First Ray Dorsal Monility in Relation to Hallux Vlagus Deformity and First Intermetatarsal Angle

Glasoe, Ward M.; Allen, Mary K.; Saltzman, Charles L.

doi:10.1177/107110070102200203

Cited by 96 publications

(69 citation statements)

References 24 publications

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“…Measurements of dorsal mobility in clinical populations typically range from 4 to 8 mm. 3,4,5 Measures recorded with the device were reliable, with an ICC equal to 0.98 and a SEM equal to 0.15 mm. An ICC gives comparison of 2 or more repeat measures.…”

Section: Discussionmentioning

confidence: 90%

“…2 The SEM was computed as the square root of within-subjects mean-square error from a 1-way analysis of variance (ANOVA). 2 Intrarater reliability (ICC 3,10 ) for the ruler measurements of each examiner and for the device (ICC 3,1 ) were calculated. Interrater reliability (ICC 2,10 ) for the ruler measurement was calculated using data from the first measurement session.…”

Section: Discussionmentioning

confidence: 99%

“…12 A single examiner measured first ray dorsal mobility with the device (Figure 2). [3][4][5][6][7][8] The examiner (W.M.G.) operating the device was blinded from the results made with the rulers.…”

Section: Methodsmentioning

confidence: 99%

“…The device and protocol for testing are described elsewhere. [3][4][5][6][7][8] Measurements made with the device have been found to be reliable (ICCՆ 0.92; SEM Յ 0.35 mm), [3][4][5][6][7] and valid (ICC = 0.97), as judged by concurrent movement of the first ray as assessed with radiographs. 8 The device imposes a dorsiflexion force from beneath the first metatarsal head while measuring dorsal mobility of the first ray.…”

Section: Equipmentmentioning

confidence: 99%

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Criterion-Related Validity of a Clinical Measure of Dorsal First Ray Mobility

Glasoe¹,

Getsoian²,

Myers³

et al. 2005

J Orthop Sports Phys Ther

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Study Design: Test-retest methodological design using a sample of convenience. Objective: To determine the criterion-related validity and the reliability of measuring first ray mobility with a ruler. Background: Studies have questioned the accuracy of assessing first ray mobility by manual examination. Use of a ruler and adherence to strict guidelines in positioning of the patient may improve the measure. This study investigates the validity, and the intrarater and interrater reliability of measuring dorsal first ray mobility with a ruler while following recent recommendations to standardize the position of measurement. A valid and reliable mechanical device designed to measure first ray mobility was used as the validation criterion of measurement. Methods: Three clinicians performed ruler measurement of dorsal mobility on 14 subjects. A separate examiner measured dorsal mobility with the mechanical device. Intraclass correlation coefficients (ICCs) and standard error of measurements (SEMs) were computed to quantify the intrarater reliability of both testing procedures and the interrater reliability of the ruler measurement. ICCs of agreement were also computed to determine the concurrent validity of the ruler measurement for each clinician. Results: Mechanical device intrarater reliability ICC was 0.98 (SEM = 0.15 mm). Ruler intrarater ICCs were equal or less than -0.06 (SEMs = 1.1 mm); ruler interrater ICC was 0.05 (SEM = 1.2 mm). The ICCs of agreement between the mechanical device and ruler method ranged from -0.44 to 0.06. Minnesota, Mayo Mail Code 388, 420 Delaware St, Minneapolis, agreement between clinicianassessed ordinal-level hypomobile, normal, or hypermobile estimates of the first ray sagittal plane motion as compared to dorsal mobility measured by a mechanical device. Conclusion

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Equipmentmentioning

confidence: 99%

See 2 more Smart Citations

Criterion-Related Validity of a Clinical Measure of Dorsal First Ray Mobility

Glasoe¹,

Getsoian²,

Myers³

et al. 2005

J Orthop Sports Phys Ther

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“…32,33,44 Instability is described clinically as excessive dorsal excursion of the first metatarsal with a soft end point of motion. 33,34 Although the existence of the unstable first ray is well accepted, 15,18,25,32,34 the condition remains objectively undefined. Dudley Morton 33 first proposed the unstable first ray as a source of second metatarsal injury.…”

mentioning

confidence: 99%

Dorsal First Ray Mobility in Women Athletes With a History of Stress Fracture of the Second or Third Metatarsal

Glasoe¹,

Allen²,

Kepros³

et al. 2002

J Orthop Sports Phys Ther

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Study Design: Retrospective case-control study. Objective: To examine the amount of dorsal first ray mobility in subjects having a history of stress fracture of the second or third metatarsal as compared to control subjects, and to test the influence of navicular drop, length of the first ray, and generalized joint laxity on the measure of dorsal mobility. Background: Instability of the first ray may cause the lesser metatarsals to carry greater weight and contribute to the incidence of metatarsal stress fracture. Stability of the first ray is believed to be compromised when subtalar joint pronation continues into late stance, the first metatarsal is short, or an individual has generalized joint laxity. To date, no research has assessed the relationship of these etiological factors to the measure of first ray mobility. Methods and Measures: Fifteen women athletes having a history of a second or third metatarsal stress fracture were matched by age, body mass, and sport activity to women athletes without fracture. Dorsal first ray mobility was quantified by a device using a standard load of 55 N. Change in vertical height of the navicular during stance was the measure of foot pronation. Relative length of the first ray navicular segment compared to the length of the second ray navicular segment was measured by caliper. Generalized joint laxity was evaluated using the Beighton 9-point scale. Within-day repeated measures assessed reliability. Differences between groups were determined by independent t test. Multiple polynomial regression analysis assessed the relationship between dorsal mobility and navicular drop, length of the first ray, and joint laxity. Results: Interrater reliability coefficients ranged from 0.36 for metatarsal length to 0.71 for navicular drop. The intrarater reliability coefficient for dorsal first ray mobility was 0.93. Dorsal first ray mobility was not significantly different between the 2 groups. With regression analysis, the Beighton score was the only variable retained as a significant predictor of dorsal mobility (R 2 = 0.24). Conclusion: Results do not support the theory that describes the unstable first ray as a common cause of metatarsal stress fracture. In addition, this investigation found generalized joint laxity to be a significant predictor of dorsal first ray mobility.

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First Ray Kinematics in Women With Rheumatoid Arthritis and Bunion Deformity: A Gait Simulation Imaging Study

Glasoe

Jensen

Kampa

et al. 2014

Arthritis Care & Research

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Objective. The first ray plays a role in the development of bunion foot deformity, but for unknown reasons. This prospective, cross-sectional study investigated first ray kinematics in women with rheumatoid arthritis (RA) and bunion. Methods. Nine participants having RA-bunion were analyzed in comparison to a control group (n ‫؍‬ 10). Data were acquired using a magnetic resonance scanner. Conditions were standardized to simulate gait midstance, heel off, and terminal stance. Foot posture (hallux angle, intermetatarsal angle, arch angle, and calcaneus angle) and relative first ray position angles/helical axis parameters registered across gait conditions were measured. An analysis of variance model compared data between groups and across conditions, and correlation assessed the relationship between selected variables. Results. Eversion of the calcaneus averaged 9°, and adduction of the first ray was increased (F ‫؍‬ 6.29, P ‫؍‬ 0.02) by >4.6°a cross conditions in the RA-bunion group. There was an interaction (F ‫؍‬ 7.73, P ‫؍‬ 0.01) for the first ray axis. Followup comparisons identified increased inclination of the first ray axis over middle stance compared to late stance in the group with RA and bunion. There was moderate correlation (r ‫؍‬ ؊0.42) between the calcaneus angle of eversion and inclination of the first ray axis. Conclusion. Optimal treatment for bunion has not been defined. This research identified calcaneus eversion and first ray adduction, as well as inclination of the first ray axis as risk factors of bunion. This result may inform the evaluation and treatment of bunion in women with RA.

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First Ray Dorsal Monility in Relation to Hallux Vlagus Deformity and First Intermetatarsal Angle

Cited by 96 publications

References 24 publications

Criterion-Related Validity of a Clinical Measure of Dorsal First Ray Mobility

Criterion-Related Validity of a Clinical Measure of Dorsal First Ray Mobility

Dorsal First Ray Mobility in Women Athletes With a History of Stress Fracture of the Second or Third Metatarsal

First Ray Kinematics in Women With Rheumatoid Arthritis and Bunion Deformity: A Gait Simulation Imaging Study

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