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PubMed1991

[Three-dimensional CT study of the carpus under pronation-supination constraints].

By studying 3D imaging of the wrist under pronation-supination strain, we found that the simple comparison of a series of two corresponding cuts may provide a great deal of useful information on how the carpus transmits the longitudinal torque from the forearm to the hand. A special wooden trestle was made to fix the subject in the CT scanner in a permanent effort of pronation or supination. In the first group of scans, this effort was said to be "free" because the hand was simply maintained in a fixed window without any muscular contraction, except pronation or supination muscles. In the second group of scans, this effort was said to be "constrained" because the hand gripped a fixed bar with contraction of the flexor muscles. The thickness of the cuts was 1.2 millimeters and they were separated by 1.5 millimeters. Four levels were specially studied: the lower radio-ulnar joint (LRUJ), the proximal row of the carpus, the distal one and the metacarpal bases. Many elementary movements occur in the carpus in constrained supination: the triquetrum "supinates" (7 degrees), the scaphoid flattens and "pronates" (2 degrees) around the capitum the ridges of the carpal anterior concavity approximate (3 mm). In constrained pronation, the anterior concavity of the carpus flattens emphasizing the role of the anterior retinaculum. The LRUJ is very unstable: in free pronation, the ulnar head moves dorsally, firmly pressing the posterior part of the sigmoid notch, responsible for fracture of a postero-medial fragment in Colles fracture. The quadratus pronatus is a very important muscle to coapt this joint. We propose the "screwing (or unscrewing) test" in the diagnosis of arthrosis or instability of the LRUJ. We define the notion of "rotational shift" to appreciate the quality of the pronation/supination torque transmission. In constrained pronation/supination, this rotational shift is 5 degrees in the radio-carpal joint. This is very important to appreciate the quality of the wrist prosthesis. In free pronation/supination, the rotational shift is 45 degrees between radius and metacarpal bases. In constrained pronation/supination, it becomes 10 degrees. The wrist ligaments are unable to resist the wrist rotational shift and favor the torque transmission. The tendinous caging of the wrist is the main factor for maintaining rigidity of the carpus and transmitting the torque as muscles are contracted. The wrist can be compared with a fluid drive clutch, whose pedal is muscular contraction.

Biomechanical Phenomena↗
PubMed2006

Randomized comparison of pain perception during radial head subluxation reduction using supination-flexion or forced pronation.

OBJECTIVE: To determine if a difference exists in perceived pain between the forced pronation and supination-flexion methods of radial head subluxation (RHS) reduction. DESIGN AND METHODS: We developed a prospective randomized trial of children aged 6 months to 7 years who presented to the emergency department (ED) at Miami Children's Hospital with an immobile arm and physical findings suggestive of RHS. Children were randomized into 2 groups for RHS reduction: forced pronation and supination-flexion. Parents, physicians, and nurses were given a standard visual analog pain scale for pain assessment before, during, and at 1 minute after successful reduction. RESULTS: Seventy-five children presented to the ED with RHS; 3 children were excluded from the study because of nonadherence to the protocol and another 9 were excluded because of unsuccessful reduction during the first attempt. Of the remaining children, 32 children underwent forced pronation and 31 underwent supination-flexion. Physicians did not find a significant difference in gain scores between their perceptions of the premeasure and postmeasure of pain between those patients receiving supination-flexion and those receiving forced pronation. For nurses (P < 0.031) and parents (P < 0.043), there were statistically significant differences in gain scores. Nurses and parents perceived forced pronation as being less painful. The mean difference for parents was 1.7 cm, which exceeded the value of 1.3 cm identified as clinically significant. CONCLUSIONS: Forced pronation is perceived as less painful than the supination-flexion method by parents of children treated for RHS in our ED.

Arm Injuries↗
PubMed1999

Relationship between foot pronation and rotation of the tibia and femur during walking.

The purpose of this study was to test the hypothesis that the magnitude and timing of peak foot pronation would be predictive of the magnitude and timing of peak rotation of tibia and femur. Thirty subjects who demonstrated a wide range of pronation participated. Three-dimensional kinematics of the foot, tibia, and femur segments were recorded during self-selected free walking trials using a six-camera VICON motion analysis system. Regression analysis demonstrated that the magnitude and timing of peak pronation was not predictive of the magnitude and timing of tibial and femoral rotation. The lack of a relationship between peak foot pronation and the rotation of the tibia and femur is contrary to the clinical hypothesis that increased pronation results in greater lower extremity rotation. It would seem, therefore, that the relationship between foot pronation and rotation of the lower extremity segments should be assessed on a patient-by-patient basis.

Adult↗
PubMed2003

Scaphoid and pronator fat stripes are unreliable soft tissue signs in the detection of radiographically occult fractures.

AIM: To determine the clinical value of scaphoid and pronator fat stripes in identifying occult underlying scaphoid and distal radius fractures, respectively. MATERIALS AND METHODS: In our department, all patients with clinically suspected scaphoid fractures and normal scaphoid series of radiographs undergo magnetic resonance imaging (MRI) of the wrist. We selected 50 cases with unequivocal MRI evidence of scaphoid fracture, 50 cases with distal radius fracture and 50 cases with no MRI evidence of bony injury. All 150 initial plain radiographs were examined retrospectively in random order without knowledge of the MRI findings and the scaphoid and pronator fat stripes scrutinized. RESULTS: The scaphoid fat stripe was abnormal in only 25 cases (50%) with confirmed scaphoid fracture on MRI. The pronator fat stripe was abnormal in 13 cases (26%) with confirmed distal radius fracture. In the 50 cases with no MRI evidence of bony injury, the scaphoid fat stripe and pronator fat stripe were abnormal in 25 (50%) and 15 (30%) cases, respectively. The sensitivity and specificity for an abnormal scaphoid fat stripe was 50%. The sensitivity and specificity for an abnormal pronator fat stripe was 26 and 70%, respectively. CONCLUSION: Scaphoid and pronator fat stripes are poor predictors of the presence or absence of underlying occult fractures.

Adipose Tissue↗
PubMed1997

[Pronation angle of the rear foot during running in relation to load].

In 20 volunteers the relationship between rear-foot pronation and increasing physical exertion during treadmill ergometry was examined. In order to assess the influence of regularly performed running training a group of 10 endurance trained middle- and long-distance runners (age: 27.4 +/- 4.9 years; weight: 71.0 +/- 8.8 kg; height: 184.2 +/- 8.3 cm) was compared to another group of 10 untrained subjects (age: 24.7 +/- 2.1 years; weight: 73.3 +/- 9.8 kg; height: 179.1 +/- 8.3 cm). The examinations were carried out on a treadmill using a high-frequency motion analyzing system. Heart rate, blood lactate as well as rear-foot pronation were measured. Regarding heart rate and lactate concentration there were significant differences between trained and untrained volunteers. The pronation angle increased with higher speed up to a maximum of 6.54 +/- 4.22 degree for the trained group and 6.84 +/- 4.59 degree for the untrained group. With reference to maximal as well as submaximal stages the pronation angles showed no significant differences between both groups. Following the maximal exercise level the runners performed an additional 3 min run with a velocity reduced by 8 km/h compared to the maximal speed. At this level the total group as well as the untrained group showed significantly greater pronation angles compared to those of the corresponding velocity at the beginning of the test. The extent of the differences, however, was not significantly correlated with the lactate levels. Our results demonstrate that the increase of the pronation angle is a function of the running speed. But there is also an influence of fatigue, which depends neither on the running velocity nor on the lactate levels during exercise. Therefore, further investigations should emphasize the question which factors are responsible for this effect.

Adult↗
PubMed2000

The effects of ulnar axial malalignment on supination and pronation.

BACKGROUND: Forearm fractures are common injuries in both adults and children. Despite efforts to obtain anatomical alignment, axial rotational malunions occur, resulting in a decreased range of motion and a poor appearance. The objective of this study was to quantify loss of forearm rotation after simulation of ulnar malunions in supination and pronation. METHODS: Six fresh-frozen cadaveric upper extremities (mean age at the time of death, 79.4+/-2.8 years) were used to quantify loss of forearm rotation after simulation of axial rotational malunions of the ulna. First, maximum forearm rotation in supination and pronation was measured at torques of 6.8, 13.6, and 20.4 kilograms-centimeter applied with use of a custom jig. Following a midshaft ulnar osteotomy, a custom adjustable internal fixation plate was used to simulate axial rotational malunions of the ulna of 0, 15, 30, and 45 degrees in both directions. Measurements in supination and pronation were then repeated at the prespecified torques. Analysis of variance, with a p value of 0.05, was used for statistical analysis. RESULTS: In all instances, a decrease in forearm rotation after simulation of the ulnar rotational malunion was accompanied by an increase in rotation in the opposite direction. Supination and pronation were significantly influenced, whereas the total arc of rotation was not affected by ulnar rotational malunion. At a torque of 20.4 kilograms-centimeter, pronation malunions of 15, 30, and 45 degrees resulted in a mean loss of supination (and standard error of the mean) of 5+/-1, 11+/-1, and 20+/-1 degrees, respectively, and supination malunions of 15, 30, and 45 degrees resulted in a mean loss of pronation of 4+/-1, 10+/-2, and 18+/-4 degrees, respectively. The ratio of the simulated rotational malunion to the loss of motion was larger than one. CONCLUSIONS: Ulnar rotational malunions do not lead to a significant change in the total arc of forearm rotation. Instead, loss of motion in one direction is accompanied by increased motion in the opposite direction. Even with a 45-degree ulnar rotational malunion, forearm rotation decreases no more than 20 degrees.

Aged↗
PubMed2004

Dynamic contributions of the flexor-pronator mass to elbow valgus stability.

BACKGROUND: Previous studies have indicated that the demands placed on the medial ulnar collateral ligament of the elbow when it is subjected to valgus torque during throwing exceed its failure strength, which suggests the necessary dynamic contribution of muscle forces. We hypothesized that the flexor-pronator mass assists the medial ulnar collateral ligament in stabilizing the elbow against valgus torque. METHODS: Six cadaveric elbows were tested at 30 degrees and 90 degrees of flexion with no other constraints to motion. A full medial ulnar collateral ligament tear was simulated in each elbow. Muscle forces were simulated on the basis of the centroids and physiological cross-sectional areas of individual muscles. The biceps, brachialis, and triceps were simulated during flexor carpi ulnaris, flexor digitorum superficialis, flexor digitorum superficialis and flexor carpi ulnaris, and pronator teres-loading conditions. Kinematic data were obtained at each flexion angle with use of a three-dimensional digitizer. RESULTS: Release of the medial ulnar collateral ligament caused a significant increase in valgus instability of 5.9 degrees +/- 2.4 degrees at 30 degrees of elbow flexion and of 4.8 degrees +/- 2.0 degrees at 90 degrees of elbow flexion (p < 0.05). The differences in valgus angulation between each muscle-simulation condition and the medial ulnar collateral ligament-intact condition were significantly different from each other (p < 0.05), except for the difference between the flexor carpi ulnaris contraction condition and the flexor digitorum superficialis-flexor carpi ulnaris co-contraction condition. This co-contraction provided the most correction of the valgus angle in comparison with the intact condition at both 30 degrees and 90 degrees of elbow flexion (1.1 degrees +/- 1.8 degrees and 0.38 degrees +/- 2.3 degrees , respectively). Simulation of the flexor carpi ulnaris alone provided the greatest reduction of the valgus angle among all individual flexor-pronator mass muscles tested (p < 0.05), whereas simulation of the pronator teres alone provided the least reduction of the valgus angle (p < 0.05). CONCLUSIONS: The flexor-pronator mass dynamically stabilizes the elbow against valgus torque. The flexor carpi ulnaris is the primary stabilizer, and the flexor digitorum superficialis is a secondary stabilizer. The pronator teres provides the least dynamic stability.

Adult↗
PubMed2003

Reliability of 2 functional goniometric methods for measuring forearm pronation and supination active range of motion.

STUDY DESIGN: Test-retest reliability study. OBJECTIVES: To determine intra- and intertester reliability of the hand-held pencil (HHP) and the plumbline goniometer (PLG) methods for measuring active forearm pronation and supination motions in individuals with and without injuries. BACKGROUND: The distal forearm method has been considered the gold standard for measuring forearm pronation and supination motion. The HHP and PLG, however, are 2 more functional methods for measuring forearm motions, though limited information on the psychometric properties of these tests is currently available. METHODS AND MEASURES: Intra- and intertester reliability of the HHP and PLG methods were determined in 40 subjects of convenience (20 injured and 20 noninjured). Two testers performed 3 repeated measurements for each motion and method on all subjects. Intraclass correlation coefficients (ICC3,1 for intratester reliability, ICC2,3 for intertester reliability) and standard error of measurements (SEMs) were determined. RESULTS: The ICCs for the measurements of pronation and supination using the HHP and PLG methods were high (range, 0.86-0.98) for individuals with and without injuries, with the reliability for the PLG method being equal or slightly greater than the HHP method for the majority of pronation and supination measurements. Intratester ICCs were higher (SEMs were conversely lower) than intertester ICCs for nearly all measurements. The ICC values were generally the same or higher for individuals with injuries compared to individuals without injuries. CONCLUSIONS: The HHP and PLG are highly reliable methods for measuring functional forearm pronation and supination. Because plumbline goniometers are not commercially available and the instrumentation for the HHP method is readily accessible, clinicians should consider the latter as their method of choice for measuring functional forearm pronation and supination.

Adult↗
PubMed1982

Roentgen stereophotogrammetric analysis of growth pattern after pronation ankle injuries in children.

In a prospective study of ankle fractures in children, the posttraumatic growth pattern was registered with a roentgen stereophotogrammetric technique. This method allows determination of growth rates within 3 months after fracture, and the prognosis for future growth can be determined within 6-8 months after fracture. The ankle fractures were classified anatomically according to Salter-Harris and traumatologically according to Gerner-Smidt. Nine cases were classified as due to pronation: two pronation-abduction injuries and seven pronation-eversion injuries. The pronation-abduction injuries had Salter-Harris type I injury in distal fibula and tibia, respectively, and showed initial growth stimulation and symmetric growth. The pronation-eversion injuries had a Salter-Harris type II injury in distal tibia and showed three types of growth pattern: initial growth stimulation (3 cases), growth arrest (2 cases), and progressive growth retardation (1 case), besides one case with no significant growth registered bilaterally. Asymmetric growth within the growth region was found in four cases; in three mainly as a varus position, in one mainly as antecurvation of the ankle joint. In conclusion, the pronation-abduction injuries showed growth stimulation, whereas the older showed progressive growth retardation or growth arrest.

Adolescent↗
PubMed2005

Effects of Pronated and Supinated Foot Postures on Static and Dynamic Postural Stability.

Context: The foot is the most distal segment in the lower extremity chain and represents a relatively small base of support on which the body maintains balance (particularly in single-leg stance). Although it seems reasonable that even minor biomechanical alterations in the support surface may influence postural-control strategies, the implications of a hypermobile or hypomobile foot on balance have received little attention to date.Objective: To determine if supinated and pronated foot types influence measures of static and dynamic balance.Design: Participants were assigned to 1 of 3 groups depending on foot type, as defined by navicular-drop measures: pronated (>/=10 mm), neutral (5-9 mm), or supinated (</=4 mm). Measures of static and dynamic balance were obtained for each participant and compared across groups.Setting: Sports medicine and athletic training research laboratory.Patients or Other Participants: Sixteen individuals with pronated (navicular drop = 13.0 +/- 3.7 mm), neutral (navicular drop = 6.2 +/- 1.1 mm), or supinated (navicular drop = 2.2 +/- 1.7 mm) foot postures volunteered to participate in the study.Main Outcome Measure(s): We used the Chattecx Balance System to measure center of balance, stability index, and postural sway during static single-limb stance under eyes-open and eyes-closed conditions. Center of balance was defined as the point on the foot at which the body weight was equally distributed between the medial-lateral and anterior-posterior quadrants and was recorded in centimeters. Stability index was defined as the mean deviation in sway around the center of balance. Postural sway was expressed as the maximum sway distance recorded (cm) in the medial-lateral and anterior-posterior directions. The Star Excursion Balance Test was used to measure dynamic balance, which was reported as the reach distance (cm) in each of the 8 directions tested. The average of 3 trials of each measure was calculated and normalized to the subject's height.Results: We found no difference in center of balance or postural sway as a function of foot type. The stability index was greater in pronators than in supinators, but neither group was different from those with neutral foot types. Dynamic reach differed among groups but only in some directions. Generally, pronators reached farther in the anterior and anterior medial directions and supinators reached farther in the posterior and posterio-lateral directions. In the lateral direction, supinators reached farther than pronators but not farther than neutrals.Conclusions: Our results suggest that postural stability is affected by foot type under both static and dynamic conditions. These differences appear to be related to structural differences as opposed to differences in peripheral input. These effects should be considered when clinicians use such balance measures to assess injury deficits and recovery.

Journal Article↗
PubMed2002

Effects of prophylactic ankle supports on pronation during gait.

We performed a gait analysis of 12 healthy subjects in order to analyse the rear foot pronation-supination angle and the shift of centre of pressure (COP) during walking. We used a video system and a force plate and examined the effects of semi-rigid Air-Stirrup brace, lace-up cloth RocketSoc brace, ankle taping and no bracing. Both the lace-up cloth brace and taping increased the maximum pronation angle during the stance phase. The lace-up cloth brace alone was associated with a larger maximum pronation velocity. With the lace-up cloth brace and taping, the COP was more laterally placed, allowing greater leverage about the subtalar axis and thus increasing the tendency toward pronation. The two braces and the tape did not similarly affect ankle joint biomechanics during gait. The ability to reduce excessive amounts of pronation is an important design consideration for prophylactic ankle supports.

Adult↗
PubMed2006

In vivo 3D arthrokinematics of the proximal and distal radioulnar joints during active pronation and supination.

BACKGROUND: Pronation and supination of the forearm are important motions with major impact of impairment on daily activities. Despite this, the migration of contact of the articular surfaces of the proximal and distal radioulnar joints during active pronation has not been evaluated in vivo. METHOD: Helical CT-data in elbow positions of full active supination, mid position and full pronation with the elbow in extension were acquired from three female subjects and processed in 3D skeletal reconstructions. From the sets of skeletal landmarks relative radioulnar finite helical axes were estimated. The migration of the articular contact was evaluated in the planes perpendicularly reconstructed on these finite helical axes. FINDINGS: The center of the radial head translated 1.96 (SD 0.24) mm from a posterior location on the ulna in supination to a centered location in mid-position and an anterior location in pronation. For the distal radioulnar joint, the center of rotation remained relatively fixed about the center of the curvature of the articular surface of the ulna. RELEVANCE: The motion of the radial head on the ulnar surface consists of an anterior spinning with anterior gliding which contrasts with the concave-convex rule as used in manual therapy i.e. posterior gliding of the caput radii on the ulna with pronation. As such, the findings have major therapeutic implications for manual therapy.

Adult↗
PubMedDate not supplied

Functional comparison of pronation and supination strengths.

Studies have shown that functional activities involving pronation and supination, such as turning a doorknob or a screwdriver, involve wrist positions of extension and/or ulnar deviation. Previous studies of isometric forearm pronation and supination strength have utilized a neutral wrist position, resulting in a possible underestimation of true functional strength. Twenty healthy subjects between the ages of 24 and 45 years were assessed for isometric pronation and supination strength using cylinder, screwdriver, and doorknob handle adaptations. Maximal strength in both pronation and supination was observed with the use of the doorknob handle. Although pronation strength was exceeded by supination strength within all three handle adaptations, the difference was statistically significant for the screwdriver and doorknob handles. The results suggest that in clinical and research-oriented testing of maximal forearm rotation strength, further consideration must be given to the terminal grip device and positioning of the wrist.

Adult↗
PubMed2002

Comparison of measurement accuracy between two wrist goniometer systems during pronation and supination.

Pronation and supination have been shown to affect wrist goniometer measurement accuracy. The purpose of this study was to compare differences in measurement accuracy between a commonly used biaxial, single transducer wrist goniometer (System A) and a biaxial, two-transducer wrist goniometer (System B) over a wide range of pronation and supination (P/S) positions. Eight subjects moved their wrist between -40 and 40 degrees of flexion/extension (F/E) and -10 and 20 degrees of radial/ulnar (R/U) deviation in four different P/S positions: 90 degrees pronation; 45 degrees pronation; 0 degrees neutral and 45 degrees supination. System A was prone to more R/U crosstalk than System B and the amount of crosstalk was dependent on the P/S position. F/E crosstalk was present with both goniometer systems and was also shown to be dependent on P/S. When moving from pronation to supination, both systems experienced a similar extension offset error; however R/U offset errors were roughly equal in magnitude but opposite in direction. The calibration position will affect wrist angle measurements and the magnitude and direction of measurement errors. To minimize offset errors, the goniometer systems should be calibrated in the P/S posture most likely to be encountered during measurement. Differences in goniometer design and application accounted for the performance differences.

Adult↗
PubMed2006

A prospective biomechanical study of the association between foot pronation and the incidence of anterior knee pain among military recruits.

Excessive foot pronation has been considered to be related to anterior knee pain. We undertook a prospective study to test the hypothesis that exertional anterior knee pain is related to the static and dynamic parameters of foot pronation. Two weeks before beginning basic training lasting for 14 weeks, 473 infantry recruits were enrolled into the study and underwent two-dimensional measurement of their subtalar joint displacement angle during walking on a treadmill. Of the 405 soldiers who finished the training 61 (15%) developed exertional anterior knee pain. No consistent association was found between the incidence of anterior knee pain and any of the parameters of foot pronation. While a statistically significant association was found between anterior knee pain and pronation velocity (left foot, p = 0.05; right foot, p = 0.007), the relationship was contradictory for the right and left foot. Our study does not support the hypothesis that anterior knee pain is related to excessive foot pronation.

Biomechanical Phenomena↗
PubMedDate not supplied

Relationship of functional leg-length discrepancy to abnormal pronation.

The objective of this study was to determine whether a correlation exists between abnormal pronation and functional leg-length discrepancies. Visual assessment and a pelvic thrust maneuver were used to identify the functionally short leg in 56 indigenous Mexicans (20 males and 36 females; mean age, 33 years; mean weight, 59 kg; and mean height, 1.60 m). The Foot Posture Index was used with a modified stance position to identify the more pronated foot. The posterosuperior iliac spines were used to identify the "relative" position of the innominate bones. The raw data obtained from this study were evaluated using the McNemar test for paired proportions. A significant positive correlation was found between abnormal pronation and hip position and between hip position and functional leg-length discrepancy. These results are consistent with a theoretical ascending dysfunctional pelvic model: Abnormal pronation pulls the innominate bones anteriorly (forward); anterior rotation of the innominate bones shifts the acetabula posteriorly and cephalad (backward and upward); and this shift in the acetabula hyperextends the knees and shortens the legs, with the shortest leg corresponding to the most pronated foot.

Adolescent↗
PubMed1991

[Complex movement analysis: dynamic study of the effect of a tape bandage on pronation in high-jumping with three-dimensional movement analysis and electromyography].

Overuse syndromes in the lower extremity are a frequent problem in athletics, especially in jumping events. Athletes notice a comfortable support by using ankle taping without restriction of their performance. Up to now no objective data is available about efficiency of taping against overpronation which is frequent in high jumping. In high jumping without boots little difference of pronation between taped and untaped take off leg was found. In contrast in jumping with spikes boots a marked pronation during take off was found, which was reduced by ankle taping with a reduction of maximum medial malleolar medialisation by 77%, reduction of pronation time by 33% and time of maximum pronation by 8.2% in the take off leg. Surface electromyography showed an increased activity of M. peroneus longus by 30.7% as a plantarflector and pronator muscle with ankle taping. Activity of other jump supporting muscles of the lower extremity was little influenced.

Adolescent↗
PubMed1996

Prevention of injuries in excessive pronators through proper soccer shoe fit.

OBJECTIVE: Properly fitting shoes are important in the prevention of injuries. When it involves the lower extremity and pronation, proper fitting of shoes is considered as a treatment for gender variations in shoe fit and excessive pronators. The purpose of the study therefore, is to compare static and dynamic foot tracings in excessive pronators to determine if there were differences between right and left feet of male and female soccer athletes. DESIGN AND SETTING: Multivariate analysis with static and dynamic foot tracing measurements of foot length, first metatarsal length, fifth metatarsal length, metatarsal width, and heel width as the dependent variables and male and female (gender) as the effect. Interscholastic soccer players who were excessive pronators were used in the study. SUBJECTS: Volunteers were solicited from a boys and girls interscholastic soccer team (level C to varsity). From this pool of 40 subjects, a group of 20 (10 males and 10 females, n = 40 feet), with excessive pronation were used in the study. Criteria for selection was based on navicular height (? 10 mm) and arch index (? .26). MEASUREMENTS: Static and dynamic foot tracings were determined. From these tracings, foot length, first metatarsal length, fifth metatarsal length, metatarsal width, and heel width were determined. Multivariate analysis of variance (MANOVA; p < .05), one-way repeated measures analysis of variance (ANOVA; p < .05), and pairwise comparisons (p < .05) were performed to determine significance, as well as intraclass correlation coefficients for intraclass reliability of the measurements. RESULTS: For between genders, male foot tracings for static and dynamic right and/or left feet were statistically greater in all foot parameters except heel width. Comparison of same side static and dynamic measurements for the right or left foot indicated differences for foot length, metatarsal width, and heel width for males, and foot length, fifth metatarsal width, metatarsal width, and heel width for females. There were no significant differences between static and dynamic foot measurements for either foot between genders and within genders. CONCLUSIONS: Foot length should not be the only consideration used for determining proper shoe fit. Static and dynamic measurements for the right or left foot, as well as metatarsal width, fifth metatarsal length, and heel width should also be included.

Journal Article↗