A novel method of measuring passive quasi‐stiffness in the first metatarsophalangeal joint

Wiley - 2016
Marabelle Li-Wen Heng1,2, Yong Kang Chua1, Hong Kiat Pek1, Priathashini Krishnasamy3, Pui Wah Kong1
1Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
2Podiatry Department, Singapore General Hospital, Diabetes & Metabolism Centre, Singapore, Singapore
3Sports Medicine and Surgery Clinic, Tan Tock Seng Hospital, Medical Centre 2, Singapore, Singapore

Tóm tắt

AbstractBackgroundFirst metatarsophalangeal joint (MTPJ) mobility is commonly assessed by its angular displacement (joint angle) or subjectively rated as ‘hypermobile’, ‘normal’ or ‘stiff’ by a clinician. Neither of these methods is ideal because displacement alone does not take into account the force required to displace the joint and subjective evaluation is not always reliable. This study presented a novel method to determine the passive quasi‐stiffness of the first MTPJ. The reliability of the proposed method was also assessed. The first MTPJ passive quasi‐stiffness of 13 healthy subjects were measured at two occasions, 7 days apart, by two testers (experienced and inexperienced). A tactile pressure sensing system was used to measure the force applied to dorsiflex the first toe by the testers. The torque (in Nmm) about the first MTPJ was calculated as the applied force (in N) multiplied by a moment arm (in mm), where moment arm was the length of the first proximal phalanx. A video camera recorded the motion of the first MTPJ, simultaneously with force measurements, to determine the joint angular displacement (in degrees) using the Dartfish software. The quasi‐stiffness (in Nmm/degrees) was calculated as the slope of a graph where torque was plotted against first MTPJ angular displacement. Descriptive statistics of the first MTPJ quasi‐stiffness were calculated. Intra‐rater and inter‐rater reliability were assessed using Bland and Altman plot, intraclass correlation coefficients (ICC), and standard error of measurement (SEM).ResultsFirst MTPJ quasi‐stiffness of the subjects ranged widely from 0.66 to 53.4 Nmm/degrees. Intra‐rater reliability for experienced tester was moderate (Session 1: 14.9 ± 14.6 Nmm/degrees, Session 2: 14.2 ± 8.5 Nmm/degrees, ICC = .568, SEM = 7.71 Nmm/degrees). Inter‐rater reliability between experienced (12.6 ± 8.4 Nmm/degrees) and non‐experienced (19.9 ± 9.2 Nmm/degrees) testers was poor (ICC = ‐.447, SEM = 11.29 Nmm/degrees).ConclusionsFirst MTPJ passive quasi‐stiffness can be quantified from torque and angular displacement measurements using simple equipment in a clinical setting. The tester's experience affected the consistency in joint quasi‐stiffness measurements.

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Tài liệu tham khảo

10.1002/jor.20700

Mann RA, 1979, The function of the toes in walking, jogging and running, Clin Orthop Relat Res, 142, 24

10.1302/0301-620X.36B3.450

10.7547/87507315‐78‐9‐439

10.1093/ptj/79.9.854

10.1177/107110079401500103

Morton DJ, 1928, Hypermobility of the first metatarsal bone: the interlinking factor between metatarsalgia and longitudinal arch strains, J Bone Joint Surg, 10, 187

10.2337/diacare.23.5.606

10.3113/FAI.2008.0903

Magee DJ, 2014, Orthopedic physical assessment

Norkin CC, 2009, Measurement of joint motion: a guide to goniometry

10.1177/107110070202300310

10.7547/1020290

10.2106/00004623-199903000-00009

10.7547/87507315‐85‐4‐198

10.2106/00004623-198668030-00012

10.1016/S0894‐1130(12)80315‐2

10.1016/0167‐9457(93)90010‐M

10.1109/TBME.2012.2230261

10.1177/107110070402500807

10.1177/107110070002100310

10.1177/107110070402500809

10.1053/j.oto.2009.07.001

10.7547/87507315‐91‐2‐74

10.7547/87507315‐93‐2‐97

10.7547/87507315‐79‐7‐330

10.1067/mmt.2002.121415

10.1136/bmj.328.7441.702

10.1080/16506073.2010.520731

10.1093/ptj/80.4.352

Brink SJ, 1987, Limited joint mobility as a risk factor for diabetes complications, Clin Diabetes, 5, 121

10.1111/j.0954‐6820.1957.tb15511.x

Kelikian H, 1965, Hallux valgus, allied deformities of the forefoot and metatarsalgia

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