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- Author or Editor: Nachiappan Chockalingam x
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Clinical Assessment of Ankle Joint Dorsiflexion
A Review of Measurement Techniques
Ankle dorsiflexion measurement is important for clinical and research use. With so much evidence on the unreliability of goniometric measurements, a systematic review was performed to investigate various alternative techniques for measuring ankle dorsiflexion in the nonneurologic patient. All of the major databases were queried electronically to identify studies that used any method of ankle dorsiflexion measurement in the nonneurologic subject. Keywords included ankle dorsiflexion NOT cerebral palsy NOT stroke, the latter to exclude neurologic conditions. In 755 studies that used some form of ankle joint dorsiflexion measurement, ten different techniques were identified that included various apparatuses designed specifically for this purpose. Reliability testing of these techniques involved test-retest trials with small student populations as subjects, which returned high intraclass correlation coefficient scores. However, their methodological quality would have benefitted from the use of an actual patient population and comparison with a reference standard. When validating ankle dorsiflexion measurement techniques, actual patient populations should be used, otherwise papers would score poorly on methodological quality assessment. Standardizing patient position, foot posture, amount of moment applied, and reference landmarks will ensure that various trial results can be compared directly. (J Am Podiatr Med Assoc 101(1): 59–69, 2011)
Posterior Tibial Tendon Dysfunction
A Review
Posterior tibial tendon dysfunction is a progressive deformity that can result in the development of a pathologic flatfoot deformity. Numerous publications have studied the effects of clinical interventions at specific stages of progression of posterior tibial tendon dysfunction, but there is still uncertainty regarding the clinical identification of the condition. It is clear that more information regarding the etiology, progression, and risk factors of posterior tibial tendon dysfunction is required. Clear evidence exists that suggests that the quality of life for patients with posterior tibial tendon dysfunction is significantly affected. Furthermore, evidence suggests that early conservative intervention can significantly improve quality of life regarding disability, function, and pain. This would suggest that significant cost burden reductions could be made by improving awareness of the condition, which would improve early diagnosis. Early conservative intervention may help reduce the number of patients requiring surgery. This review focuses on the etiologic factors, epidemiologic features, and pathogenesis of posterior tibial tendon dysfunction. It aims to analyze, discuss, and debate the current understanding of this condition using the available literature. In addition, there is a discussion of the evidence base surrounding disease characteristics associated with the different clinical stages of posterior tibial tendon dysfunction. (J Am Podiatr Med Assoc 101(2): 176–186, 2011)
The Effect of Heel Height on Gait and Posture
A Review of the Literature
This article explores relevant full-text literature to reveal the effects of heel height on gait and posture and the kinetics and kinematics of the foot, ankle, knee, hip, and spine. Furthermore, special attention will be given to the implications of increased heel height for clinicians treating locomotor disorders and provide information to aid clinical decision making. Full-text articles accessed from databases including AMED, ASSIA, Blackwell Synergy, BNI, Voyager, CINAHL, ScienceDirect, and Taylor Francis inform the review. (J Am Podiatr Med Assoc 99(6): 512–518, 2009)