Reliability Study of Diagnostic Tests for Functional Hallux Limitus

Abstract

Background: Functional hallux limitus (FHL) refers to dorsiflexion hallux mobility limitation when the first metatarsal head is under loading conditions but not in the unloaded state. The goal of the study was to evaluate 3 common manual tests (Buell, Dananberg, and Jack tests) for assessing first metatarsophalangeal joint (MPJ) mobility and determining the normal values needed to detect FHL, and clarify the signs and symptoms associated with this pathology. Methods: Forty-four subjects were included in this reliability study. Subjects were divided into healthy control (non-FHL) and FHL groups according to the Buell first MPJ limitation values in addition to signs and symptoms derived from the literature. In both groups, we measured the mobility in the Buell, Dananberg, and Jack tests using a goniometer; their intraclass correlation coefficients (ICCs), sensitivities, and specificity indexes were also calculated. Results: All techniques showed high reliability across measurement trials with ICCs ranging from 0.928 to 0.999. The optimal mobility grades for predicting FHL were 68.6 ± 3.7 degrees, 21 ± 5.9 degrees, and 25.5 ± 6.5 degrees (mean±SD) ( P < .05) for the Buell, Dananberg, and Jack tests, respectively. Conclusion: Normal and limited mobility values were established for assessing FHL using each technique. The sensitivity and specificity data were perfect for the Dananberg and Jack tests, thus identifying these tests as specific and valid tools for use in FHL diagnosis. Pinch callus was the sign most associated with FHL. Level of Evidence: Level II, comparative series.

Effects of Novel Inverted Rocker Orthoses for First Metatarsophalangeal Joint on Gastrocnemius Muscle Electromyographic Activity during Running: A Cross-Sectional Pilot Study

“…The following inclusion criteria were used to select the participants: (1) healthy participants, between 18 and 30 years old; (2) recreational runners with 3-4 h of training per week with more than 1 year of experience; (3) neutral foot posture index (FPI) with values between 0 and +5 points according to a validity tool [28]; and (4) no injuries or pain at the time of the test. The exclusion criteria were as follows: (1) any lower limb injury during the last 6 months; (2) less movement in either foot joint than what is required to perform the optimal biomechanics according to normal values [29,30]; or (3) under the influence of any drugs effects at the time of the measurements. Body mass index (BMI) was taken into account to select a homogeneous sample, using Quetelet's equation as follows: BMI = weight (kg)/height (m 2 ) [31].…”

Medially positioned plate in first metatarsophalangeal joint arthrodesis

“…Considerably greater maximal load and lower stress values may allow immediate weight-bearing or reduce the non-weight bearing period in MTP1 joint arthrodesis with the medial plate. However, further research is required in this area, which considers, for example, the effect of repetitive loading and statistical analysis of the data [ 34 ].…”

IMU-Based Effects Assessment of the Use of Foot Orthoses in the Stance Phase during Running and Asymmetry between Extremities

“…These results should be considered when talking about runners with functional hallux limitus as the FOs would further reduce the dorsiflexion of the first metatarsal. The less this movement, the more the foot is forced to take off in adduction [ 56 ].…”