Intrarater and interrater reliability of the first metatarsophalangeal joint dorsiflexion resistance test.

Abstract

The first metatarsophalangeal joint plays a fundamental role during the gait cycle. The Hubscher manoeuvre, which consists of passively dorsiflexing the first metatarsophalangeal joint of an individual in relaxed stance and observing the raising of the medial longitudinal arch, is a clinical test thought to examine the function of the first metatarsophalangeal joint. However, the hallux dorsiflexion achieved during this test is not related to hallux dorsiflexion during gait. On the other hand, unlike kinematic tests, results from kinetic tests have been shown to be strongly correlated with dynamic joint biomechanics. Thus, given the need for valid and reliable tests to evaluate the function of the first metatarsophalangeal joint, this study aimed to assess the reliability of a new kinetic test, namely, the first metatarsophalangeal joint dorsiflexion resistance test. Thirty young adults completed two data collection sessions 1week apart, during which the first metatarsophalangeal joint dorsiflexion resistance test was performed. Intrarater and interrater reliability were assessed using intraclass correlation coefficients (ICC), minimal detectable difference (MDD), standard error of the mean (SEM) and limits of agreements (LoA). For the intrarater reliability, the ICC was 0.77 (p<0.001), the SEM was 6.5N, the MDD was 18.1N and the LoA were -7.9 to 26.9N. For the interrater reliability, the ICC was 0.86 (p<0.001), the SEM was 6.9N, the MDD was 19.0N and the LoA were -6.4 to 21.8N. The results of this study demonstrate good intra and interrater reliability of the first metatarsophalangeal joint dorsiflexion resistance test, which provides evidence to support its use in clinical and research contexts. Further work is required to establish the test results' relationship with joint kinetics during gait and to provide normative values in individuals with and without musculoskeletal disorders as well as among different age groups and genders to optimise its utilization in clinical and research settings.