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The Subtalar Joint Axis Palpation Technique—Part 1

Validating a Clinical Mechanical Model

Ken K. Van Alsenoy Department of Podiatry, Artevelde University College, Ghent, Belgium.

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Joris De Schepper Department of Podiatry, Artevelde University College, Ghent, Belgium.
Department of Rehabilitation Sciences and Physical Therapy, Ghent University, Ghent, Belgium.

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Derek Santos Queen Margaret University, Edinburgh, School of Health Sciences, Musselburgh, Scotland.

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Evie E. Vereecke Department of Development and Regeneration, Katholieke Universiteit of Leuven, Kulak, Kortrijk, Belgium.

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Kristiaan D'Août Department of Biology, Antwerp University, Wilrijk, Belgium. Dr. D'Aout is now with the Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, England.

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Background

Locating the position of the subtalar joint axis can be a predictive clinical variable in biomechanical analysis and a valuable tool in the design of functional foot orthoses. Before testing Kirby's palpation technique to locate the subtalar joint axis in cadavers, it was important to develop and test the experimental methods in a mechanical model in which the exact location of the hinge joint can be controlled.

Methods

Four testers determined the hinge joint location and moved it through its range of motion, capturing the movement of the joint axis using a kinematic model. The joint axis location was determined and validated by comparing the actual hinge joint location on the mechanical model with the location determined by the palpation technique described by Kirby in 1987 and the location determined by the helical joint axis method using three-dimensional kinematic data.

Results

The overall angles result in mean slopes and intersections of 87° and 92 mm, 86° and 97 mm, 85° and 92 mm, and 88° and 91 mm for testers 1, 2, 3, and 4, respectively. Testers 1 and 3 were able to determine the location to 1° and 1 mm accuracy, tester 2 to 0° and 4 mm, and tester 4 to 2° and 2 mm compared with the kinematic data.

Conclusions

The technique of determining the points of no rotation as described by Kirby could be validated by using a three-dimensional kinematic model to determine the helical axis.

Corresponding author: Ken K. Van Alsenoy, MSc, Department of Podiatry, Artevelde University College, Voetweg 66, Ghent, 9000, Belgium. (E-mail: kenvanalsenoy@gmail.com)
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