What is it about?
This study investigated the measurement properties of using a hand-held ruler to quantify motion of the first metatarsal (ray) as part of a manual examination of the foot. The measurement was performed on 14 subjects by a surgeon and two physical therapists. The examiner imposed a manual force beneath the head of the first ray, and recorded movement on a ruler placed on the top of the foot. The measure had poor reliability and was not valid, mostly because of the subjectivity in the delivery of force and other challenges associated with measuring first ray motion with a manual examination.
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Why is it important?
Multiple sources have suggested ways to objectify the measure of first ray motion in practice. One approach was to quantify motion with a hand-held ruler. This study tested the technique. It was found to have questionable reliability and validity and therefore, should not be used in research or in clinical practice to quantify first ray motion.
Perspectives
Assessment of first ray mobility is advised when considering options for the treatment of individuals who suffer foot pain and dysfunction. Although widely used, manual examination of the first ray has been shown to have considerable error because the direction and the amount of force imposed cannot be standardized, and because joint motion is not easily quantified with clinical tools. This study found that augmenting the manual examination method with a hand-held ruler does not improve the measurement. Alternatives, such as measuring motion with a mechanical device or from series of radiographs, remain the preferred choices for quantifying first ray motion for research or in clinical practice settings.
Dr Ward M Glasoe
University of Minnesota Twin Cities
Read the Original
This page is a summary of: Criterion-Related Validity of a Clinical Measure of Dorsal First Ray Mobility, Journal of Orthopaedic and Sports Physical Therapy, September 2005, Journal of Orthopaedic & Sports Physical Therapy (JOSPT),
DOI: 10.2519/jospt.2005.35.9.589.
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