Skip to main content
Top
Published in: Journal of Foot and Ankle Research 1/2014

Open Access 01-12-2014 | Research

Intra-observer reliability for measuring first and second toe and metatarsal protrusion distance using palpation-based tests: a test-retest study

Authors: Carmen-Belén Martínez-Cepa, Juan-Carlos Zuil-Escobar, Raquel Chillón-Martínez, José-Jesús Jiménez-Rejano, Inmaculada-Concepción Palomo-Toucedo

Published in: Journal of Foot and Ankle Research | Issue 1/2014

Login to get access

Abstract

Background

Measurement of first and second metatarsal and toe protrusion is frequently used to explain foot problems using x-rays, osteological measurements or palpation-based tests. Length differences could be related to the appearance of problems in the foot. A test-retest design was conducted in order to establish the intra-rater reliability of three palpation-based tests.

Methods

202 feet of physical therapy students and teachers of the CEU San Pablo University of Madrid, 39 men and 62 women, were measured using three different tests. Data were analysed using SPSS version 15.0. Mean, SD and 95% CI were calculated for each variable. A normal distribution of quantitative data was assessed using the Kolmogorov-Smirnov test. The test-retest intra-rater reliability was assessed using an Intraclass Correlation Coefficient (ICC). The Standard Error Mean (SEM) and the Minimal Detectable Change (MDC) were also obtained.

Results

All the ICC values showed a high degree of reliability (Test 1 = 0.97, Test 2 = 0.86 and Test 3 = 0.88) as did the SEM (Test 1 = 0.07, Test 2 = 0.10 and Test 3 = 0.11) and the MDC (Test 1 = 0.21, Test 2 = 0.30 and Test 3 = 0.31).

Conclusions

Reliability of measuring first and second metatarsal and toe protrusion using the three palpation-based tests showed a high degree of reliability.
Appendix
Available only for authorised users
Literature
1.
go back to reference Davidson G, Pizzari T, Mayes S: The influence of second toe and metatarsal length on stress fractures at the base of the second metatarsal in classical dancers. Foot Ankle Int. 2007, 28: 1082-1086. 10.3113/FAI.2007.1082.CrossRefPubMed Davidson G, Pizzari T, Mayes S: The influence of second toe and metatarsal length on stress fractures at the base of the second metatarsal in classical dancers. Foot Ankle Int. 2007, 28: 1082-1086. 10.3113/FAI.2007.1082.CrossRefPubMed
2.
go back to reference Travell JG, Simons DG: Myofascial Pain and Dysfunction. The Trigger Point Manual; Vol. 2. The Lower Extremities. 1992, Williams &Wilkins, Baltimore Travell JG, Simons DG: Myofascial Pain and Dysfunction. The Trigger Point Manual; Vol. 2. The Lower Extremities. 1992, Williams &Wilkins, Baltimore
3.
go back to reference Ogilvie-Harris DJ, Carr MM, Fleming PJ: The foot in ballet dancers: the importance of second toe length. Foot Ankle Int. 1995, 16: 144-147. 10.1177/107110079501600307.CrossRefPubMed Ogilvie-Harris DJ, Carr MM, Fleming PJ: The foot in ballet dancers: the importance of second toe length. Foot Ankle Int. 1995, 16: 144-147. 10.1177/107110079501600307.CrossRefPubMed
4.
go back to reference Heden RI, Sorto LA: The bucle point and the metatarsal protrusion’s relationship to the hallux valgus. J Am Podiatry Assoc. 1981, 71: 200-208. 10.7547/87507315-71-4-200.CrossRefPubMed Heden RI, Sorto LA: The bucle point and the metatarsal protrusion’s relationship to the hallux valgus. J Am Podiatry Assoc. 1981, 71: 200-208. 10.7547/87507315-71-4-200.CrossRefPubMed
5.
go back to reference Oztekin HH, Boya H, Nalcakan M, Ozcan O: Second-toe length and forefoot disorders in ballet and folk dancers. J Am Podiatr Med Assoc. 2007, 97: 385-388. 10.7547/0970385.CrossRefPubMed Oztekin HH, Boya H, Nalcakan M, Ozcan O: Second-toe length and forefoot disorders in ballet and folk dancers. J Am Podiatr Med Assoc. 2007, 97: 385-388. 10.7547/0970385.CrossRefPubMed
6.
go back to reference Davitt JS, Kadel N, Sangeorzan BJ, Hansen ST, Holt SK, Donaldson-Fletcher E: An association between functional second metatarsal length and midfoot arthrosis. J Bone Joint Surg Am. 2005, 87: 795-800. 10.2106/JBJS.C.01238.CrossRefPubMed Davitt JS, Kadel N, Sangeorzan BJ, Hansen ST, Holt SK, Donaldson-Fletcher E: An association between functional second metatarsal length and midfoot arthrosis. J Bone Joint Surg Am. 2005, 87: 795-800. 10.2106/JBJS.C.01238.CrossRefPubMed
7.
go back to reference Domínguez G, Munuera PV, Lafuente G: Relative metatarsal protusion in the adult: a preliminary study. J Am Podiatr Med Assoc. 2006, 96: 238-244. 10.7547/0960238.CrossRefPubMed Domínguez G, Munuera PV, Lafuente G: Relative metatarsal protusion in the adult: a preliminary study. J Am Podiatr Med Assoc. 2006, 96: 238-244. 10.7547/0960238.CrossRefPubMed
8.
go back to reference Drez D, Young JC, Johnston RD, Parker WD: Metatarsal stress fractures. Am J Sports Med. 1980, 8: 123-125. 10.1177/036354658000800212.CrossRefPubMed Drez D, Young JC, Johnston RD, Parker WD: Metatarsal stress fractures. Am J Sports Med. 1980, 8: 123-125. 10.1177/036354658000800212.CrossRefPubMed
9.
go back to reference Hardy R, Clapham JC: Observations on hallux valgus. J Bone Joint Surg (Br). 1951, 33 B: 376-391. Hardy R, Clapham JC: Observations on hallux valgus. J Bone Joint Surg (Br). 1951, 33 B: 376-391.
10.
go back to reference Harris RI, Beath T: The short first metatarsal: its incidence and clinical significance. J Bone Joint Surg Am. 1949, 31 A: 553-565. Harris RI, Beath T: The short first metatarsal: its incidence and clinical significance. J Bone Joint Surg Am. 1949, 31 A: 553-565.
11.
go back to reference Morton DJ: Structural factors in static disorders of the foot. Am J Surg. 1930, 9: 315-326. 10.1016/S0002-9610(30)91100-2.CrossRef Morton DJ: Structural factors in static disorders of the foot. Am J Surg. 1930, 9: 315-326. 10.1016/S0002-9610(30)91100-2.CrossRef
12.
go back to reference Davidson G, Pizzari T, Mayes S: Reliability of measuring first and second metatarsal and toe length. Foot. 2007, 17: 32-37. 10.1016/j.foot.2006.10.003.CrossRef Davidson G, Pizzari T, Mayes S: Reliability of measuring first and second metatarsal and toe length. Foot. 2007, 17: 32-37. 10.1016/j.foot.2006.10.003.CrossRef
13.
go back to reference Spooner SK, Kilmartin TE, Merriman LM: The palpation technique for determination of metatarsal formula: a study of validity. Foot. 1994, 4: 198-200. 10.1016/0958-2592(94)90052-3.CrossRef Spooner SK, Kilmartin TE, Merriman LM: The palpation technique for determination of metatarsal formula: a study of validity. Foot. 1994, 4: 198-200. 10.1016/0958-2592(94)90052-3.CrossRef
14.
go back to reference Griffin NL, Richmond BG: Cross-sectional geometry of the human foot. Bone. 2005, 37: 253-260. 10.1016/j.bone.2005.04.019.CrossRefPubMed Griffin NL, Richmond BG: Cross-sectional geometry of the human foot. Bone. 2005, 37: 253-260. 10.1016/j.bone.2005.04.019.CrossRefPubMed
15.
go back to reference Mafart B: Hallux valgus in a historical french population: paleopathological study of 605 first metatarsal bones. Joint Bone Spine. 2007, 74: 166-170. 10.1016/j.jbspin.2006.03.011.CrossRefPubMed Mafart B: Hallux valgus in a historical french population: paleopathological study of 605 first metatarsal bones. Joint Bone Spine. 2007, 74: 166-170. 10.1016/j.jbspin.2006.03.011.CrossRefPubMed
16.
go back to reference Smith SL: Attribution of foot bones to sex and population groups. J Forensic Sci. 1997, 42: 186-195.PubMed Smith SL: Attribution of foot bones to sex and population groups. J Forensic Sci. 1997, 42: 186-195.PubMed
17.
go back to reference Monreal Redondo D: Biometría del esqueleto del primer radio del pie. Tesis doctoral. Universidad Alcalá de Henares, Departamento de Ciencias Morfológicas y Cirugía; 2004. Monreal Redondo D: Biometría del esqueleto del primer radio del pie. Tesis doctoral. Universidad Alcalá de Henares, Departamento de Ciencias Morfológicas y Cirugía; 2004.
18.
go back to reference Glasoe WM, Allen MK, Kepros T, Stonewall L, Ludewing PM: Dorsal first ray mobility in women athletes with a history of stress fractures of the second and third metatarsal. J Orthop Sports Phys Ther. 2002, 32: 560-567. 10.2519/jospt.2002.32.11.560.CrossRefPubMed Glasoe WM, Allen MK, Kepros T, Stonewall L, Ludewing PM: Dorsal first ray mobility in women athletes with a history of stress fractures of the second and third metatarsal. J Orthop Sports Phys Ther. 2002, 32: 560-567. 10.2519/jospt.2002.32.11.560.CrossRefPubMed
19.
go back to reference Martínez CB: Análisis de la Fiabilidad Intraobservador de la Clasificación del Pie mediante las Fórmulas Digitales y Metatarsales a través de un Método Palpatorio. 2008, Diploma de Estudios Avanzados, Universidad CEU-San Pablo de Madrid, Madrid Martínez CB: Análisis de la Fiabilidad Intraobservador de la Clasificación del Pie mediante las Fórmulas Digitales y Metatarsales a través de un Método Palpatorio. 2008, Diploma de Estudios Avanzados, Universidad CEU-San Pablo de Madrid, Madrid
20.
go back to reference Roukis TS, Jacobs PM, Dawson DM, Erdmann BB, Ringstrom JB: A prospective comparison of clinical, radiographic, and intraoperative features of hallux rigidus. J Foot Ankle Surg. 2002, 41: 158-165. 10.1016/S1067-2516(02)80065-5.CrossRefPubMed Roukis TS, Jacobs PM, Dawson DM, Erdmann BB, Ringstrom JB: A prospective comparison of clinical, radiographic, and intraoperative features of hallux rigidus. J Foot Ankle Surg. 2002, 41: 158-165. 10.1016/S1067-2516(02)80065-5.CrossRefPubMed
21.
go back to reference Oliveira VC, Furiati T, Sakamoto A, Ferreira P, Ferreira M, Maher C: Health locus of control questionnaire for patients with chronic low back pain: psychometric properties of the Brazilian–Portuguese version. Physiother Res Int. 2008, 13: 42-52. 10.1002/pri.391.CrossRefPubMed Oliveira VC, Furiati T, Sakamoto A, Ferreira P, Ferreira M, Maher C: Health locus of control questionnaire for patients with chronic low back pain: psychometric properties of the Brazilian–Portuguese version. Physiother Res Int. 2008, 13: 42-52. 10.1002/pri.391.CrossRefPubMed
22.
go back to reference Portney LG, Watkins MP: Foundation of Clinical Research: Applications to Practice. 2000, Prentice-Hall, Inc., New Jersey Portney LG, Watkins MP: Foundation of Clinical Research: Applications to Practice. 2000, Prentice-Hall, Inc., New Jersey
23.
go back to reference Mancuso JE, Abramov SP, Landsman MJ, Waldman M, Carioscia M: The zero-plus first metatarsal and its relation to bunion deformity. J Foot Ankle Surg. 2003, 42: 319-326. 10.1053/j.jfas.2003.09.001.CrossRefPubMed Mancuso JE, Abramov SP, Landsman MJ, Waldman M, Carioscia M: The zero-plus first metatarsal and its relation to bunion deformity. J Foot Ankle Surg. 2003, 42: 319-326. 10.1053/j.jfas.2003.09.001.CrossRefPubMed
24.
go back to reference Viladot A: Patología del antepié. 2001, Springer-Verlag Ibérica, Barcelona Viladot A: Patología del antepié. 2001, Springer-Verlag Ibérica, Barcelona
25.
go back to reference Hay SM, Harris NJ, Duckworth T: Freiberg’s disease present in adjacent metatarsals. Foot. 1995, 5: 95-97. 10.1016/0958-2592(95)90020-9.CrossRef Hay SM, Harris NJ, Duckworth T: Freiberg’s disease present in adjacent metatarsals. Foot. 1995, 5: 95-97. 10.1016/0958-2592(95)90020-9.CrossRef
26.
go back to reference Brockwell J, Yeung Y, Griffith JF: Stress fractures of the foot and ankle. Sports Med Arthrosc Rev. 2009, 17: 149-159. 10.1097/JSA.0b013e3181b12727.CrossRef Brockwell J, Yeung Y, Griffith JF: Stress fractures of the foot and ankle. Sports Med Arthrosc Rev. 2009, 17: 149-159. 10.1097/JSA.0b013e3181b12727.CrossRef
27.
go back to reference Sarimo J, Orava S, Alamen J: Operative treatment of stress fractures of the proximal second metatarsal. Scand J Med Sci Sports. 2007, 17: 383-386. 10.1111/j.1600-0838.2006.00532.x.CrossRefPubMed Sarimo J, Orava S, Alamen J: Operative treatment of stress fractures of the proximal second metatarsal. Scand J Med Sci Sports. 2007, 17: 383-386. 10.1111/j.1600-0838.2006.00532.x.CrossRefPubMed
28.
go back to reference Martínez CB, Alegre M: Influencia del Pie de Morton en la Activación de Puntos Gatillo Miofasciales (PGM) en Miembros Inferiores de Maratonianos. 2005, Comunicación Oral. Libro de Ponencias de las X Jornadas Nacionales de Fisioterapia en el Deporte, Logroño Martínez CB, Alegre M: Influencia del Pie de Morton en la Activación de Puntos Gatillo Miofasciales (PGM) en Miembros Inferiores de Maratonianos. 2005, Comunicación Oral. Libro de Ponencias de las X Jornadas Nacionales de Fisioterapia en el Deporte, Logroño
29.
go back to reference Martínez CB, Alegre M, Rodríguez AL, Zuil JC: Prevalencia de Activación de Puntos Gatillo Miofasciales (PGM) en Miembros Inferiores en Maratonianos. 2005, Comunicación Cartel. Libro de Ponencias de las X Jornadas Nacionales de Fisioterapia en el Deporte, Logroño Martínez CB, Alegre M, Rodríguez AL, Zuil JC: Prevalencia de Activación de Puntos Gatillo Miofasciales (PGM) en Miembros Inferiores en Maratonianos. 2005, Comunicación Cartel. Libro de Ponencias de las X Jornadas Nacionales de Fisioterapia en el Deporte, Logroño
30.
go back to reference Munuera PV, Domínguez G, Castillo JM: Radiographic study of the size of the first metatarso-digital segment in feet with incipient hallux limitus. J Am Podiatr Med Assoc. 2007, 97: 460-468. 10.7547/0970460.CrossRefPubMed Munuera PV, Domínguez G, Castillo JM: Radiographic study of the size of the first metatarso-digital segment in feet with incipient hallux limitus. J Am Podiatr Med Assoc. 2007, 97: 460-468. 10.7547/0970460.CrossRefPubMed
31.
go back to reference Bryant A, Tinley P, Singer K: A comparison of radiographic measurements in normal, hallux valgus and hallux limitus feet. J Foot Ankle Surg. 2000, 39: 39-43. 10.1016/S1067-2516(00)80062-9.CrossRefPubMed Bryant A, Tinley P, Singer K: A comparison of radiographic measurements in normal, hallux valgus and hallux limitus feet. J Foot Ankle Surg. 2000, 39: 39-43. 10.1016/S1067-2516(00)80062-9.CrossRefPubMed
32.
go back to reference Menz HB: Analysis of paired data in physical therapy research: time to stop double-dipping?. J Orthop Sports Phys Ther. 2005, 35: 477-478. 10.2519/jospt.2005.0108.CrossRefPubMed Menz HB: Analysis of paired data in physical therapy research: time to stop double-dipping?. J Orthop Sports Phys Ther. 2005, 35: 477-478. 10.2519/jospt.2005.0108.CrossRefPubMed
Metadata
Title
Intra-observer reliability for measuring first and second toe and metatarsal protrusion distance using palpation-based tests: a test-retest study
Authors
Carmen-Belén Martínez-Cepa
Juan-Carlos Zuil-Escobar
Raquel Chillón-Martínez
José-Jesús Jiménez-Rejano
Inmaculada-Concepción Palomo-Toucedo
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2014
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-014-0037-6

Other articles of this Issue 1/2014

Journal of Foot and Ankle Research 1/2014 Go to the issue