# Rizzoli Marker Sets

## Overview

Rizzoli Marker Sets protocols are available in Motive for human motion tracking. The Rizzoli protocols are developed and researched from the Movement Analysis Laboratory in the Rizzoli Orthopedics Institute, Italy.

In biomechanics tracking applications, proper marker placements are critical to the human motion tracking and the respective biomechanical analysis; and for this reason, precise identification of the anatomical landmarks and marker placements have to be performed[\[1\]](#references). With a Motive Body license, marker locations are indicated over the avatar displayed in the [Builder pane](../../motive-ui-panes/builder-pane). This page provides additional details on the anatomical locations of the marker placements for the Rizzoli protocols.

## Rizzoli Lower Body

The Rizzoli Lower Body template integrates a novel marker placement for lower body tracking. This Marker Sets is designed to provide a complete description of 3D segment and joint motion for analyzing the pelvis and lower extremity kinematics[\[1\]](#references). The following chart includes anatomical landmark descriptions of where the markers need to be placed for accurate and reliable analysis of the lower body movement.

* Includes total six calibration markers for creating the Skeleton asset during static trials (RME/LME, RMM/LMM, RSM/LSM). They are highlighted in red.
* Two thigh markers (RTH and LTH) and two shank markers (RSK and LSK) have been added to the protocol to better distinguish the left and right of the Skeleton.

For more information on the segment and joint definitions, please refer to the referenced research papers.

![Diagram showing the locations of the markers and the segment axis defined in the lower body Marker Set (Leardini et al. 2007\[1\]).](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2FzudeV1O8zKRSPBMzbzPn%2Fimage.png?alt=media\&token=fe2d0069-78a1-4f50-b1ea-fa15d2997c7d)

![](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2FIEjgiFH1IKXxj4fCjr91%2Fimage.png?alt=media\&token=aed108ee-1cdc-41d8-aed4-5e2c1e8e039c)

Rizzoli Lower Body Protocol Markers

| Label                                                                                                                                     | Related Segment | Description                                                                                                                                                                                                                                                                              |
| ----------------------------------------------------------------------------------------------------------------------------------------- | --------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| <p>RASIS<a href="#references">[2]</a><a href="#references">[1]</a><br>LASIS<a href="#references">[2]</a><a href="#references">[1]</a></p> | Pelvis          | Anterior superior iliac spine.                                                                                                                                                                                                                                                           |
| <p>RPSIS<a href="#references">[2]</a><a href="#references">[1]</a><br>LPSIS<a href="#references">[2]</a><a href="#references">[1]</a></p> | Pelvis          | Posterior superior iliac spine.                                                                                                                                                                                                                                                          |
| <p>RGT<a href="#references">[1]</a><br>LGT<a href="#references">[1]</a></p>                                                               | Upper Leg       | Most lateral prominence of the greater trochanter external surface.                                                                                                                                                                                                                      |
| <p>RTH<br>LTH</p>                                                                                                                         | Upper Leg       | Place near the midline of the thigh. Used only for a tracking purpose of distinguishing left and right side. For best result, offset the height of the marker between left and right side.                                                                                               |
| <p>RLE<a href="#references">[1]</a><br>LLE<a href="#references">[1]</a></p>                                                               | Upper Leg       | Most lateral prominence of the lateral femoral epicondyle. Together with LM markers, it determines the location of knee joint axis.                                                                                                                                                      |
| <p>RHF<a href="#references">[2]</a><a href="#references">[1]</a><br>LHF<a href="#references">[2]</a><a href="#references">[1]</a></p>     | Lower Leg       | Head, proximal end, of the fibula.                                                                                                                                                                                                                                                       |
| <p>RTT<a href="#references">[1]</a><br>LTT<a href="#references">[1]</a></p>                                                               | Lower Leg       | Most anterior border of the tibial tuberosity.                                                                                                                                                                                                                                           |
| <p>RSK<br>LSK</p>                                                                                                                         | Upper Leg       | Place near the midline of the shin. Used only for a tracking purpose of distinguishing left and right side. For best result, offset the height of the marker between left and right side.                                                                                                |
| <p>RLM<a href="#references">[1]</a><a href="#references">[3]</a><br>LLM<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Lower Leg       | Distal apex of the lateral malleolus.                                                                                                                                                                                                                                                    |
| <p>RCA<a href="#references">[1]</a><a href="#references">[3]</a><br>LCA<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Foot            | Upper ridge of the calcaneus posterior surface. The aspect of the Achilles tendon insertion on the calcaneus[\[1\]](#references).                                                                                                                                                        |
| <p>RVM<a href="#references">[1]</a><a href="#references">[3]</a><br>LVM<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Foot            | Dorsal aspect of fifth metatarsal head.                                                                                                                                                                                                                                                  |
| <p>RFM<a href="#references">[1]</a><a href="#references">[3]</a><br>LFM<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Foot            | Dorsal aspect of first metatarsal head.                                                                                                                                                                                                                                                  |
| <p>RDP1<br>LDP1</p>                                                                                                                       | Foot            | These markers are added on the distal phalanx only for the toe segment tracking purpose, and they are not included in the biomechanical analysis. 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. |
| <p>RME*<a href="#references">[1]</a><br>LME*<a href="#references">[1]</a></p>                                                             | Upper Leg       | Medial prominence of the medial femoral epicondyle.                                                                                                                                                                                                                                      |
| <p>RMM*<a href="#references">[1]</a><br>LMM*<a href="#references">[1]</a></p>                                                             | Lower Leg       | Distal apex of the medial malleolus.                                                                                                                                                                                                                                                     |
| <p>RSM*<a href="#references">[1]</a><a href="#references">[3]</a><br>LSM<a href="#references">[1]</a><a href="#references">[3]</a></p>    | Foot            | Dorsal aspect of second metatarsal head.                                                                                                                                                                                                                                                 |

\*These markers need to be removed after the Skeleton has been created in Motive.

## Rizzoli Upper

This Marker Set is designed for tracking multi-segment trunk kinematics[\[2\]](#references). Total 10 markers are place on the torso and 4 markers are placed around pelvis[\[2\]](#references), and an extra back marker (RBAK) was added on the right scapula solely for improved tracking.

* Total four markers were placed around the waist for tracking the pelvis segment, and the orientation of the pelvis segment (Pel) is defined by these markers[\[1\]](#references)[\[2\]](#references).
* Total four markers are used for tracking the thorax segment, where two acromion markers (RA and LA) make the shoulder line segment for tracking the segment rotation and translations[\[2\]](#references).
* For the spine motion tracking, a 5-link segment model is created from the six spine markers[\[2\]](#references).
* An extra RBAK marker was added to the protocol for improved identification of left and right side of the tracked Skeleton.

For more information on the Rizzoli Trunk Marker Set, please refer to the referenced research papers.

![Marker placement diagram with marker labels from (Leardini et al.,2011)\[2\]](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2FdMeHNP50hYkw4FL4YpyS%2Fimage.png?alt=media\&token=4b10252b-7993-418c-911e-c33e641112f1)

![](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2F8312ruOkRuNqjIGNzqen%2Fimage.png?alt=media\&token=853df2ea-ba4e-42cd-935e-97864d0ed566)

Rizzoli Trunk Markers

| Label                                                                                                                                     | Related Segment | Description                                                                               |
| ----------------------------------------------------------------------------------------------------------------------------------------- | --------------- | ----------------------------------------------------------------------------------------- |
| <p>RA<a href="#references">[2]</a><br>LA<a href="#references">[2]</a></p>                                                                 | Torso           | Acromio-clavicular joint                                                                  |
| RBAK                                                                                                                                      | Torso           | Placed near the right scapula apex: Used only to Identify left and right of the Skeleton. |
| C7[\[2\]](#references)                                                                                                                    | Torso           | Seventh cervical vertebrae.                                                               |
| T2[\[2\]](#references)                                                                                                                    | Torso           | Second thoracic vertebrae                                                                 |
| MAI[\[2\]](#references)                                                                                                                   | Torso           | Midpoint between left and right scapular apex, near the T10 vertebrae.                    |
| IJ[\[2\]](#references)                                                                                                                    | Torso           | Jugular Notch. Most superior region of the sternum, where it meets the clavicle bones.    |
| PX[\[2\]](#references)                                                                                                                    | Torso           | Xiphoid process of the sternum. Most inferior region of the sternum.                      |
| L1[\[2\]](#references)                                                                                                                    | Torso           | First lumbar vertebrae.                                                                   |
| L3[\[2\]](#references)                                                                                                                    | Torso           | Third lumbar vertebrae.                                                                   |
| L5[\[2\]](#references)                                                                                                                    | Torso           | First lumbar vertebrae.                                                                   |
| <p>RASIS<a href="#references">[2]</a><a href="#references">[1]</a><br>LASIS<a href="#references">[2]</a><a href="#references">[1]</a></p> | Pelvis          | Anterior superior iliac spine.                                                            |
| <p>RPSIS<a href="#references">[2]</a><a href="#references">[1]</a><br>LPSIS<a href="#references">[2]</a><a href="#references">[1]</a></p> | Pelvis          | Posterior superior iliac spine.                                                           |

## Rizzoli Body

The Rizzoli Body template combines the Rizzoli Lower Body Protocol and the Rizzoli Trunk Protocol to provide tracking of the full-body kinematics.

![](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2FBvVm205Itxm8xEg0e5h4%2Fimage.png?alt=media\&token=155ad931-59c1-4d17-a73e-5c760dfa0202)

Rizzoli Full Body Markers

| Label                                                                                                                                     | Related Segment | Description                                                                                                                                                                                                                                                                              |
| ----------------------------------------------------------------------------------------------------------------------------------------- | --------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| <p>RA<a href="#references">[2]</a><br>LA<a href="#references">[2]</a></p>                                                                 | Torso           | Acromio-clavicular joint                                                                                                                                                                                                                                                                 |
| RBAK                                                                                                                                      | Torso           | Placed near the right scapula apex: Used only for identifying left and right of the Skeleton.                                                                                                                                                                                            |
| C7[\[2\]](#references)                                                                                                                    | Torso           | Seventh cervical vertebrae.                                                                                                                                                                                                                                                              |
| T2[\[2\]](#references)                                                                                                                    | Torso           | Second thoracic vertebrae                                                                                                                                                                                                                                                                |
| MAI[\[2\]](#references)                                                                                                                   | Torso           | Midpoint between left and right scapular apex, near the T10 vertebrae.                                                                                                                                                                                                                   |
| IJ[\[2\]](#references)                                                                                                                    | Torso           | Jugular Notch. Most superior region of the sternum, where it meets the clavicle bones.                                                                                                                                                                                                   |
| PX[\[2\]](#references)                                                                                                                    | Torso           | Xiphoid process of the sternum. Most inferior region of the sternum.                                                                                                                                                                                                                     |
| L1[\[2\]](#references)                                                                                                                    | Torso           | First lumbar vertebrae.                                                                                                                                                                                                                                                                  |
| L3[\[2\]](#references)                                                                                                                    | Torso           | Third lumbar vertebrae.                                                                                                                                                                                                                                                                  |
| L5[\[2\]](#references)                                                                                                                    | Torso           | First lumbar vertebrae.                                                                                                                                                                                                                                                                  |
| <p>RASIS<a href="#references">[2]</a><a href="#references">[1]</a><br>LASIS<a href="#references">[2]</a><a href="#references">[1]</a></p> | Pelvis          | Anterior superior iliac spine.                                                                                                                                                                                                                                                           |
| <p>RPSIS<a href="#references">[2]</a><a href="#references">[1]</a><br>LPSIS<a href="#references">[2]</a><a href="#references">[1]</a></p> | Pelvis          | Posterior superior iliac spine.                                                                                                                                                                                                                                                          |
| <p>RGT<a href="#references">[1]</a><br>LGT<a href="#references">[1]</a></p>                                                               | Upper Leg       | Most lateral prominence of the greater trochanter external surface.                                                                                                                                                                                                                      |
| <p>RTH<br>LTH</p>                                                                                                                         | Upper Leg       | Place near the midline of the thigh. Used only for a tracking purpose of distinguishing left and right side. For best result, offset the height of the marker between left and right side.                                                                                               |
| <p>RLE<a href="#references">[1]</a><br>LLE<a href="#references">[1]</a></p>                                                               | Upper Leg       | Most lateral prominence of the lateral femoral epicondyle. Together with LM markers, it determines the location of knee joint axis.                                                                                                                                                      |
| <p>RHF<a href="#references">[2]</a><a href="#references">[1]</a><br>LHF<a href="#references">[2]</a><a href="#references">[1]</a></p>     | Lower Leg       | Head, proximal end, of the fibula.                                                                                                                                                                                                                                                       |
| <p>RTT<a href="#references">[1]</a><br>LTT<a href="#references">[1]</a></p>                                                               | Lower Leg       | Most anterior border of the tibial tuberosity.                                                                                                                                                                                                                                           |
| <p>RSK<br>LSK</p>                                                                                                                         | Upper Leg       | Place near the midline of the shin. Used only for a tracking purpose of distinguishing left and right side For best result, offset the height of the marker between left and right side.                                                                                                 |
| <p>RLM<a href="#references">[1]</a><a href="#references">[3]</a><br>LLM<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Lower Leg       | Distal apex of the lateral malleolus.                                                                                                                                                                                                                                                    |
| <p>RCA<a href="#references">[1]</a><a href="#references">[3]</a><br>LCA<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Foot            | Upper ridge of the calcaneus posterior surface. The aspect of the Achilles tendon insertion on the calcaneus[\[1\]](#references).                                                                                                                                                        |
| <p>RVM<a href="#references">[1]</a><a href="#references">[3]</a><br>LVM<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Foot            | Dorsal aspect of fifth metatarsal head.                                                                                                                                                                                                                                                  |
| <p>RFM<a href="#references">[1]</a><a href="#references">[3]</a><br>LFM<a href="#references">[1]</a><a href="#references">[3]</a></p>     | Foot            | Dorsal aspect of first metatarsal head.                                                                                                                                                                                                                                                  |
| <p>RDP1<a href="#references">[1]</a><a href="#references">[3]</a><br>LDP1<a href="#references">[1]</a><a href="#references">[3]</a></p>   | Foot            | These markers are added on the distal phalanx only for the toe segment tracking purpose, and they are not included in the biomechanical analysis. 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. |
| <p>RME*<a href="#references">[1]</a><br>LME*<a href="#references">[1]</a></p>                                                             | Upper Leg       | Medial prominence of the medial femoral epicondyle.                                                                                                                                                                                                                                      |
| <p>RMM*<a href="#references">[1]</a><br>LMM*<a href="#references">[1]</a></p>                                                             | Lower Leg       | Distal apex of the medial malleolus.                                                                                                                                                                                                                                                     |
| <p>RSM*<a href="#references">[1]</a><a href="#references">[3]</a><br>LSM*<a href="#references">[1]</a><a href="#references">[3]</a></p>   | Foot            | Dorsal aspect of second metatarsal head.                                                                                                                                                                                                                                                 |

\*These markers need to be removed after the Skeleton has been created in Motive.

## Rizzoli Foot

The Rizzoli Left/Right Foot template provides precise tracking of the foot kinematics by modeling three-foot segments – rear-foot, mid-foot, and fore-foot – from the markers that are placed on carefully identified anatomical landmarks of the foot [\[3\]](#references). The following diagrams and the chart detail on where each marker needs to be placed on the right foot protocol. The placements for the left foot will be anatomically equivalent but reflected.

There are two calibration markers in each foot protocol. They are located at the apex of the medial malleolus (RMM/LMM) and the lowest point of the heel center (RCAp/LCAp). These markers are only for creating the asset for static trials, and they need to be removed for dynamic trials.

Refer to the referenced papers for specific information on the joint and segment definitions.

![Foot marker labels and segment definitions for the foot model (Leardini et al., 2007)](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2FVXiM2Qh8ZTL4GYjIMtXA%2Fimage.png?alt=media\&token=cb47fb58-5308-4448-92da-c1e801959c21)

![Marker placement diagram for the Rizzoli Right Foot Protocol (14)](https://2142239968-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FTSFWA3dBvgCMGQlNWsHE%2Fuploads%2FTYP4P8VySFbG9ElER7lu%2Fimage.png?alt=media\&token=0b240d94-53de-4e2c-acab-ade5edb9514d)

Rizzoli Foot Markers

| Label (Right/Left)                                                                                                                                                                             | Description                                                                                                                                                                                                                    |
| ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| RPM/LPM[\[3\]](#references)[\[4\]](#references)                                                                                                                                                | Most distal and dorsal point of the head of the proximal phalanx of the hallux[\[3\]](#references)[\[4\]](#references).                                                                                                        |
| RFMH/LFMH[\[1\]](#references)[\[3\]](#references)[\[4\]](#references)                                                                                                                          | Head of the first metatarsal, dorso-medial aspect of the first metatarso-phalangeal joint[\[3\]](#references)[\[4\]](#references).                                                                                             |
| RSMH/RSMH[\[1\]](#references)[\[3\]](#references)[\[4\]](#references)                                                                                                                          | Head of the second metatarsal, dorso-medial aspect of the second metatarso-phalangeal joint[\[3\]](#references)[\[4\]](#references).                                                                                           |
| RVMH/LVMH[\[1\]](#references)[\[3\]](#references)[\[4\]](#references)                                                                                                                          | Head of the fifth metatarsal, dorso-lateral aspect of the fifth metatarso-phalangeal joint[\[3\]](#references)[\[4\]](#references).                                                                                            |
| RFMB/LFMB[\[3\]](#references)[\[4\]](#references)                                                                                                                                              | Base of the first metatarsal, dorso-medial aspect of the first metatarso-cuneiform joint[\[3\]](#references)[\[4\]](#references).                                                                                              |
| RSMB/LSMB[\[3\]](#references)[\[4\]](#references)                                                                                                                                              | Base of the second metatarsal, dorso-medial aspect of the first metatarso-cuneiform joint[\[3\]](#references)[\[4\]](#references).                                                                                             |
| RVMB/LVMB[\[3\]](#references)[\[4\]](#references)                                                                                                                                              | Base of the first metatarsal, dorso-medial aspect of the first metatarso-cuboid joint[\[3\]](#references)[\[4\]](#references).                                                                                                 |
| RTN/LTN[\[3\]](#references)[\[4\]](#references)                                                                                                                                                | Most medial apex of the tuberosity of the navicular[\[3\]](#references)[\[4\]](#references).                                                                                                                                   |
| RST/LST[\[3\]](https://v30.wiki.optitrack.com/index.php?title=Rizzoli_Markersets#cite_note-foot-3)[\[4\]](https://v30.wiki.optitrack.com/index.php?title=Rizzoli_Markersets#cite_note-foot2-4) | Lateral apex of the sustentaculum tali[\[3\]](https://v30.wiki.optitrack.com/index.php?title=Rizzoli_Markersets#cite_note-foot-3)[\[4\]](https://v30.wiki.optitrack.com/index.php?title=Rizzoli_Markersets#cite_note-foot2-4). |
| RPT/LPT[\[3\]](#references)[\[4\]](#references)                                                                                                                                                | Lateral apex of the peroneal tubercle[\[3\]](#references)[\[4\]](#references).                                                                                                                                                 |
| RCA/LCA[\[3\]](#references)[\[4\]](#references)                                                                                                                                                | Upper central ridge of the calcaneus posterior surface, i.e. Achilles's tendon attachment[\[3\]](#references)[\[4\]](#references).                                                                                             |
| RLM/LLM[\[1\]](#references)[\[3\]](#references)[\[4\]](#references)                                                                                                                            | Distal apex of the lateral malleolus[\[3\]](#references)[\[4\]](#references).                                                                                                                                                  |
| RHF/LHF[\[1\]](#references)[\[3\]](#references)[\[4\]](#references)                                                                                                                            | Most proximal apex of the head of the fibula[\[3\]](#references)[\[4\]](#references).                                                                                                                                          |
| RTT/LTT[\[1\]](#references)[\[3\]](#references)[\[4\]](#references)                                                                                                                            | Most anterior prominence of the tibial tuberosity[\[3\]](#references)[\[4\]](#references).                                                                                                                                     |
| RMM/LMM\*[\[1\]](#references)                                                                                                                                                                  | Distal apex of the medial malleolus.                                                                                                                                                                                           |
| RHL/LHL\* (RCAp/LCAp[\[4\]](#references))                                                                                                                                                      | Projection of the CA marker on the ground[\[4\]](#references). Vertically aligned with the CA marker and placed near the ground level. This is a calibration marker that needs to be removed for dynamic trials.               |

\*These markers need to be removed after the Skeleton has been created in Motive.

## References

1. 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.
2. 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.
3. &#x20;Leardini, A., Benedetti, M.G., Berti, L., Bettinelli, D., Nativo, R., Giannini, S., 2007. Rear-foot, mid-foot and fore-foot motion during the stance phase of gait. _Gait Posture_ 25. 453-462.
4. Portinaro, N., Leardini, A., Panou, A., Monzani, V., Caravaggi, P., 2014. 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_ 7, 57.
