IORFoot Paper

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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

foot markersIOR.png

CA[1](FCC) [2]:p. 160 = Posterior Surface of Calcaneus
ST[1](FST)[2] = Sustentaculum Tali of Calcaneus
PT[1](FPT)[2] = Lateral apex of the peroneal tubercle
TN[1](FNT)[2] = Medial apex of the tuberosity navicular
FMH[1](FM1)[2] = Head of 1st Metatarsus
SMH[1](FM2)[2] = Head of 2nd Metatarsus
VMH[1](FM5)[2] = Head of 5th Metatarsus
VMB[1](FMT)[2] = Tuberosity of 5th Metatarsal
PM[1](PM6)[2] = Proximal Medial Phalanx
FMB[1] = Base of First Metatarsal
SMB[1] = Base of Second Metatarsal

Metatarsus (Met)

Landmarks

1. Create RMET_DIST:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RMET_DIST

       Landmark Name: RMET_DIST

       Define Orientation Using:
       Starting Point: RFMH
       Ending Point: RVMH
       Lateral Object: RSMB
       Project From: RSMH

  4. Do NOT Check: Offset by Percent (1.0 = 100%)
  5. Check: Calibration Only Landmark

caption

Segment Definition

1. Create RMet Segment:

  1. In the Segments tab, select RMet in the Segment Name box.
  2. Select Kinematic Only
  3. Click on the Create Segment button.
  4. 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

  5. Click on Build Model.
  6. Click on Close Tab before proceeding.

caption


2. Modify the Segment Coordinate System:

  1. Define the Segment Orientation as:

       A/P Axis: +Y
       Distal to Proximal: -X

caption

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:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RID

       Landmark Name: RID

       Define Orientation Using:
       Starting Point: RTN
       Ending Point: RVMB

  4. Offset Using the Following AXIAL Offset: 0.5
  5. Check: Offset by Percent (1.0 = 100%)
  6. Check: Calibration Only Landmark

caption

Segment Definition

1. Create RMid Segment:

  1. In the Segments tab, select RMid in the Segment Name box.
  2. Select Kinematic Only.
  3. Click on the Create Segment button.
  4. 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

  5. Click on Build Model.
  6. Click on Close Tab before proceeding.

caption


2. Modify the Segment Coordinate System:

  1. Define the Segment Orientation as:

       A/P Axis: +Y
       Distal to Proximal: -X

caption

Calcaneus (Cal)

Landmarks

1. Create RIC Joint Center:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RIC

       Landmark Name: RIC

       Define Orientation Using:
       Starting Point: RST
       Ending Point: RPT

  4. Offset Using the Following AXIAL Offset: 0.5
  5. Check: Offset by Percent (1.0 = 100%)
  6. Check: Calibration Only Landmark

caption

Segment Definition

1. Create RCal Segment:

  1. In the Segments tab, select RCal in the Segment Name box.
  2. Click on the Create Segment button.
  3. 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

  4. Click on Build Model.
  5. Click on Close Tab before proceeding.

caption


2. Modify the Segment Coordinate System:

  1. Define the Segment Orientation as:

       A/P Axis: +Y
       Distal to Proximal: -X

caption

Foot (Foo)

Landmarks

1. Create RFT_DIST:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RFT_DIST

       Landmark Name: RFT_DIST

       Define Orientation Using:
       Starting Point: RCA
       Ending Point: RFMH
       Lateral Object: RVMH
       Project From: RSMH

  4. Do NOT Check: Offset by Percent (1.0 = 100%)
  5. Check: Calibration Only Landmark

caption

Segment Definition

1. Create Right Foot Segment:

  1. In the Segments tab, select Right Foot in the Segment Name box.
  2. Click on the Create Segment button.
  3. 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

  4. Click on Build Model.
  5. Click on Close Tab before proceeding.

caption


2. Modify the Segment Coordinate System:

  1. Define the Segment Orientation as:

       A/P Axis: +Y
       Distal to Proximal: -X

caption

Shank (Sha)

Landmarks

1. Create RIM:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RIM

       Landmark Name: RIM

       Define Orientation Using:
       Starting Point: RLM
       Ending Point: RMM

  4. Offset Using the Following AXIAL Offset: 0.5
  5. Check: Offset by Percent (1.0 = 100%)
  6. Check: Calibration Only Landmark

caption

2. Create RSK_PROX:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RSK_PROX

       Landmark Name: RSK_PROX

       Define Orientation Using:
       Starting Point: RIM
       Ending Point: RLM
       Lateral Object: RHF
       Project From: RTT

  4. Do NOT Check: Offset by Percent (1.0 = 100%)
  5. Check: Calibration Only Landmark

caption

Segment Definition

1. Create Right Shank Segment:

  1. In the Segments tab, select Right Shank in the Segment Name box.
  2. Click on the Create Segment button.
  3. 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

  4. Click on Build Model.
  5. Click on Close Tab before proceeding.

caption


2. Modify the Segment Coordinate System:

  1. Define the Segment Orientation as:

       A/P Axis: +X
       Distal to Proximal: +Y

caption

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:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: RF2P_Offset

       Landmark Name: RF2P_Offset

       Define Orientation Using:
       Starting Point: RFMB
       Ending Point: RFMH

  4. Offset Using the Following AXIAL Offset: 1.5
  5. Check: Offset by Percent (1.0 = 100%)
  6. Do NOT Check: Calibration Only Landmark

caption


2. Create LF2P_Offset:

  1. 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:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: Lab_O

       Landmark Name: Lab_O

  4. Offset Using the Following ML/AP/AXIAL Offsets:
       X: 0.0    Y: 0.0    Z: 0.0
  5. Do NOT Check: Offset by Percent (1.0 = 100%) (Meters when not checked)
  6. Do NOT Check: Calibration Only Landmark (Not generated for assigned motion file(s))

caption


4. Create Lab_X:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: Lab_X

       Landmark Name: Lab_X

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

caption


5. Create Lab_Y:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. Create Landmark: Lab_Y

       Landmark Name: Lab_Y

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

caption


6. Create RFMH_proj:

  1. Click Landmarks button
  2. Click Add New Landmark button
  3. 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

  4. Do NOT Check: Offset by Percent (1.0 = 100%)
  5. Do NOT Check: Calibration Only Landmark

caption


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:

  1. Define Resulting Signal Name: RF2Pt
  2. 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.

PlanarAngle RF2Pt.png


2. Create LF2Pt planar angle:

  1. 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:

  1. Define Resulting Signal Name: RS2F
  2. 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.

PlanarAngle RS2F.png


2. Create LS2F planar angle:

  1. 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:

  1. Define Resulting Signal Name: RS2V
  2. 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.

PlanarAngle RS2V.png


2. Create LS2V planar angle:

  1. 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:

  1. Define Resulting Signal Name: RF2G
  2. 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

PlanarAngle RF2G.png


2. Create LF2G planar angle:

  1. 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:

  1. Define Resulting Signal Name: RS2G
  2. 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

PlanarAngle RS2G.png


2. Create LS2G planar angle:

  1. 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:

  1. Define Resulting Signal Name: RV2G
  2. 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

PlanarAngle RV2G.png


2. Create LV2G planar angle:

  1. 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:

  1. Define Resulting Signal Name: RF2Ps
  2. 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.

PlanarAngle RF2Ps.png


2. Create LF2Ps planar angle:

  1. 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:

  1. Define Resulting Signal Name: RMLA
  2. 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.

PlanarAngle RMLA.png


2. Create LMLA planar angle:

  1. 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:

  1. Open the Compute Model Based dialog
  2. Select JOINT_ANGLE from drop down list

       Data Name: RSha_Foo_Angle

       Segment: Right Foot
       Reference Segment: Right Shank
       Cardan Sequence: Z-X-Y

  3. Use Negative:
       X: TRUE    Y: TRUE    Z: FALSE

caption

Sha_Cal_Angle

1. Define the RSha_Cal_Angle:

  1. Open the Compute Model Based dialog
  2. Select JOINT_ANGLE from drop down list

       Data Name: RSha_Cal_Angle

       Segment: RCal
       Reference Segment: Right Shank
       Cardan Sequence: Z-X-Y

  3. Use Negative:
       X: TRUE    Y: TRUE    Z: FALSE

caption

Cal_Mid_Angle

1. Define the RCal_Mid_Angle:

  1. Open the Compute Model Based dialog
  2. Select JOINT_ANGLE from drop down list

       Data Name: RCal_Mid_Angle

       Segment: RMid
       Reference Segment: RCal
       Cardan Sequence: Z-X-Y

  3. Use Negative:
       X: TRUE    Y: TRUE    Z: FALSE

caption

Mid_Met_Angle

1. Define the RMid_Met_Angle:

  1. Open the Compute Model Based dialog
  2. Select JOINT_ANGLE from drop down list

       Data Name: RMid_Met_Angle

       Segment: RMet
       Reference Segment: RMid
       Cardan Sequence: Z-X-Y

  3. Use Negative:
       X: TRUE    Y: TRUE    Z: FALSE

caption

Cal_Met_Angle

1. Define the RCal_Met_Angle:

  1. Open the Compute Model Based dialog
  2. Select JOINT_ANGLE from drop down list

       Data Name: RCal_Met_Angle

       Segment: RMet
       Reference Segment: RCal
       Cardan Sequence: Z-X-Y

  3. Use Negative:
       X: TRUE    Y: TRUE    Z: FALSE

caption

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 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 Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content Cite error: Invalid <ref> tag; name "Leardini" defined multiple times with different content
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Serge van Sint Jan "Color Atlas of Skeletal Landmark Definitions: Guidelines for Reproducible Manual and Virtual Palpations" 2007 - Churchill Livingstone Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content Cite error: Invalid <ref> tag; name "Serge" defined multiple times with different content
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