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Lunge test and ACT casting

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kenva, Nov 4, 2006.

  1. Kenva

    Kenva Active Member


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    Dear all,

    To bring something else into the discussions around casting and foot modeling, i was wondering if the advanced casting technology would be something usefull in negative foot modeling ;) .

    I was browsing and came across this site , remembering the thread on the Lunge test, i was wondering if anybody had seen this before and if these are somehow related?

    cheers

    Ken
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    There is more than one way to 'skin a cat', as the saying goes. From the links Andy posted to other threads, there is more than one way to cast a foot.

    The lunge test is weightbearing assessment of ankle joint range of movement that factors in body weight. I use it to determine the need for a heel raise on orthotic issue.

    My key criteria for any method of negative model production (or direct mold as used by the ACT system) is that you must be able to manipulate the segments of the foot into the positions that you want.

    With that ACT system, you can't do that. Moving the tibia anteriorly will pronate the subtalar joint (negative model will be of a pronated foot/orthotic will be pronated). If you place the STJ in neutral to stop that and still maintain the flexed ankle position, then the midfoot will be more pronated (arch lower on negative model/orthotic will have lower arch). The method will also probably dorsiflex the first metatarsal (and we all know the consequences of that).
     
  4. Kenva

    Kenva Active Member

    Hi Craig,

    I can follow the pronated cast/foot shape with the tibia being moved forward. I'm only a bit puzzeled with the exact structure tested with the Lunge test.

    Correct me please if i'm wrong,
    There is functional stiffness because the foot can ponate even less on the orthotic, so if you already have a positive Lunge test at intake, you will for sure have a positive testing when dispensing the FO(?).
    The patiënt will try to pronate on the orthotic, and can get some irritation on the medial arch(?)... So you give a standard +/- 3 mm heelraise.
    wouldn't you get the same result if you add a +/- 4° pronation mobility in your rearfoot post?

    Anatomically you would be testing the soleus muscle, since the knee is flexed, if you can't get enough out of the muscle, you'll start to pronate to compensate the lack of motion. Wouldn't a stretching program be usefull to add to your heelraise or maybe even instead of(?)
     
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