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Reliability and Validity of Clinically Assessing First-Ray Mobility of the Foot

Mark W. Cornwall Gait Research Laboratory, Department of Physical Therapy, Northern Arizona University, Flagstaff.

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William D. Fishco Private practice, Phoenix, AZ; The Podiatry Institute, Tucker, GA.

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Thomas G. McPoil Gait Research Laboratory, Department of Physical Therapy, Northern Arizona University, Flagstaff.

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Camilla Rae Lane Gait Research Laboratory, Department of Physical Therapy, Northern Arizona University, Flagstaff.

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Deborah O'Donnell Gait Research Laboratory, Department of Physical Therapy, Northern Arizona University, Flagstaff.

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Lea Hunt Gait Research Laboratory, Department of Physical Therapy, Northern Arizona University, Flagstaff.

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The objective of the present study was to determine the amount of agreement among three clinicians in the clinical assessment of dorsal mobility of the foot’s first ray and the agreement between their assessments and that of a mechanical device designed to quantify first-ray mobility. Sixty feet from 30 individuals evaluated clinically by three health-care professionals were classified as having a hypomobile, normal, or hypermobile first ray. The amount of first-ray dorsal mobility of each participant’s foot was then measured using a device specifically constructed for that purpose. The results of this study show generally poor agreement among the three clinicians on whether a foot should be classified as having hypomobility, hypermobility, or normal mobility of the first ray. The amount of agreement with the quantitative device was poor for two of the clinicians and moderate for the third clinician. (J Am Podiatr Med Assoc 94(5): 470–476, 2004)

Corresponding author: Mark W. Cornwall, PhD, PT, CPed, Department of Physical Therapy, Northern Arizona University, PO Box 15105, Flagstaff, AZ 86011.