini, A., M.G. Benedetti, L. Berti, D. Bettinelli, R. Nativo, and S. Giannini. "Rear-foot, Mid-foot and Fore-foot Motion during the Stance Phase of Gait." Gait & Posture 25 (2007): 453-55

Modifications were made to the original IOR Foot analysis (published in the paper below). The modified tutorial can be found here.

Portinaro, N., A. Leardini, A. Panou, V. Monzani, and P. Caravaggi. "Modifying the Rizzoli foot model to improve the diagnosis of pes-planus: application to kinematics of feet in teenagers." Journal of Foot and Ankle Research (2014)

Below is a tutorial demonstrating how to implement the ORIGINAL analysis in Visual3D. If you would rather see a fully completed model you can simply download the following file [blank] and open it in Visual3D.

Multi-Segment Foot Marker Set

CA(FCC) ^{:p. 160} = Posterior Surface of Calcaneus

ST(FST) = Sustentaculum Tali of Calcaneus

PT(FPT) = Lateral apex of the peroneal tubercle

TN(FNT) = Medial apex of the tuberosity navicular

FMH(FM1) = Head of 1st Metatarsus

SMH(FM2) = Head of 2nd Metatarsus

VMH(FM5) = Head of 5th Metatarsus

VMB(FMT) = Tuberosity of 5th Metatarsal

PM(PM6) = Proximal Medial Phalanx

FMB = Base of First Metatarsal

SMB = Base of Second Metatarsal

Metatarsus (Met)

Landmarks

1. Create RMET_DIST: Click Landmarks button Click Add New Landmark button Create Landmark: RMET_DIST    Landmark Name: RMET_DIST    Define Orientation Using:    Starting Point: RFMH    Ending Point: RVMH    Lateral Object: RSMB    Project From: RSMH Do NOT Check: Offset by Percent (1.0 = 100%) Check: Calibration Only Landmark

Segment Definition

1. Create RMet Segment: In the Segments tab, select RMet in the Segment Name box. Select Kinematic Only Click on the Create Segment button. In the RMet tab, enter these values:    Define Proximal Joint and Radius    Lateral: None     Joint: RSMB     Medial: None         Radius: 0.1    Define Distal Joint and Radius    Lateral: None     Joint: RMET_DIST     Medial: None         Radius: 0.1    Extra Target to Define Orientation    Location: Medial     RFMH    Select Tracking Targets:      RFMB, RFMH, RSMB, RSMH, RVMB, RVMH Click on Build Model. Click on Close Tab before proceeding.

2. Modify the Segment Coordinate System: Define the Segment Orientation as:    A/P Axis: +Y    Distal to Proximal: -X

The image to the right (and all other images in this tutorial) show a mediolateral view of the segment coordinate system after it has been modified.

Mid-foot (Mid)

Landmarks

1. Create RID Joint Center: Click Landmarks button Click Add New Landmark button Create Landmark: RID    Landmark Name: RID    Define Orientation Using:    Starting Point: RTN    Ending Point: RVMB Offset Using the Following AXIAL Offset: 0.5 Check: Offset by Percent (1.0 = 100%) Check: Calibration Only Landmark

Segment Definition

1. Create RMid Segment: In the Segments tab, select RMid in the Segment Name box. Select Kinematic Only. Click on the Create Segment button. In the RMid tab, enter these values:    Define Proximal Joint and Radius    Lateral: None     Joint: RID     Medial: None         Radius: 0.1    Define Distal Joint and Radius    Lateral: None     Joint: RSMB     Medial: None         Radius: 0.1    Extra Target to Define Orientation    Location: Medial     RTN    Select Tracking Targets:      RSMB, RTN, RVMB Click on Build Model. Click on Close Tab before proceeding.

2. Modify the Segment Coordinate System: Define the Segment Orientation as:    A/P Axis: +Y    Distal to Proximal: -X

Calcaneus (Cal)

Landmarks

1. Create RIC Joint Center: Click Landmarks button Click Add New Landmark button Create Landmark: RIC    Landmark Name: RIC    Define Orientation Using:    Starting Point: RST    Ending Point: RPT Offset Using the Following AXIAL Offset: 0.5 Check: Offset by Percent (1.0 = 100%) Check: Calibration Only Landmark

Segment Definition

1. Create RCal Segment: In the Segments tab, select RCal in the Segment Name box. Click on the Create Segment button. In the RCal tab, enter these values:    Define Proximal Joint and Radius    Lateral: None     Joint: RCA     Medial: None         Radius: 0.1    Define Distal Joint and Radius    Lateral: None     Joint: RIC     Medial: None         Radius: 0.1    Extra Target to Define Orientation    Location: Medial     RST    Select Tracking Targets:      RCA, RPT, RST Click on Build Model. Click on Close Tab before proceeding.

2. Modify the Segment Coordinate System: Define the Segment Orientation as:    A/P Axis: +Y    Distal to Proximal: -X

Foot (Foo)

Landmarks

1. Create RFT_DIST: Click Landmarks button Click Add New Landmark button Create Landmark: RFT_DIST    Landmark Name: RFT_DIST    Define Orientation Using:    Starting Point: RCA    Ending Point: RFMH    Lateral Object: RVMH    Project From: RSMH Do NOT Check: Offset by Percent (1.0 = 100%) Check: Calibration Only Landmark

Segment Definition

1. Create Right Foot Segment: In the Segments tab, select Right Foot in the Segment Name box. Click on the Create Segment button. In the Right Foot tab, enter these values:    Define Proximal Joint and Radius    Lateral: None     Joint: RCA     Medial: None         Radius: 0.5*DISTANCE(RST,RPT)    Define Distal Joint and Radius    Lateral: None     Joint: RFT_DIST     Medial: None         Radius: 0.5*DISTANCE(RFMH,RVMH)    Extra Target to Define Orientation    Location: Medial     RFMH    Select Tracking Targets:      RCA, RFMH, RVMH Click on Build Model. Click on Close Tab before proceeding.

2. Modify the Segment Coordinate System: Define the Segment Orientation as:    A/P Axis: +Y    Distal to Proximal: -X

Shank (Sha)

Landmarks

1. Create RIM: Click Landmarks button Click Add New Landmark button Create Landmark: RIM    Landmark Name: RIM    Define Orientation Using:    Starting Point: RLM    Ending Point: RMM Offset Using the Following AXIAL Offset: 0.5 Check: Offset by Percent (1.0 = 100%) Check: Calibration Only Landmark

2. Create RSK_PROX: Click Landmarks button Click Add New Landmark button Create Landmark: RSK_PROX    Landmark Name: RSK_PROX    Define Orientation Using:    Starting Point: RIM    Ending Point: RLM    Lateral Object: RHF    Project From: RTT Do NOT Check: Offset by Percent (1.0 = 100%) Check: Calibration Only Landmark

Segment Definition

1. Create Right Shank Segment: In the Segments tab, select Right Shank in the Segment Name box. Click on the Create Segment button. In the Right Shank tab, enter these values:    Define Proximal Joint and Radius    Lateral: None     Joint: RSK_PROX     Medial: None         Radius: DISTANCE(RSK_PROX,RHF)    Define Distal Joint and Radius    Lateral: None     Joint: RIM     Medial: None         Radius: 0.5*DISTANCE(RLM,RMM)    Extra Target to Define Orientation    Location: Lateral     RLM    Select Tracking Targets:      RHF, RLM, RMM, RTT Click on Build Model. Click on Close Tab before proceeding.

2. Modify the Segment Coordinate System: Define the Segment Orientation as:    A/P Axis: +X    Distal to Proximal: +Y

Angles

Landmarks

The F2Pt and F2Ps planar angles are calculated as the angle between the lines created by the targets FMB-FMH and FMH-PM. To calculate this angle using the Compute Planar Angle command, an offset along the line between FMB and FMH is created to define the 3 point angle.

1. Create RF2P_Offset: Click Landmarks button Click Add New Landmark button Create Landmark: RF2P_Offset    Landmark Name: RF2P_Offset    Define Orientation Using:    Starting Point: RFMB    Ending Point: RFMH Offset Using the Following AXIAL Offset: 1.5 Check: Offset by Percent (1.0 = 100%) Do NOT Check: Calibration Only Landmark

2. Create LF2P_Offset: When defining the left signal, use same definitions as for the RF2P_Offset landmark

The F2G, S2G and V2G angles are calculated in the plane orthogonal to the ground. These landmarks will need to be projected onto the ground. To project landmarks onto the ground, the Lab_O, Lab_X and Lab_Y landmarks will need to be created to identify the plane of the ground.

3. Create Lab_O: Click Landmarks button Click Add New Landmark button Create Landmark: Lab_O    Landmark Name: Lab_O Offset Using the Following ML/AP/AXIAL Offsets:    X: 0.0    Y: 0.0    Z: 0.0 Do NOT Check: Offset by Percent (1.0 = 100%) (Meters when not checked) Do NOT Check: Calibration Only Landmark (Not generated for assigned motion file(s))

4. Create Lab_X: Click Landmarks button Click Add New Landmark button Create Landmark: Lab_X    Landmark Name: Lab_X Offset Using the Following ML/AP/AXIAL Offsets:    X: 0.05    Y: 0.0    Z: 0.0 Do NOT Check: Offset by Percent (1.0 = 100%) (Meters when not checked) Do NOT Check: Calibration Only Landmark (Not generated for assigned motion file(s))

5. Create Lab_Y: Click Landmarks button Click Add New Landmark button Create Landmark: Lab_Y    Landmark Name: Lab_Y Offset Using the Following ML/AP/AXIAL Offsets:    X: 0.0    Y: 0.05    Z: 0.0 Do NOT Check: Offset by Percent (1.0 = 100%) (Meters when not checked) Do NOT Check: Calibration Only Landmark (Not generated for assigned motion file(s))

6. Create RFMH_proj: Click Landmarks button Click Add New Landmark button Create Landmark: RFMH_proj    Landmark Name: RFMH_proj    Define Orientation Using:    Starting Point: LAB_O    Ending Point: LAB_X    Lateral Object: LAB_Y    Project From: RFMH Do NOT Check: Offset by Percent (1.0 = 100%) Do NOT Check: Calibration Only Landmark

Create landmarks 7-17 by following the same format as the RFMH_proj landmark for:

7. RFMB 8. RSMH 9. RSMB 10. RVMH 11. RVMB

12. LFMH 13. LFMB 14. LSMH 15. LSMB 16. LVMH 17. LVMB

Planar Angles

F2Pt

F2Pt - the angle between the lines FMH-PM and FMB-FMH projected onto the transverse plane of the metatarsus
Represents - valgus of the first metatarsophalangeal joint

1. Create RF2Pt planar angle: Define Resulting Signal Name: RF2Pt Calculate a 3 point angle between the following targets:    1 - LANDMARK::ORIGINAL::RF2P_offset    2 - TARGET::ORIGINAL::RFMH    3 - TARGET::ORIGINAL::RPM Angle Direction: Left Hand Rule Use Range: -180 to 180 degrees Projected onto Plane: XZ Note: The reference segment will need to be changed to RMet within the text option.

2. Create LF2Pt planar angle: When defining the left signal, use same definitions except set: Angle Direction: Right Hand Rule Note: The reference segment will need to be changed to LMet within the text option.

S2F

S2F - the angle between the lines FMB-FMH and SMB-SMH projected onto the transverse plane of the metatarsus

1. Create RS2F planar angle: Define Resulting Signal Name: RS2F Calculate a 4 point angle between the following targets:    1 - TARGET::ORIGINAL::RSMH    2 - TARGET::ORIGINAL::RSMB    3 - TARGET::ORIGINAL::RFMB    4 - TARGET::ORIGINAL::RFMH Angle Direction: Right Hand Rule Use Range: -180 to 180 degrees Projected onto Plane: XZ Note: The reference segment will need to be changed to RMet within the text option.

2. Create LS2F planar angle: When defining the left signal, use same definitions except set: Angle Direction: Left Hand Rule Note: The reference segment will need to be changed to LMet within the text option.

S2V

S2V - the angle between the lines VMB-VMH and SMB-SMH projected onto the transverse plane of the metatarsus

1. Create RS2V planar angle: Define Resulting Signal Name: RS2V Calculate a 4 point angle between the following targets:    1 - TARGET::ORIGINAL::RSMH    2 - TARGET::ORIGINAL::RSMB    3 - TARGET::ORIGINAL::RVMB    4 - TARGET::ORIGINAL::RVMH Angle Direction: Right Hand Rule Use Range: -180 to 180 degrees Projected onto Plane: XZ Note: The reference segment will need to be changed to RMet within the text option.

2. Create LS2V planar angle: When defining the left signal, use same definitions except set: Angle Direction: Left Hand Rule Note: The reference segment will need to be changed to LMet within the text option.

F2G

F2G - the angle between the lines FMB-FMH and the ground, plane orthogonal to the ground (3D angle relative to the ground)

The FMH_proj and FMB_proj landmarks will be used to calculate the F2G planar angle which are described in the landmarks section.

1. Create RF2G planar angle: Define Resulting Signal Name: RF2G Calculate a 4 point angle between the following targets:    1 - TARGET::ORIGINAL::RFMB    2 - TARGET::ORIGINAL::RFMH    3 - TARGET::ORIGINAL::RFMH_proj    4 - TARGET::ORIGINAL::RFMB_proj Angle Direction: Right Hand Rule 3D Space: Always 0 to 180 degrees

2. Create LF2G planar angle: When defining the left signal, use same definitions as for the right angle

S2G

S2G - the angle between the lines SMB-SMH and the ground, plane orthogonal to the ground (3D angle relative to the ground)

The SMH_proj and SMB_proj landmarks will be used to calculate the S2G planar angle which are described in the landmarks section.

1. Create RS2G planar angle: Define Resulting Signal Name: RS2G Calculate a 4 point angle between the following targets:    1 - TARGET::ORIGINAL::RSMB    2 - TARGET::ORIGINAL::RSMH    3 - TARGET::ORIGINAL::RSMH_proj    4 - TARGET::ORIGINAL::RSMB_proj Angle Direction: Right Hand Rule 3D Space: Always 0 to 180 degrees

2. Create LS2G planar angle: When defining the left signal, use same definitions as for the right angle

V2G

V2G - the angle between the lines VMB-VMH and the ground, plane orthogonal to the ground (3D angle relative to the ground)

The VMH_proj and VMB_proj landmarks will be used to calculate the V2G planar angle which are described in the landmarks section.

1. Create RV2G planar angle: Define Resulting Signal Name: RV2G Calculate a 4 point angle between the following targets:    1 - TARGET::ORIGINAL::RVMB    2 - TARGET::ORIGINAL::RVMH    3 - TARGET::ORIGINAL::RVMH_proj    4 - TARGET::ORIGINAL::RVMB_proj Angle Direction: Right Hand Rule 3D Space: Always 0 to 180 degrees

2. Create LV2G planar angle: When defining the left signal, use same definitions as for the right angle

F2Ps

F2Ps - the angle between the lines FMH-PM and FMB-FMH projected onto the sagittal plane of the metatarsus
Represents - dorsiflexion of the first metatarso-phalangeal joint

1. Create RF2Ps planar angle: Define Resulting Signal Name: RF2Ps Calculate a 3 point angle between the following targets:    1 - LANDMARK::ORIGINAL::RF2P_offset    2 - TARGET::ORIGINAL::RFMH    3 - TARGET::ORIGINAL::RPM Angle Direction: Right Hand Rule Use Range: -180 to 180 degrees Projected onto Plane: XY Note: The reference segment will need to be changed to RMet within the text option.

2. Create LF2Ps planar angle: When defining the left signal, use same definitions as for the right angle Note: The reference segment will need to be changed to LMet within the text option.

MLA

MLA - the angle between the lines CA-ST and ST-FMH projected onto the sagittal plane of the foot
Represents - navicular drop

1. Create RMLA planar angle: Define Resulting Signal Name: RMLA Calculate a 3 point angle between the following targets:    1 - TARGET::ORIGINAL::RCA    2 - TARGET::ORIGINAL::RST    3 - TARGET::ORIGINAL::RFMH Angle Direction: Right Hand Rule Use Range: -180 to 180 degrees Projected onto Plane: XY Note: The reference segment will need to be changed to RMet within the text option.

2. Create LMLA planar angle: When defining the left signal, use same definitions as for the right angle Note: The reference segment will need to be changed to LMet within the text option.

Joint Angles

Sha_Foo_Angle

1. Define the RSha_Foo_Angle: Open the Compute Model Based dialog Select JOINT_ANGLE from drop down list    Data Name: RSha_Foo_Angle    Segment: Right Foot    Reference Segment: Right Shank    Cardan Sequence: Z-X-Y Use Negative:    X: TRUE    Y: TRUE    Z: FALSE

Sha_Cal_Angle

1. Define the RSha_Cal_Angle: Open the Compute Model Based dialog Select JOINT_ANGLE from drop down list    Data Name: RSha_Cal_Angle    Segment: RCal    Reference Segment: Right Shank    Cardan Sequence: Z-X-Y Use Negative:    X: TRUE    Y: TRUE    Z: FALSE

Cal_Mid_Angle

1. Define the RCal_Mid_Angle: Open the Compute Model Based dialog Select JOINT_ANGLE from drop down list    Data Name: RCal_Mid_Angle    Segment: RMid    Reference Segment: RCal    Cardan Sequence: Z-X-Y Use Negative:    X: TRUE    Y: TRUE    Z: FALSE

Mid_Met_Angle

1. Define the RMid_Met_Angle: Open the Compute Model Based dialog Select JOINT_ANGLE from drop down list    Data Name: RMid_Met_Angle    Segment: RMet    Reference Segment: RMid    Cardan Sequence: Z-X-Y Use Negative:    X: TRUE    Y: TRUE    Z: FALSE

Cal_Met_Angle

1. Define the RCal_Met_Angle: Open the Compute Model Based dialog Select JOINT_ANGLE from drop down list    Data Name: RCal_Met_Angle    Segment: RMet    Reference Segment: RCal    Cardan Sequence: Z-X-Y Use Negative:    X: TRUE    Y: TRUE    Z: FALSE