# Biomech (57)

![The anterior and posterior views of the Biomech Marker Set (49). The calibration markers are highlighted in red.](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2F3mUxy5NTzWrBfUyL6kga%2Fimage.png?alt=media\&token=43715aec-7cc4-4fa5-ab37-b1fae1f1ac13)

Head Markers

| Labels            | Related Segment | Anatomical Location                                    | Placement Description                                                                                                                        |
| ----------------- | --------------- | ------------------------------------------------------ | -------------------------------------------------------------------------------------------------------------------------------------------- |
| <p>LAH<br>RAH</p> | Head            | <p>Left Anterior Head<br>Right Anterior Head</p>       | Place the markers on the left and right side of the fore head. The respective location is shown in the Skeleton figure.                      |
| <p>LPH<br>RPH</p> | Head            | <p>Left Posterior head<br>Right Posterior head<br></p> | Place the markers on the left and right side of the head about 2 cm behind the ear. The respective location is shown in the Skeleton figure. |

Torso Markers

| Labels                       | Related Segment      | Anatomical Location                                        | Additional Description                                                                                                                                                             |
| ---------------------------- | -------------------- | ---------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| SJN (IJ[\[1\]](#references)) | Thorax               | Sternum Jugular Notch                                      | Top most section of the sternum. Place the marker on the center of the two clavicle bones.                                                                                         |
| SXS (PX[\[1\]](#references)) | Thorax               | Sternum Xiphoid Process                                    | Lowest section of the sternum. Place the marker 1-2 cm above where bottom of the two rib cages conjoin.                                                                            |
| CV7 (C7[\[1\]](#references)) | Thorax               | Cervical Spine Vertebra 7                                  | The 7th cervical spine vertebra is the largest vertebra located at the most inferior region of the neck. This section usually protrudes to the posterior side and can be palpated. |
| TV2 (T2[\[1\]](#references)) | Thorax               | Thoracic Spine Vertebra 2                                  | The second thoracic spine vertebra is located three spine levels below the C7 vertebra. Which is located approximately at same height with shoulder joint markers.                 |
| TV7 (T7[\[1\]](#references)) | Thorax               | Thoracic Spine Vertebra 7                                  | Usually located at the center of the thoracic spinal column.                                                                                                                       |
| <p>LHGT<br>RHGT</p>          | Upper Arm / Shoulder | <p>Left Glenohumeral Joint<br>Right Glenohumeral Joint</p> | Place the marker on the posterior side of the shoulder axis. Ask the subject to posture in T-pose while placing the markers.                                                       |

Waist Markers

| Labels                                                                                                                                                 | Related Segment | Anatomical Location                                              | Additional Description                                                                           |
| ------------------------------------------------------------------------------------------------------------------------------------------------------ | --------------- | ---------------------------------------------------------------- | ------------------------------------------------------------------------------------------------ |
| <p>LIAS (PSISl<a href="#references">[2]</a><a href="#references">[1]</a>)<br>RIAS (PSIS<a href="#references">[2]</a><a href="#references">[1]</a>)</p> | Pelvis          | <p>Left Iliac Anterior Spine<br>Right Iliac Anterior Spine</p>   | Place the marker on the protruding bones located on the left and right side of the pelvis front. |
| <p>LIPS (ASIS<a href="#references">[2]</a><a href="#references">[1]</a>)<br>RIPS (ASIS<a href="#references">[2]</a><a href="#references">[1]</a>)</p>  | Pelvis          | <p>Left Iliac Posterior Spine<br>Right Iliac Posterior Spine</p> | Place each marker on the two dimples which can be palpated near the spine right above the hips.  |

{% hint style="info" %}
Note that the waist markers are the key markers in modeling the pelvis bone, which is the major segment governing the other subsequent Skeleton segments.
{% endhint %}

Upper Extremity Markers

| Labels                                                                                  | Related Segment | Anatomical Location                                                        | Placement Description                                                                                                                                                                                                                              |
| --------------------------------------------------------------------------------------- | --------------- | -------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| <p>LCAJ (LA<a href="#references">[1]</a>)<br>RCAJ (RA<a href="#references">[1]</a>)</p> | Thorax          | <p>Left Clavicle-Acromion Joint<br>Right Clavicle-Acromion Joint</p>       | Ask the subject to stretch both arms towards the side (T-pose), then palpate top of each shoulder for the protruding bone. The prominence is usually located at the end of the corresponding clavicle bone just before where the upper arm starts. |
| <p>LHLE<br>RHLE</p>                                                                     | Upper Arm       | <p>Left Humerus Lateral Epicondyle<br>Right Humerus Lateral Epicondyle</p> | Placed the markers on the lateral side of the elbow axis. Flex and extend the arm few times to find where elbow axis is located.                                                                                                                   |
| <p>LHME*<br>RHME*</p>                                                                   | Upper Arm       | <p>Left Humerus Medial Epicondyle<br>Right Humerus Medial Epicondyle</p>   | Place on the medial side of the elbow axis. Ask the subject to flex and extend the arm while placing the markers.                                                                                                                                  |
| <p>LUA<br>RUA</p>                                                                       | Upper Arm       | <p>Left Upper Arm<br>Right Upper Arm</p>                                   | Ask the subject to stand in T-pose while placing the marker. Palpate to find the groove between the triceps muscles where skin movements are relatively minimal.                                                                                   |

Hand Markers

| Labels              | Related Segment | Anatomical Location                                                | Placement Description                                          |
| ------------------- | --------------- | ------------------------------------------------------------------ | -------------------------------------------------------------- |
| <p>LHM2<br>RHM2</p> | Hand            | <p>Left Hand Second metatarsal<br>Right Hand Second metatarsal</p> | Place the marker slight below the knuckle of the index finger. |
| <p>LUSP<br>RUSP</p> | Hand            | <p>Left Ulna Styloid Process<br>Right Ulna Styloid Process</p>     | Place the marker on the lateral side of the wrist axis.        |
| <p>LRSP<br>RRSP</p> | Hand            | <p>Left Radius Styloid Process<br>Right Radius Styloid Process</p> | Place the marker on the medial side of the wrist axis.         |

{% hint style="info" %}
For best results, place the three hand markers so the created shape is asymmetrical (avoid isosceles shape) and unique from the marker arrangements on the other hand. Since the wrist markers have defined placement — along the wrist axis — introduce small amount of positional offset to the LHM2 and RHM2 markers.
{% endhint %}

Lower Extremity Markers

| Labels                                                                                    | Related Segment | Anatomical Location                                                        | Placement Description                                                                                                                                                                                                                                |
| ----------------------------------------------------------------------------------------- | --------------- | -------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| <p>LFTC (GT<a href="#references">[2]</a>)<br>RFTC (GT<a href="#references">[2]</a>)</p>   | Pelvis          | <p>Left Femoral greater Trochanter<br>Right Femoral greater Trochanter</p> | Place the markers on left and right side of the hip, where you can palpate the hip joint or the most lateral prominence of the greater trochanter.                                                                                                   |
| <p>LFLE (LE<a href="#references">[2]</a>)<br>RFLE (LE<a href="#references">[2]</a>)</p>   | Upper Leg       | <p>Left Femur Lateral Epicondyle<br>Right Femur Lateral Epicondyle</p>     | Place the marker on the lateral prominence of the knee joint axis. More specifically, the marker should be placed on the femur epicondyle. You may need to ask the subject to flex and extend the knee few times to locate the axis.                 |
| <p>LFME* (ME<a href="#references">[2]</a>)<br>RFME* (ME<a href="#references">[2]</a>)</p> | Upper Leg       | <p>Left Femur Medial Epicondyle<br>Right Femur Medial Epicondyle</p>       | Place the marker on the Medial prominence of the knee joint axis. Ask the subject to flex and extend the knee few times to locate the knee axis.                                                                                                     |
| <p>LTH<br>RTH</p>                                                                         | Upper Leg       | <p>Left Thigh<br>Right Thigh</p>                                           | Place the markers at the front center of the thigh near the midline. This marker is placed for distinguishing left and right side of the Skeleton. For best results, slightly offset the height of right and left marker to introduce an asymmetry.  |
| <p>LSK<br>RSK</p>                                                                         | Upper Leg       | <p>Left Superior Knee<br>Right Superior Knee</p>                           | Place the markers on the shin bone near the midline of the lower leg. This marker is placed for distinguishing left and right side of the Skeleton. For best results, slightly offset the height of right and left marker to introduce an asymmetry. |
| <p>LTTC (TT<a href="#references">[2]</a>)<br>RTTC (TT<a href="#references">[2]</a>)</p>   | Lower Leg       | <p>Left Tibial Tubercle<br>Right Tibial Tubercle</p>                       | Place the marker about 2-3 cm below the knee cap bone. This marker should be placed on the most anterior point of the tibial tuberosity.                                                                                                             |
| <p>LFAX (HF<a href="#references">[2]</a>)<br>RFAX (HF<a href="#references">[2]</a>)</p>   | Lower Leg       | <p>Left Fibula Apex<br>Right Fibula Apex</p>                               | While standing, place the markers approximately 5 cm below the LFLE and RFLE markers. This marker should be placed on the lateral prominence of proximal end of the fibula.                                                                          |

{% hint style="info" %}
The joint center of the knee and the ankle is modeled at the midpoint of the lateral and medial joint markers (FLE/FME and FAL/TAM). Assuming that center of the femoral head aligns with the center of the acetabulum, its virtual location is modeled using markers on the pelvis segment (posterior and anterior iliac spine markers). The lower extremity segments are modeled along these three virtual locations.
{% endhint %}

Foot Markers

| Labels                                                                                   | Related Segment | Anatomical Location                                                | Placement Description                                                                                                                  |
| ---------------------------------------------------------------------------------------- | --------------- | ------------------------------------------------------------------ | -------------------------------------------------------------------------------------------------------------------------------------- |
| <p>LFAL(LM<a href="#references">[2]</a>)<br>RFAL</p>                                     | Lower Leg/Foot  | <p>Left Fibula Ankle Lateral<br>Right Fibula Ankle Lateral</p>     | Place the maker on the lateral side of the ankle axis; on the lateral prominence of the lateral malleolus bone.                        |
| <p>LTAM* (MM<a href="#references">[2]</a>)<br>RTAM*(MM<a href="#references">[2]</a>)</p> | Lower Leg/Foot  | <p>Left Talus Ankle Medial<br>Right Talus Ankle Medial</p>         | Place the maker on the medial side of the ankle axis; on the medial prominence of the medial malleolus bone                            |
| <p>LFM5(VM<a href="#references">[2]</a>)<br>RFM5</p>                                     | Foot            | <p>Left Foot Fifth Metatarsal<br>Right Foot Fifth Metatarsal</p>   | Place the marker on the dorsal aspect of the fifth metatarsal bone.                                                                    |
| <p>LFM2* (SM<a href="#references">[2]</a>)<br>RFM2*</p>                                  | Foot            | <p>Left Foot Second Metatarsal<br>Right Foot Second Metatarsal</p> | Place the marker on the dorsal aspect of the second metatarsal bone.                                                                   |
| <p>LFM1 (FM<a href="#references">[2]</a>)<br>RFM1</p>                                    | Foot            | <p>Left Foot First Metatarsal<br>Right Foot First Metatarsal</p>   | Place the marker on the dorsal aspect of the first metatarsal bone.                                                                    |
| <p>LFCC (CA<a href="#references">[2]</a>)<br>RFCC</p>                                    | Foot            | <p>Left Foot Calcaneus<br>Right Foot Calcaneus</p>                 | Place the marker on center of the heel, where the Achilles tendon attaches to the calcneous bone.                                      |
| <p>LDP1<br>RDP1</p>                                                                      | Toes            | <p>Left First Distal Phalanx<br>Right First Distal Phalanx</p>     | Place the marker near the end of the big toe. More specifically, the marker should be placed at the distal end of the first phalanges. |

### References

1. Leardini, A., Biagi, F., Merlo, A., Belvedere, C., Benedetti, M.G., 2011. Multi-segment trunk kinematics during locomotion and elementary exercises. Clin. Biomech. 26, 562-571.
2. Leardini, A., Sawacha, Z., Paolini, G., Ingrosso, S., Nativo, R., Benedetti, M.G., 2007. A new anatomically based protocol for gait analysis in children. Gait Posture 26. 560-571.
