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用于三维足部功能评估的最小标记集:动态条件下测量舟骨下降和偏移

A minimal markerset for three-dimensional foot function assessment: measuring navicular drop and drift under dynamic conditions.

作者信息

Eichelberger Patric, Blasimann Angela, Lutz Nicole, Krause Fabian, Baur Heiner

机构信息

1Bern University of Applied Sciences, Department of Health Professions, Discipline of Physiotherapy, Murtenstrasse 10, Bern, 3008 Switzerland.

2Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.

出版信息

J Foot Ankle Res. 2018 Apr 18;11:15. doi: 10.1186/s13047-018-0257-2. eCollection 2018.

Abstract

BACKGROUND

The 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 () and medial navicular drift () 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.

METHODS

The minimal markerset uses markers at the lateral and medial caput of the 1 and 5 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.

RESULTS

Intra- and interday repeatability were 1.1 mm ( 0.97) and 2.3 mm ( 0.87) for dynamic navicular drop and 1.5 mm ( 0.96) and 5.3 mm ( 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.

CONCLUSIONS

Interday 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.

摘要

背景

通过后足的替代测量方法(如外翻偏移)来预测主要发生在中足的足部旋前的有效性有限。从垂直舟骨下降()和内侧舟骨漂移()方面来看,动态舟骨活动度可被视为代表整体足部功能的有意义的临床指标。本研究旨在开发一种测量这两个参数的简易方法,并检查其在步行过程中的日内和日间可靠性。

方法

最小标记集分别在第1和第5跖骨的外侧和内侧头部、跟骨背侧以及舟骨结节处使用标记。采用单检查者重复测试研究设计,对21名健康个体进行三维运动捕捉,以评估动态舟骨下降和漂移。

结果

动态舟骨下降的日内和日间重复性分别为1.1毫米(标准差0.97)和2.3毫米(标准差0.87),动态舟骨漂移的日内和日间重复性分别为1.5毫米(标准差0.96)和5.3毫米(标准差0.46)。动态舟骨下降的仪器误差估计为0.25毫米,动态舟骨漂移的仪器误差估计为0.86毫米。

结论

日间可靠性通常比日内可靠性差,主要原因是运动模式的日常变化,动态舟骨下降的仪器误差贡献低于23%,但动态舟骨漂移的仪器误差贡献达到57%。最小标记集允许将已知的舟骨下降和漂移概念从准静态临床测试条件简单地转移到功能任务中,建议将评估与足部的功能行为更紧密地联系起来。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54bb/5907216/b6673670ea8f/13047_2018_257_Fig1_HTML.jpg

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