Proficiency of foot care specialists to place the rearfoot at subtalar neutral

MR PierrynowskiSchool of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

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SB SmithSchool of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

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JH MlynarczykSchool of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

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The proficiency of clinicians to place a rearfoot at the subtalar neutral position is important for the treatment of patients with lower extremity dysfunctions, and especially for foot orthosis prescription, fabrication, and management. However, the ability of experienced foot care specialists to perform this task has not been statistically compared with an average capacity. In this study, eight experienced chiropodists and eight untrained physiotherapy students placed six rearfeet at the subtalar neutral position five times. Statistically, the foot care specialists were able to find the subtalar neutral position better than the students (mean 0.00 versus 0.99 degrees, SD 1.84 versus 2.97 degrees, range -5.27 degrees to 4.33 degrees versus -6.25 degrees to 9.27 degrees). This can be interpreted as stating that foot care specialists and untrained students place a rearfoot within +/- 1 degree of the subtalar neutral position 41.3% and 25.0% of the time, respectively. Corresponding values within +/- 2 degrees of the subtalar neutral position are 72.3 degrees and 47.6 degrees, respectively. Alternatively, it can be stated that experienced foot care specialists are within +/- 3.0 degrees of the subtalar neutral position 90% of the time. A corresponding value for the students is +/- 4.9 degrees. These results suggest that although experienced foot care specialists position a rearfoot at the subtalar neutral position better than untrained physiotherapy students, there is room for improvement.