Abstract
BackgroundThe validity of predicting foot pronation occurring mainly at the midfoot by surrogate measures from the rearfoot, like eversion excursion, is limited. The dynamic navicular mobility in terms of vertical navicular drop (dNDrop) and medial navicular drift (dNDrift) may be regarded as meaningful clinical indicators to represent overall foot function. This study aimed to develop a minimal approach to measure the two parameters and to examine their intra- and interday reliability during walking.MethodsThe minimal markerset uses markers at the lateral and medial caput of the 1st and 5th metatarsals, respectively, at the dorsal calcaneus and at the tuberosity of the navicular bone. Dynamic navicular drop and drift were assessed with three-dimensional motion capture in 21 healthy individuals using a single-examiner test-retest study design.ResultsIntra- and interday repeatability were 1.1 mm (ICC21 0.97) and 2.3 mm (ICC21 0.87) for dynamic navicular drop and 1.5 mm (ICC21 0.96) and 5.3 mm (ICC21 0.46) for dynamic navicular drift. The contribution of instrumental errors was estimated to 0.25 mm for dynamic navicular drop and 0.86 mm for dynamic navicular drift.ConclusionsInterday reliability was generally worse than intraday reliability primary due to day-to-day variations in movement patterns and the contribution of instrumental errors was below 23% for dynamic navicular drop but reached 57% for dynamic navicular drift. The minimal markerset allows to simply transfer the known concepts of navicular drop and drift from quasi-static clinical test conditions to functional tasks, which is recommended to more closely relate assessments to the functional behavior of the foot.
Highlights
The validity of predicting foot pronation occurring mainly at the midfoot by surrogate measures from the rearfoot, like eversion excursion, is limited
At all three testing sessions the proposed markerset delivered distinct movement patterns of navicular height and width throughout the stance phase among the 21 healthy individuals examined in the present study (Fig. 2a and c)
In contrast to recent multi-segment models consisting of many markers, relying on rigid body assumptions and delivering rather complex 3D rotations to characterize foot function, the presented minimal approach uses projections of the trajectory of the navicular tuberosity to the foot’s transverse and sagital planes
Summary
The validity of predicting foot pronation occurring mainly at the midfoot by surrogate measures from the rearfoot, like eversion excursion, is limited. Conventional measures, like maximum and minimum rearfoot eversion or eversion excursion, are thought to represent foot pronation. These parameters acquired at the rearfoot are likely to be limited for predicting a motion that mainly occurs at the midfoot. Numerous foot models to study multi-segment foot kinematics are currently available [10] they do not come up with the requirements of clinical assessments such as being simple and efficient [11] owing to complexity [12] and the knowledge about their reliability [10] is limited
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