The modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model provides clinically acceptable measurements of ankle and midfoot angles: A dual fluoroscopy study.
Koren E Roach, K Bo Foreman, Bruce A MacWilliams and 3 others
PMID 33626450WHAT IT FOUND
Skin-marker gait analysis closely matches bone-level dual fluoroscopy for ankle and midfoot angles in healthy adults.
Differences were mostly under 4 degrees, which is clinically acceptable. However, accuracy dropped as midfoot motion increased, and one forefoot marker shifted significantly during loading.
Key findings
01Skin-marker models produced ankle and midfoot angles that were clinically similar to dual fluoroscopy, with differences mostly under the 4-degree threshold.
02Larger coronal midfoot range of motion was significantly associated with larger differences between skin-marker and fluoroscopy angles.
03The fifth metatarsal skin marker showed significant positional differences compared to the underlying bone during foot loading and unloading.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (n=5) and consisted only of healthy young adults, so findings may not apply to patients with pathological gait or deformities. Only one trial per participant was analyzed. The analysis was restricted to the stance phase (foot-strike to push-off) due to fluoroscopy field-of-view limitations. The study evaluated only one specific multi-segment foot model (mSHCG). Skin-marker accuracy decreased as midfoot range of motion increased, indicating potential error in more dynamic or mobile feet.
Declared interests
The authors declared no conflicts of interest. The work was supported by the National Institutes of Health (NIH) and non-US government research support.
The easy way to misread this
Do not assume this accuracy applies to patients with foot pathology or high midfoot mobility. The study was small, involved only healthy adults, and showed that skin-marker errors increase significantly as coronal midfoot range of motion increases.