Members do not see these Ads.
Sign Up .
Severity of pronation and classification of first metatarsophalangeal joint dorsiflexion increases the validity of the Hubscher Manoeuvre for the diagnosis of Functional Hallux Limitus
Alfred Gatt, Tiziana Mifsud, Nachiappan Chockalingam
The Foot; Available online 20 March 2014
Background
Functional Hallux Limitus (FHL) is diagnosed with a static test known as the Hubscher Manoeuvre, the validity of which has been previously questioned.
Objective/s
To investigate the validity of this manoeuvre and whether introducing severity of pronation as a second concurrent test would increase this validity.
Method
30 participants with a hallux dorsiflexion <12deg were divided into 2 equal groups, depending on their severity of pronation according to the Foot Posture Index. A single video camera, placed perpendicular to the plane of motion of the 1st MPJ, captured its movement, from which the angle of maximum dorsiflexion of this joint was measured.
Results
10 males and 20 females, aged 18 to 56 years (mean 28yrs, SD+/-12.1yrs) participated. There was no significant relationship between non-weight bearing and dynamic maximum dorsiflexion (p = 0.160), and between Weight Bearing and dynamic maximum dorsiflexion (p = 0.865). A significant relationship between 1st MPJ dynamic maximum dorsiflexion and severity of pronation (p = 0.004) was found.
Conclusions
None of the participants exhibited a complete lack of hallux dorsiflexion. A positive Hubscher Manoeuvre test, on its own, is not a good indicator of limited 1st MPJ dorsiflexion during dynamic motion. However, as pronation increases, 1st MPJ maximum dorsiflexion during gait decreases.
Click to expand...