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Will muscle changes effect the supinatory resistance test

Discussion in 'Biomechanics, Sports and Foot orthoses' started by mike weber, Dec 4, 2009.


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    Here we go.

    This is cut for another thread started by Asher.


    Which Ian wrote

     
  2. Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    Then I wrote

    What do people think ?
     
  3. Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    Here´s an Article on Supination resistance testing for those who have not read it-

    Written by MR PA himself.
     

    Attached Files:

  4. What factors determine the position of rotational equilibrium the foot adopts during relaxed stance? Answer this and you'll have the answer to your question..:santa:
     
  5. Joints - compression forces
    Ligaments
    intrinsic muscles plantar
    extrinsic muscle tendons
    Ground reaction force
    COP
    Tension of Plantar fascia
    skin ( maybe a bit extreme)
     
  6. I began experimenting, developing and creating the supination resistance test during my Biomechanics Fellowship at CCPM in 1985. By that time, I had already been palpating many feet (patients and podiatry students) for subtalar joint (STJ) axis location for about 2-3 months and had already discovered a correlation between STJ axis spatial location and foot function and symptoms in the individual.

    The reason that I started doing the supination resistance test was that I was trying to find a way to "feel" how much force the strongest supinator muscle of the foot, the posterior tibial muscle, would need to supinate the foot. By that time, in early 1985, I had already realized that medial deviation of the STJ axis would shorten the moment arm for the posterior tibial muscle to supinate the STJ which would increase the tensile force required within the posterior tibial tendon to supinate the STJ. Therefore, I created the supination resistance test in order for me to find a way to "feel the forces within the foot" which I felt was much more important than measuring subtalar joint range of motion, measuring forefoot to rearfoot relationship, measuring relaxed calcaneal stanc position and all the other measurements that my biomechanics professors at CCPM had taught me as the proper methods of evaluating patients for their biomechanical function.

    Now, nearly 25 years since the creation of the supination resistance test, I still find it to be a fairly good test, but it is not without it's problems. The biggest problem when performing the supination resistance test is trying to get the patient to not assist you when you are attempting to supinate the foot with manual pressure plantar to the medial navicular. Ideally, during relaxed bipedal stance, the individual should only have the gastrocnemius and soleus muscles being active. In other words, no other extrinsic muscles of the foot should have contractile activity within them during relaxed bipedal stance as long as the center of the mass of the body is balanced in its normal position, anterior to the ankle joint axis.

    Of course, this does not always occur. Contrary to popular podiatric belief, the peroneal muscles and posterior tibial muscles are commonly tonically active during relaxed bipedal stance in many individuals. Those individuals with medially deviated STJ axes will be more likely to have tonic contractile activity within their posterior tibial muscle during relaxed bipedal stance and those individuals with laterally deviated STJ axes will be more likely to have tonic contractile activity within their peroneal muscles during relaxed bipedal stance. These extrinsic muslces will definitely alter the findings from the supination resistance test and this may result in a second to second alteration in the supination resistance test (rather than a day to day or week to week alteration) depending on the prevailing level of contractile activity within either the posterior tibial or peroneal muscles during the supination resistance testing procedure.

    Therefore, my advice to all of you is to not just rely on the supination resistance test for estimating the forces that are present within the foot since it may be erroneous unless you have been very careful to make sure that the posterior tibial and peroneal muscles are not firing during the test. I now like to estimate the STJ axis spatial location while the patient is standing in relaxed bipedal stance to make sure it correlates with the supination resistance test to make sure my patient assessment is accurate. However, all in all, I think the supination resistance test is valuable test that is under-utilized and that is not understood by the vast majority of the podiatric profession.

    Good discussion.:drinks
     
  7. You also need to think about the patient leaning forward "to see what you are doing" this will shift the centre of pressure forward and may influence the result.
     
  8. Griff

    Griff Moderator

    Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    Thank you Kevin and Simon for a few gems to consider whilst performing the manual test - things I hadn't necessarily considered.

    Mikey - are you talking about the load-deformation characteristics of viscoelastic tissues or about muscle fatigue? I'm a bit confused by your statement (Long day in the office and brain struggling tonight). Either way I'm not sure the supination resistance test would be that different following fatigue. Craig - is this something you and your colleagues have looked at with your machine at La Trobe?

    Ian
     
  9. Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    Muscle length/ tension relationship is key to this topic.
     
  10. Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    What I was heading towards was the more the tendon is fatigued it is the less resistance it will provide.

    This is what I was trying to when I said


    But as normal not as clearly stated as Simon and Kevin

    as this is a great example of

    me
    Kevin
    Would be a good study though.
     
  11. Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    Would be an excellent study- I have the kit to do it, if you are really interested.
     
  12. Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    I would love to be part of a 2 -3 author study, Ive never done anything like it so would need some guidence and as most have realised by now My dyslectic english sometimes means I dont understand myself !!!

    Be would be great
     
  13. Peter1234

    Peter1234 Active Member

    Re: will muscle changes (strength/weakness/fatigue) effect the supinatory resistance test

    PMSL !!!!:santa:
     
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