Shriners Children's, Motion Analysis Center, Greenville, SC, USA.
Shriners Children's, Motion Analysis Center, Greenville, SC, USA.
Gait Posture. 2024 Sep;113:26-31. doi: 10.1016/j.gaitpost.2024.05.031. Epub 2024 May 30.
Multi-segment foot models have been used to quantify foot kinematics during walking. However, walking kinematics is not sufficient to assess hindfoot flexibility (available range of hindfoot varus-valgus motion). The modified Shriners Hospitals for Children - Greenville (mSHCG) foot model has been used to quantify hindfoot flexibility with Coleman block test (peak hindfoot valgus) and Root test (peak hindfoot varus). Sensitivity of mSHCG foot model to detect clinically relevant difference in hindfoot flexibility measures for planovalgus (PV) and cavovarus (CV) feet has not been demonstrated.
Can mSHCG foot model detect statistically significant difference in hindfoot flexibility measures between PV, CV and typically developing (TD) feet?
Hindfoot flexibility assessment was completed for 32 PV (37 feet), 27 CV (37 feet) and 20 TD (40 feet) individuals. Hindfoot position relative to tibia in coronal plane was measured in three postures: standing, heel raise and Coleman block test. Radiographic measures in standing position were also completed for PV and CV individuals and their correlation with hindfoot flexibility measures were evaluated.
Statistically significant (p<0.001) differences were observed between three groups (TD, PV, CV) in all three hindfoot flexibility measures- (i) Hindfoot varus in standing position (ii) Peak hindfoot varus in heel raise and (iii) Peak hindfoot valgus in Coleman block test. There was relatively stronger correlation (R=0.407-0.854) between three radiographic measures and hindfoot varus in standing position. Correlation between hindfoot range of motion towards valgus from standing to Coleman block test and the three radiographic measures was weaker (R=0.2329-0.3042).
Hindfoot flexibility assessment can detect statistically significant difference between PV, CV and TD feet and provides additional information about available dynamic range of motion of hindfoot in the coronal plane that cannot be predicted from radiographic measures. Therefore, hindfoot flexibility assessment may assist in treatment planning of foot deformities.
多节段足部模型已被用于量化步行时的足部运动学。然而，步行运动学不足以评估后足灵活性（后足内翻-外翻运动的可用范围）。改良的格林维尔 Shriners 儿童医院（mSHCG）足部模型已用于通过 Coleman 块试验（后足最大外翻）和 Root 试验（后足最大内翻）来量化后足灵活性。mSHCG 足部模型检测足内翻（PV）和足内翻（CV）与正常发育（TD）足后足灵活性测量的临床相关差异的敏感性尚未得到证明。
mSHCG 足部模型能否检测到 PV、CV 和 TD 足后足灵活性测量值的统计学显著差异？
对 32 例 PV（37 足）、27 例 CV（37 足）和 20 例 TD（40 足）个体进行后足灵活性评估。在冠状面测量跟骨相对于胫骨的后足位置，共测量三种姿势：站立位、提踵位和 Coleman 块试验位。还完成了 PV 和 CV 个体的站立位 X 线测量值，并评估了它们与后足灵活性测量值的相关性。
在所有三种后足灵活性测量值中，TD、PV 和 CV 三组之间存在统计学显著差异（p<0.001）：（i）站立位后足内翻；（ii）提踵时后足最大内翻；（iii）Coleman 块试验时后足最大外翻。三种 X 线测量值与站立位后足内翻之间的相关性较强（R=0.407-0.854）。从站立位到 Coleman 块试验，后足向外翻的运动范围与三种 X 线测量值的相关性较弱（R=0.2329-0.3042）。
后足灵活性评估可检测到 PV、CV 和 TD 足之间的统计学显著差异，并提供有关冠状面后足动态运动范围的额外信息，这些信息无法从 X 线测量值预测。因此，后足灵活性评估可能有助于足部畸形的治疗计划。
