Measurements Of Foot Research Articles

Foot and Ankle Strength, Range of Motion, Posture, and Deformity Are Associated With Balance and Functional Ability in Older Adults

Spink MJ, Fotoohabadi MR, Wee E, Hill KD, Lord SR, Menz HB. Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older adults. Objective To determine the extent to which measures of foot and ankle strength, range of motion, posture, and deformity are associated with performance in a battery of balance and functional ability tests in older adults. Design Cross-sectional study of people over 65 years. Setting Community. Participants Participants (N=305; age range, 65–93y) recruited for a randomized trial investigating the efficacy of a podiatry intervention to prevent falls. Interventions Not applicable. Main Outcome Measures Clinical measures of foot and ankle strength (using hand-held dynamometry), range of motion, posture, and deformity, and a battery of balance tests (postural sway, maximum balance range, lateral stability, coordinated stability) and functional ability tests (alternate step test, sit-to-stand, timed 6-m walk). Results Most (67/88) of the correlations between the foot and ankle tests and performance on the balance and functional tests were statistically significant. Hierarchic linear regression analysis identified hallux plantar flexion strength and ankle inversion-eversion range of motion to be the most consistent significant and independent predictors of balance and functional test performance, explaining up to 25% of the variance in the test scores. Conclusions Foot and ankle characteristics, particularly plantar flexor strength of the hallux and ankle inversion-eversion range of motion, are important determinants of balance and functional ability in older people. Further research is required to establish whether intervention programs that include strengthening and stretching exercises for the foot and ankle may achieve improvements in balance and functional ability and reduce the risk of falls in older people.

Foot and Ankle Characteristics in Patellofemoral Pain Syndrome: A Case Control and Reliability Study

Case-control and reliability study. To compare foot and ankle characteristics between individuals with and without patellofemoral pain syndrome (PFPS) and to identify reliable weight-bearing foot and ankle measurements for use in future research on PFPS. PFPS is a common presentation to sports medicine and orthopaedic clinics. Characteristics of the foot and ankle are often linked with PFPS development, although evidence to support this link is equivocal and there is a lack of consensus on how best to evaluate these characteristics. A variety of weight-bearing foot and ankle measurements were evaluated by 3 raters of varying experience in 20 individuals with PFPS and 20 controls matched by age, sex, height, and body mass. Between-group comparisons were made for each measurement using data from an experienced podiatrist blinded to group assignment of the participants. Intrarater and interrater reliability was compared between all measurements using the first 15 participants from each group. Between-group comparisons showed that the individuals in the PFPS group had a more pronated foot posture when assessed by the foot posture index and longitudinal arch angle, and for all measurements relative to subtalar joint neutral. Foot posture index, normalized navicular drop, and calcaneal angle relative to subtalar joint neutral measurements also possessed high reliability in both groups when used by experienced raters. Reliability was not influenced by rater experience or the presence of PFPS for relaxed-stance foot posture measurements. Both tester inexperience and the presence of PFPS reduced reliability for all measurements of foot posture relative to subtalar joint neutral and measurement of weight-bearing ankle dorsiflexion. The foot posture index, normalized navicular drop, and calcaneal angle relative to subtalar joint neutral are all reliable and sensitive to group differences when used in a population with PFPS. Individuals with PFPS possess a more pronated foot posture and increased foot mobility compared to controls. Prospective evaluation of these measurements is now required to determine whether they contribute to the development of PFPS. J Orthop Sports Phys Ther 2010;40(5):286-296, Epub 12 April 2010. doi:10.2519/jospt.2010.3227.

Analysis of Foot Structure in Athletes Sustaining Proximal Fifth Metatarsal Stress Fracture

In the past, several studies provided anecdotal descriptions of high-arched feet in individuals sustaining proximal fifth metatarsal stress fractures. This relationship has never been supported by scientific evidence. Our objective was to examine whether athletes who sustained this injury had an exceptional static foot structure or dynamic loading pattern. Ten injured professional soccer players who regained full professional activity following a unilateral proximal fifth metatarsal stress fracture and ten control soccer players were examined. Independent variables included static evaluation of foot and arch structure, followed by dynamic plantar foot pressure evaluation. Each variable was compared between injured, contra-lateral uninjured, and control feet. Static measurements of foot and arch structure did not reveal differences among the groups. However, plantar pressure evaluation revealed relative unloading of the fourth metatarsal in injured and uninjured limbs of injured athletes compared with control, while the fifth metatarsal revealed pressure reduction only in the injured limbs of injured athletes. Athletes who sustained proximal fifth metatarsal stress fracture were not characterized by an exceptional static foot structure. Dynamically, lateral metatarsal unloading during stance may either play a role in the pathogenesis of the injury, or alternately represent an adaptive process. Footwear fabrication for previously injured athletes should not categorically address cushioning properties designed for high-arch feet, but rather focus on individual dynamic evaluation of forefoot loading, with less attention applied to static foot and arch characteristics.

Simultaneous Dynamic Blood Oxygen Level-Dependent Magnetic Resonance Imaging of Foot and Calf Muscles

To demonstrate the feasibility of simultaneous blood oxygen level-dependent (BOLD) magnetic resonance imaging of calf and foot muscles and investigate age-related changes of BOLD signal changes during ischemia and postocclusive hyperemia in healthy volunteers. In this study, 15 healthy elderly volunteers (mean age: 69.0 +/- 7.4 years) and 15 healthy young volunteers (mean age: 26.1 +/- 3.9 years) were enrolled. In both legs, simultaneous BOLD imaging of calf and foot muscles was performed at 1.5 Tesla. Short-term ischemia and consecutive reactive hyperemia were provoked by a cuff-compression paradigm. T2*-weighted signal time courses were obtained from foot and calf muscles simultaneously. Ischemia was assessed by T2* minimum ischemic value (MIV) and the time to half ischemic minimum (THIM). Reperfusion was assessed by the time to reach T2* half hyperemia peak (THHP). Reactive hyperemia was characterized by hyperemia peak value (HPV), time to peak (TTP), and relative T2* change from end of ischemia to HPV (deltaS). Parameter differences were assessed using a 2-sided Student t test. Dynamic BOLD measurement of foot and calf muscles was techniqually feasible and successful in all volunteers.In comparison, THIM was significantly longer in elderly than in young volunteers for calf (P < 0.01) muscles (young: 28.9 +/- 3.7 seconds; elderly: 57.8 +/- 31.4 seconds) and foot (P = 0.01) muscles (young: 36.8 +/- 25.5 seconds; elderly: 56.6 +/- 31.7 seconds). MIV relative to baseline T2*-signal was significantly (P < 0.01) lower in the elderly for calf (young: 96.0% +/- 2.6%; elderly: 91.3% +/- 4.4%) and foot (young: 95.8% +/- 2.5%; elderly: 91.1% +/- 8.2%) muscles. TTP was significantly (calf: P = 0.01; foot: P = 0.02) delayed in the elderly (elderly calf: 103.0 +/- 92.7 seconds and foot: 157.1 +/- 109.9 seconds vs. young calf: 54.8 +/- 42.1 seconds and foot: 95.1 +/- 77.6 seconds). HPV was significantly (calf: P < 0.01 and foot: P = 0.03) higher in (young calf: 114.1% +/- 7.2% and foot: 105.8% +/- 3.3% vs. elderly calf: 104.0% +/- 2.1% and foot: 103.9% +/- 3.2% seconds) young volunteers.In a muscle-group comparison, no significant differences in THIM and MIV were observed between calf and foot.THHP was significantly (P = 0.02) longer in foot muscles (foot young: 32.5 +/- 29.8 seconds and elderly: 34.1 +/- 25.0 seconds vs. calf young: 16.8 +/- 14.1 seconds and elderly: 23.6 +/- 14.1 seconds) of both age groups. TTP was significantly (P = 0.01 and 0.02) longer in foot muscles (foot young: 95.1 +/- 77.6 seconds and elderly: 157.1 +/- 109.9 seconds vs. calf young: 54.8 +/- 42.1 seconds and elderly: 103.0 +/- 92.7 seconds) of both age groups. HPV was lower (P < 0.01) in foot muscles of the young (calf: 114.1% +/- 7.2% vs. foot: 105.8 +/- 3.3%). Simultaneous BOLD-imaging of calf and foot muscles is feasible and reveals statistically significant age-related differences during ischemia and postocclusive hyperemia in healthy volunteers.

Diagnostic accuracy of digital photography and image analysis for the measurement of foot conformation in the horse

Rigorous evaluation of practicable methods for the objective assessment of foot conformation has not been performed. To assess the practicability, precision and accuracy of the process of obtaining measurements of horses' feet using photography and image processing software. Precision study: Lateral photographs of horses' feet were obtained twice by 2 veterinary surgeons (image acquisition - IAc). Photographs were analysed by 2 masked veterinary surgeons on 2 occasions (image analysis - IAn). Measurements were compared within and between operators for self and non-self acquired photographs. Agreement indices (AIs) and 95% limits of agreement (LOA) were calculated for the IAn process alone and for the combined IAc + IAn processes. Accuracy study: Measurements obtained from lateral photographs were compared with those obtained from lateromedial radiographs. AIs and 95% LOA were calculated for each measurement. Precision study: Mean intra- and interoperator AIs for the IAn process alone were > or = 0.90 while those for the combined IAc + IAn processes were > or = 0.89 for all measurements. Similar mean AIs and 95% LOA were calculated regardless of image origin. The 95% LOA for hoof angle, heel height/toe height% and coronary band angle for all comparisons were within target values. Accuracy study: Mean AIs were > or = 0.89 for all measurements. The 95% LOA for heel height/toe height% and coronary band angle were within target values. Excellent precision was identified within and between operators regardless of image origin. High levels of accuracy were also identified, especially for heel height/toe height% and coronary band angle, indicating that photography and radiography may be used interchangeably. Acquisition and analysis of photographic images is an appropriate method for the objective measurement of foot conformation, both in clinical and, research settings.

Age‐Related Factors in the Relationship Between Foot Measurements and Living Stature and Body Weight

The measurements of feet and footprints are especially important in forensic identification, as they have been used to predict the body height and weight of victims or suspects. It can be observed that the subjects of forensic-oriented studies are generally young adults. That is to say, researchers rarely take into consideration the body's proportional changes with age. Hence, the aim of this study is to generate equations which take age and sex into consideration, when stature and body weight are estimated from foot and footprints dimensions. With this aim in mind, we measured the stature, body weight, foot length and breadth, heel breadth, footprint length and breadth, and footprint heel breadth of 516 volunteers (253 males and 263 females) aged between 17.6 and 82.9 years using standard measurement techniques. The sample population was divided randomly into two groups. Group 1, the study group, consisted of 80% of the sample (n = 406); the remaining 20% were assigned to the cross-validation group or Group 2 (n = 110). In the first stage of the study, we produced equations for estimating stature and weight using a stepwise regression technique. Then, their reliability was tested on Group 2 members. Statistical analyses showed that the ratios of foot dimensions to stature and body weight change considerably with age and sex. Consequently, the regression equations which include these variables yielded more reliable results. Our results indicated that age and sex should be taken into consideration when predicting human body height and weight for forensic purposes.

Plantar calcaneal spurs in older people: longitudinal traction or vertical compression?

BackgroundPlantar calcaneal spurs are common, however their pathophysiology is poorly understood. This study aimed to evaluate the prevalence and correlates of plantar calcaneal spurs in a large sample of older people.MethodsWeightbearing lateral foot radiographs of 216 people (140 women and 76 men) aged 62 to 94 years (mean age 75.9, SD 6.6) were examined for plantar calcaneal and Achilles tendon spurs. Associations between the presence of spurs and sex, body mass index, radiographic measures of foot posture, self-reported co-morbidities and current or previous heel pain were then explored.ResultsOf the 216 participants, 119 (55%) had at least one plantar calcaneal spur and 103 (48%) had at least one Achilles tendon spur. Those with plantar calcaneal spurs were more likely to have Achilles tendon spurs (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.2 to 3.5). Prevalence of spurs did not differ according to sex. Participants with plantar calcaneal spurs were more likely to be obese (OR = 7.9, 95% CI 3.6 to 17.0), report osteoarthritis (OR = 2.6, 95% CI 1.6 to 4.8) and have current or previous heel pain (OR = 4.6, 95% CI 2.3 to 9.4). No relationship was found between the presence of calcaneal spurs and radiographic measures of foot posture.ConclusionCalcaneal spurs are common in older men and women and are related to obesity, osteoarthritis and current or previous heel pain, but are unrelated to radiographic measurements of foot posture. These findings support the theory that plantar calcaneal spurs may be an adaptive response to vertical compression of the heel rather than longitudinal traction at the calcaneal enthesis.

Subtalar neutral position as an offset for a kinematic model of the foot during walking

The lack of a common reference position when defining foot postures may underestimate the ability to differentiate foot function in subjects with pathology. The effect of using the subtalar neutral (STN) position as an offset for both rearfoot and forefoot through comparison of the kinematic walking patterns of subjects classified as normal ( n = 7) and abnormally pronated ( n = 14) foot postures was completed. An Optotrak™ Motion Analysis System (Northern Digital, Inc.) integrated with Motion Monitor Software™ (Innovative Sports, Inc.) was used to track three-dimensional movement of the leg, rearfoot and first metatarsal segments. Intrarater reliability of positioning the foot into STN using clinical guidelines was determined for a single rater for 21 subjects. Walking data were subsequently compared before and after an offset was applied to the rearfoot and first metatarsal segments. Repeated measures of foot positioning found the STN position to be highly repeatable (intraclass correlation coefficients > 0.9), with peak errors ranging from 1.9° to 4.3°. Utilizing STN as the offset resulted in a significant increase in rearfoot eversion ( p = 0.019) during early stance, and greater first metatarsal dorsiflexion ( p < 0.007) across stance in the pronated foot groups that was not observed prior to applying the offset. When applied to subjects with differing foot postures, the selection of a common reference position that is both clinically appropriate and reliable may distinguish kinematic patterns during walking that are consistent with theories of abnormal pronation.

Assessment of foot posture: Correlation between different clinical techniques

Background Clinical evaluation of foot posture is necessary for assessing and treating patients with lower extremity dysfunction. Although several studies have explored the reliability and validity of different clinical techniques for the measurement of foot posture, there is limited research in studies investigating whether two or more such techniques correlate with each other. Objectives To explore the correlations between the valgus and arch index measurements with the measurements of the navicular drop and drift in bipedal and single-leg stance. Methods Clinical measurements of the valgus index, the arch index, the navicular drop and drift were performed on the left foot of 26 healthy subjects in bipedal and in single-leg stance with 30° knee flexion. Results The valgus index yielded moderate to strong correlations with the measurement of navicular drop (bipedal: r = 0.657, p < 0.001; single-leg stance: r = 0.613, p = 0.001) and small correlations with navicular drift (bipedal: r = 0.481, p = 0.13; single-leg stance: r = 0.335, p = 0.094). The arch index demonstrated small correlations with the navicular drop and drift in both bipedal and single-leg stance ( r = 0.317-0.428, p = 0.115–0.029). Conclusions Although strong associations were obtained between the valgus index and the navicular drop, all other correlations demonstrated low degrees of association. Further research should explore the association of these clinical measurements in patients with foot/lower limb impairments.

The effect of topical wheatgrass cream on chronic plantar fasciitis: A randomized, double-blind, placebo-controlled trial

To investigate the efficacy of a topical wheatgrass cream for improving pain and function in patients with chronic plantar fasciitis. Randomized, double-blind, placebo-controlled trial. Eighty participants with chronic plantar fasciitis were randomly assigned to a treatment group (wheatgrass cream) or a control group (placebo cream). All participants applied a cream twice daily for 6 weeks. Follow up was conducted at 6 and 12 weeks. Visual Analogue Scale (VAS) for daily first-step pain and the Foot Health Status Questionnaire (FHSQ) for overall foot function. Secondary measures of foot posture, calf muscle strength and range of ankle dorsiflexion were also assessed. No significant differences were found between groups with respect to main outcomes of first-step pain or foot function at any time. Both groups improved significantly from baseline to 6 weeks, and these improvements were maintained at 12 weeks. The topical application of wheatgrass cream is no more effective than a placebo cream for the treatment of chronic plantar fasciitis.

Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders II: interclinician andintraclinician reliability and validity of the newly established standard rating scales and Japanese Orthopaedic Association rating scale

BackgroundThis study evaluated the validity and inter- and intraclinician reliability of (1) the Japanese Society of Surgery of the Foot (JSSF) standard rating system for four sites [ankle- hindfoot (AH), midfoot (MF), hallux (HL), and lesser toe (LT)] and the rheumatoid arthritis (RA) foot and ankle scale and (2) the Japanese Orthopaedic Association’s foot rating scale (JOA scale). MethodsClinicians from the same institute independently evaluated participating patients from their institute by two evaluations at a 1- to 4-week interval. Statistical evaluation was as follows. (1) The intraclass correlation coefficient (ICC) was calculated from data collected from at least two examinations of each patient by at least two evaluating clinicians (Data A). (2) Total scores for the two evaluations were determined from the distribution of differences in data between the two evaluations (Data B); each item was evaluated by determining Cohen’s coefficient of agreement. (3) The relation between patient satisfaction and total score was investigated only for patients who underwent surgery (Data C). Spearman’s rank correlation coefficient was obtained. ResultsParticipants were 65 clinicians and 610 patients, including those with disorders of the AH (313), MF (47), HL (153), and LT (50) and those with RA (47). From Data A, the ICC was high for AH and HL by JSSF scales and for AH, MF, and LT by the JOA scale. From Data B, the coefficient showed high validity for both scales for AH, with almost no difference between the two scales; the validity for HL was higher with the JOA scale than with the JSSF scale. From Data C, correlations were significant between patient satisfaction and outcome for AH and HL by the JSSF scales and for AH, HL, and LT by the JOA scale. ConclusionsThe validity of both scales was high. Clinical evaluation of the therapeutic results using these scales would be highly reliable.

Measuring Foot Motion: Forward and Inverse Dynamic Models—Foot and Ankle Research Retreat II, April 30-May 1, 2004, Los Angeles, California

This was the second Foot and Ankle Research Retreat sponsored by the Foot and Ankle Interest Group of the Orthopedic Section of the American Physical Therapy Association. It was hosted by the Department of Biokinesiology and Physical Therapy at the University of Southern California and was held April 30 to May 1, 2004. The purpose of this second retreat was to address the measurement of foot motion, focusing on the various foot models that have recently been proposed in the scientific community. Clinicians and scientists with a common interest in the measurement of foot and ankle mechanics attended the retreat. In this special supplement, you will find a consensus statement, a listing of the presentations and authors, and an abstract of each of the presentations made at the conference. J Orthop Sports Phys Ther 2004;34(9):A1–A18. doi:10.2519/jospt.2004.0302

Revision of failed triple arthrodesis with an opening-closing wedge osteotomy of the midfoot.

This investigation reviewed the clinical and radiographic results of a biplanar opening-closing wedge osteotomy of the midfoot to revise failed triple arthrodeses with severe rocker-bottom deformity. Five cases were reviewed to determine if this osteotomy corrects the rocker-bottom deformity, improves function and provides satisfaction to the patient. American Orthopaedic Foot and Ankle Society (AOFAS) clinical ratings scores obtained before and after the procedure were compared to assess the functional outcome. The patients' satisfaction with their results of surgery was also determined. Three parameters of foot alignment were measured from preoperative and postoperative anteroposterior and lateral weightbearing radiographs to assess the correction of the rocker-bottom deformity and the effect of the osteotomy on valgus tilting of the talus was evaluated with weightbearing views of the ankle. All clinical and radiographic measures of outcome significantly improved at a mean follow-up of 18 months (range, 13-32 months). The mean clinical rating score increased from 33 +/- 14 points (range, 14-49 points) to 70 +/- 11 points (range, 62-87 points) after the surgery (p < or = .05). Every patient was satisfied with the result and would repeat the procedure under the same circumstances. All four measures of foot and ankle alignment demonstrated significant correction after surgery. The osteotomy effectively realigned the rocker-bottom deformity. The procedure normalized the angular relationships of the foot by correction of the abduction and dorsiflexion deformities of the midfoot and valgus deformity of the hindfoot. The reduction in pain, increased functional capacity, and ability to wear conventional shoes, achieved without any major complication, account for the improved clinical rating scores and high rate of the satisfaction observed with this procedure.

Effects of barefoot habituation in winter on thermal and hormonal responses in young children--a preliminary study.

This study investigated how socks-wearing habit or habitual barefoot in the cold winter affected skin temperatures of distal lower extremities, the urinary excretion of adrenaline, noradrenaline and cortsisol in young children. In Experiment I for preschool children, the measurements of foot and leg skin temperatures were conducted for 30 min in the classroom controlled at 23+/-2 degres C and 50+/-5%RH, and the excretion of urinary catecholamines and cortisol during nocturnal sleep were analyzed. In Experiment II for elementary school children, nocturnal secretion of urinary catecholamines and cortisol was analyzed. While leg skin temperature tended to be lower in barefoot group than in socks group during Experiment I, foot skin temperature was not significantly different between the two groups. Fall of leg skin temperature during 30 min measurement tended to be smaller in barefoot group than in socks group. Urine volume and urinary excretion of cortisol tended to be greater in barefoot group than in socks group for preschool children. Urinary noradrenaline was significantly greater and cortisol tended to be greater in barefoot group than in socks group for elementary school children. Considering that most of the findings shown above were in the proximity of the established level of statistical significance, it was provisionally concluded that young children with barefoot habituation might show more effective cold adaptation of metabolic type than those without the habituation do, by keeping their skin temperatures higher even in the cold and enhancing the metabolic rate.

Foot scores of cattle 2. Relationships among measurements of feet from slaughtered steers from eight sire groups

Abstract Objective linear measurements were taken at slaughter on the front and rear feet excised from 87 Angus-sired steers by known sires and dams. Generally, means for front foot traits were similar to those for rear feet, including a difference of only 2.0° in angle of front v. rear foot. The repeatability of objectively measured traits was high (>0.76). Correlations between measures on adjacent digits were high (0.54 – 0.88), as were most correlations between data from front and rear feet. Coefficients of variation for pre-slaughter liveweight, hot-carcass weight, hoof horn length, and angle (of hoof away from the vertical) ranged from 5.9 to 8.00%, for sole length (measured underneath the hoof) 4.8 to 5.8%, and for foot circumference 2.8%. Sire group effects were the only significant source of variation for the 14 foot traits. Principal component analysis of the variance-covariance matrix showed that 85, 7, and 3% of the variation was accounted for by the first three components, mainly describing slaughter liveweight, hoof horn lengths, and sole (i.e., underside) lengths respectively. Heavier cattle had larger hooves, with an angle indicating 'feet positioned closer to the vertical than for average~ eight animals. One sire group was of particular mterest because the herd owners thought the sire himself was unsuitable for use because of poor feet. Small but significant structural effects were found in his progeny group. His progeny were the most deviant for only one trait (length of sole on rear feet, as measured from below), and that was in a negative direction, which was favourable.

1658 TROPHIC LIMB CHANGES FOLLOWING EARLY UNILATERAL BRAIS INSULT

Trophic limb changes following early unilateral brain lesions have been noted clinically for years. No studies, however, have reported foot and hand length of children with CT scan verified lesions of known age of onset. Measurements of foot and hand length for 15 neurologically normal, 17 L brain lesioned, and 12 R brain lesioned young children were taken >2 yrs. post lesion onset. Results are as follows: When a >.2 cm cut-off level in foot asymmetry is established, 9 of the 12 R lesioned children, 11 of the 17 L lesioned children, and only 1 of the 15 normal children are identified (chi square= 12.98; p .2 cm difference is L handed. These findings suggest that asymmetric foot and hand development may provide a subtle biological marker for early CNS pathology among children who otherwise are neurologically asymptomatic and may signal pathological L handedness.

An instrument for the measurement of foot and ankle volume.

An instrument for the measurement of foot and ankle volume.

On a Statistical Treatment of Measurement of Foot

The authors write this report on a statistical treatment of measurement of foot from a viewpoint of its practical use. We measured feet and classified data after Japanese size of shoes, Mon (1 Mon=24.4mm) ; 9.0, 9.3, '9.5, 9.7, 10.0, 10.3, 10.5, 10.7, 11.0 Mon.Correlation : In each size ρ=0 between foot-length and breadth. In the whole numbers (female, N=495) ρ≠0.And we noticed foot-breadth was more correlative to foot-length than to footheight (measured from the floor to the heighest median point between Os naviculare and cuneiforme I).Comparison of mean value : In the adjoining sizes we notice the significant difference in the mean value of the foot-length, height and heel-breadth, and not in breadth. Coefficient of variationt of foot-breadth (=s√x) is very large in cornparison with the others, and this means that the metatarsophalangeal joint plays the important roll in walking.We, anthropologists, meet often with the problem of treatment of index. The mean value and the standard deviation in this index can be approximately calculated with ease from the values of Sx Sy, C, x and y.