A comparison of lower body gait kinematics and kinetics between Theia3D markerless and marker-based models in healthy subjects and clinical patients

Three-dimensional (3D) marker-based motion capture is the current gold standard to assess and monitor pathological gait in a clinical setting. However, 3D markerless motion capture based on pose estimation is advancing into the field of gait analysis. This study aims at evaluating the lower-body 3D gait kinematics and kinetics from synchronously recorded Theia3D markerless and CAST marker-based systems. Twelve healthy individuals and 34 clinical patients aged 8-61 years walked at self-selected speed over a 13 m long walkway. Similarity between models was statistically analysed using inter-trial variability, root mean square error, Pearson's correlation coefficient and Statistical Parametric Mapping. Inter-trial variability was on average higher for clinical patients in both models. Overall, the markerless system demonstrated similar gait patterns although hip and knee rotations were non-comparable. Pelvic anterior tilt was significantly underestimated. Significant differences especially in peak values at specific phases of the gait cycle were observed across all planes for all joints (more so for clinical patients than healthy subjects) as well as in the sagittal powers of the hip, knee and ankle. Theia3D markerless system offers great potential in gait analysis. This study brings awareness to potential clinical users and researchers where they can have confidence, as well as areas where caution should be exercised.