Tracking Movement Without Markers: Advancing Pediatric Motion Analysis
Motion analysis center staff prepare a patient for a traditional marker-based motion capture assessment by placing reflective markers used to track movement patterns.
Understanding how a child moves can provide valuable insight into their mobility and care. The motion analysis center (MAC) at Shriners Hospitals for Children Canada uses advanced motion analysis technology to assess how children and adolescents walk, run and perform everyday movements. The center was recently accredited by the Commission for Motion Laboratory Accreditation, recognizing its commitment to high standards in motion analysis and patient care. As motion analysis technology continues to evolve, the team is exploring new tools that could enhance these assessments and the patient experience.
One promising approach is markerless motion capture, an artificial intelligence (AI)-powered technology that tracks movement without requiring physical markers to be placed on the body. By using video to create a three-dimensional model of a patient’s movement, markerless motion capture could make assessments faster and more comfortable while providing clinicians with valuable information to support clinical decision-making.
A Brief History of Motion Capture
The idea of breaking down movement to better understand it dates back more than a century. In the late 1800s, pioneers such as Eadweard Muybridge and Étienne Jules‑Jules Marey used sequential photography to capture and analyze the movements of animals and humans. The field progressed with the introduction of rotoscoping in the early 1900s and saw major advancements in the 1990s with the use of marker-based motion capture systems in the gaming and film industries.
Marker-based systems, which the MAC has used for several years, work by placing small reflective markers on the body which are tracked by cameras to capture precise movements. While it remains the established standard for clinical motion analysis, new possibilities are on the horizon.
The physio team and the MAC team at Shriners Children’s Canada treated me like family. Tearing my anterior cruciate ligament was such a negative experience, but with the support of the people around me, I was able to find something positive in it.
How Motion Analysis Supports Patient Care
Motion analysis helps the MAC team identify movement challenges associated with pediatric conditions such as cerebral palsy, Charcot-Marie-tooth disease, lower limb torsional abnormalities, arthrogryposis, sports injuries and other musculoskeletal disorders.
An interdisciplinary team of physicians, a biomedical engineer, kinesiologists and physical therapists work together to interpret each patient’s biomechanics and use these insights to help guide treatment decisions. The MAC primarily conducts two types of evaluations: gait analysis for musculoskeletal conditions and return-to-sport analysis for sports-related injuries.
What Is Markerless Motion Capture?
Traditional marker-based motion capture uses small reflective markers placed at specific points on a patient’s body. Specialized cameras track these markers as the patient moves, allowing clinicians to analyze movement patterns.
Markerless motion capture takes a different approach. Instead of physical markers, video cameras and AI-powered software identify and track body landmarks to create a three-dimensional model of a patient’s movement.
In 2024, the MAC acquired a markerless motion capture system that can identify and track more than 100 body landmarks from video footage. The team is now exploring how this technology could complement its established motion analysis tools and make certain assessments more efficient and comfortable for patients.
What Are the Benefits of Markerless Motion Capture for Patients?
For children and families, markerless motion capture may offer several advantages:
- Shorter evaluation times: Eliminating marker placement and manual calibration can reduce preparation time.
- Greater comfort: Fewer physical elements may make evaluations more comfortable, particularly for younger children and patients with sensory sensitivities.
- More efficient assessments: Streamlined preparation and data processing can help clinical teams use their time more efficiently.
- Greater flexibility: The technology can capture movement in different scenarios and, when appropriate, analyze more than one person at a time.
The technology may also reduce data processing time, giving clinicians more time to focus on interpreting the results and applying them to patient care.
Turning Movement Data into Better-Informed Care
Markerless motion capture is now being used at the MAC for some assessments in which traditional marker placement is particularly challenging or impractical. While this technology offers several advantages, marker-based motion capture remains the center's main tool, as it is still considered the "gold standard."
Published studies comparing the two systems have demonstrated the validity of markerless motion capture in certain aspects while also identifying opportunities for improvement. The MAC is currently undertaking its own research to further validate markerless motion capture and assess its role in clinical practice.
As more research becomes available, the MAC will continue to explore how markerless motion capture can be used in a wider range of assessments. The team is excited about its potential to make evaluations faster and more convenient for patients while improving efficiency and maintaining the quality of care.
Ahmed walks in the motion analysis center, where clinicians and researchers are exploring markerless motion capture technology to support movement assessment.
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