• The Journal of Korean Physical Therapy
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• v.23 no.4
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• pp.45-51
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• 2011

Purpose: To determine the correct measurement methods of the ankle joint complex range of motion for measuring the neutral position and evaluate the rater reliability. In addition, the impact of training on the rater reliability was also assessed. Methods: The subjects were eleven healthy women, who were evaluated by two physical therapists and one physical therapist recorded the results of the study. Standard goniometer was used as the measurement tool. The ankle and subtalar joint neutral position and the active range of motion of the ankle and subtalar joint were measured. Intra-rater reliability and inter-rater reliability measures were analyzed with intraclass correlation coefficients. Results: Intra-rater reliability and inter-rater reliability ranged from high to medium for the neutral position of the ankle joint complex. Intra-rater reliability for dorsiflexion and plantarflexion measurements was medium, while the inter-rater reliability was high. The range of motion of the subtalar joint was measured, and the intra-rater reliability and inter-rater reliability were low and medium, respectively Also, the intra-rater reliability was increased with formal training of the measurement techniques. Intra-rater reliability was reduced in case the raters had not undertaken the training. Conclusion: In summary, the results obtained with the measurement tools and joint measurement of position, indicate the consistency of repeated measurements made by the same observers. Under the same circumstances along with repetition of the same measurement technique during training caused an increase in the rater reliability of formally trained raters.

• Physical Therapy Korea
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• v.26 no.3
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• pp.23-31
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• 2019

Background: Measurement of passive ankle dorsiflexion range of motion (ADROM) is often part of a physical therapy assessment. Objects: The objective of this study was to identify the effects of subtalar joint neutral position (SJNP) on passive ADROM according to knee position in young adults. Methods: We recruited 14 young adult participants for this study. Two examiners used a universal goniometer to measure passive ADROM with and without SJNP. Dorsiflexion force was applied to the forefoot until maximum resistance was reached in two knee positions (extension and $90^{\circ}$ flexion) in the prone position. Subtalar joint position was also recorded at maximum ADROM. Passive ADROM was measured three times at different knee and subtalar joint positions, in random order. Two-way repeated-measures analysis of variance was used to compare the effects of subtalar joint and knee position on passive ADROM. Results: Passive ADROM was significantly lower with than without SJNP during both knee extension (mean difference: $7.4^{\circ}$) and $90^{\circ}$ flexion (mean difference: $16.9^{\circ}$) (p<.01). Passive ADROM was significantly higher during $90^{\circ}$ knee flexion than during knee extension both with (mean difference: $5.8^{\circ}$) and without SJNP (mean difference: $15.2^{\circ}$) (p<.01). The valgus position of the subtalar joint was significantly lower with than without SJNP during both knee extension (mean difference: $3.3^{\circ}$) and $90^{\circ}$ flexion (mean difference: $4.3^{\circ}$) (p<.01). Conclusion: Our results indicate that the gastrocnemius may limit ankle dorsiflexion more than the soleus does. Greater dorsiflexion at the subtalar and midtarsal joints was observed during passive ADROM measurement without than that with SJNP; therefore, SJNP should be maintained for accurate measurement of ADROM.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.69-74
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• 2018

PURPOSE: Stroke patients may develop an over-pronated foot, resulting in a lower medial longitudinal arch. This can lead to a structural change of the foot due to deformation of the musculoskeletal system. The purpose of this study was to examine the effects of modified low-dye taping on stroke patients with an excessively pronated foot. The effect of the taping on the foot after light daily activity was also examined. METHODS: The subjects consisted of 21 stroke patients with an excessively pronated foot, as measured by the navicular drop test. First, their navicular heights were measured at a relaxed standing position (measure 1) and while standing in the subtalar neutral position (measure 2). Modified low-dye taping was applied to each subject's affected foot and the navicular height was then measured for the standing posture (measure 3). Finally, each subject walked around for 10 minutes and the navicular height was measured again (measure 4). RESULTS: Statistical analyses showed that the navicular height value at the relaxed standing position (measure 1) was significantly lower than for the other 3 measurements. That is, the modified low-dye taping was effective in maintaining a subtalar neutral position, even after a 10-minute walk, for stroke patients with an excessively pronated foot. CONCLUSION: The results suggest that modified low-dye taping applied to stroke patients with an excessively pronated foot could be an effective way to place the subtalar joint in a neutral position, and that its effect can be sustained for light daily activities.

• Physical Therapy Korea
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• v.13 no.4
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• pp.64-70
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• 2006

The purpose of this study was to determine whether a relationship existed between foot type and the location of plantar callus in healthy subjects. Twenty-five healthy subjects with plantar callus were recruited for this study. Foot deformities were classified according to the operational definitions as 1) a compensated forefoot varus, 2) an uncompensated forefoot varus or forefoot valgus, or 3) a compensated rearfoot varus. The location of plantar callus was divided into two regions. Fourteen of the 19 feet with compensated forefoot varus and six of the 9 feet showed plantar callus at the second, third or fourth metatarsal head. Five of the 6 feet with uncompensated forefoot varus and twenty of the 16 feet with forefoot valgus showed plantar callus at the first or fifth metatarsal head. A significant relationship was found between foot type and location of callus (p<.01). The results support the hypothesis that certain foot types are associated with characteristic patterns of pressure distribution and callus formation. We believe diabetic patients with insensitive feet and with the types of foot deformity should be fit with foot orthoses and footwears that accommodate their respective deformity in a position as near to the subtalar joint as possible with the goal of preventing plantar ulceration.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1025-1030
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• 2016

The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.