Projects

Foot & Ankle | Footwear | Hamstring
Injury Prevention | OA | Therapeutic Interventions
Affiliated Projects

Foot & Ankle Studies

Current Projects | Completed Projects

Current Projects

The Effect of a Carbon Fiber Shank on Plantar Loading and Lower Extremity Mechanics in an Athletic Population

The purpose of this study is to determine the effect of two different shoe conditions on lower extremity kinematics as well as plantar pressure while completing a series of different athletic tasks. This study will focus specifically on hip, knee, and ankle kinematics during the stance phase of these movements. The goal of this study is to determine whether the addition of a carbon fiber shank will alter lower extremity kinematics or in-shoe pressure while performing these tasks. We hypothesize that no significant differences will exist in lower extremity kinematics between the different shoe conditions in any of the tasks. However, we hypothesize that the pressure beneath the foot will be significantly increased with the addition of the carbon fiber shank.

A total of 60 subjects will be tested. Subjects will range in age from 18-30 years and will be recruited by word of mouth and posted fliers. Subjects will have no history of lower extremity injuries in the past six months, no history of ACL reconstructive surgery within the past 3 years, no history of foot or ankle surgery, and will be physically active. Subjects who participate in some form of physical activity at least three times a week for approximately an hour each time will be considered to be physically active. Each subject will be asked to read and sign the consent form approved by the institutional review board.

After signing the consent form, height and weight will be recorded. The pressures under the plantar surface of the foot will be measured using the Pedar-X system (Novel, St. Paul MN). Connected to the insoles via cables the Pedar-X system has a small unit that contains electronics capable of performing an A/D conversion. From this unit, attached to the subject’s waist, data is transferred using wireless Bluetooth technology to a laptop computer where the data will be stored, processed, and analyzed. Prior to the data collection session, the insoles will be calibrated using the Novel calibration device. The insoles will be sampled at 100 Hz for approximately 20 seconds. Subjects will be tested in each shoe condition. The testing order will be randomized for both the movement tasks as well as the shoe condition. The testing order will be recorded for each subject. Once the testing order has been determined, the subject will be asked to sit down while the size appropriate insoles are inserted into the first test shoe. The insoles will be secured to the leg using a Nylatex wrap (elastic wrap with Velcro on the end).

A total of eight infrared cameras (Motion Analysis, Inc, Santa Rosa, CA) will be positioned around the testing area in order to record the trajectories of the retro-reflective markers, which will be placed on the subjects. A total of 40 markers will be placed on each subject at different anatomic landmarks. Following the placement of all of the markers, subjects will be asked to stand within the view of the cameras facing the direction they will be moving and a static standing trial will be recorded. Following the collection of the static standing trail, some of the markers will be removed and the subject will be ready to complete the different movement tasks. Each subject will be asked to complete seven trials in each of the following movement tasks. The first task will be a side cut in which the subjects will be asked to run approximately 10 yards, plant on his/her right foot and cut to the left. The second task will be a cross cut in which the subject will be asked to run 10 yards and plant his/her right foot and cut to the right. The third task will be a forward acceleration or sprint during which the subject will be asked to run 25 yards straight ahead. The final task will ask the subjects to complete a stop jump task in which they take two steps, jump and land on both feet then take off and jump as high as possible followed by a second two foot landing. During each of these tasks, the lower extremity kinematics as well as in-shoe pressure will be recorded. In addition, the speed into and out of each cut as well as the speed of the acceleration will be recorded so that the data can be analyzed with speed as a covariate. Subjects will be given a one minute rest between each trial and a five minute rest between each movement condition. After the first shoe condition is completed the carbon fiber shank will either be added to or removed from the shoe for the second testing condition. Testing should take approximately 1 hour per subject.

Current Status:

Pilot testing has been completed and subjects are currently being recruited and tested.

Effect of Surgical Treatment of Lateral Ankle Instability on Lower Extremity Kinetics and Kinematics during different functional tasks

The purpose of this study is to evaluate differences in lower extremity kinematics and kinetics during three different functional tasks in patients who are treated surgically for lateral ankle instability. The three tasks that will be tested will be level walking, a side-cut task, and walking on foam. Subjects will be tested both barefoot and in a standard running shoe. These three tasks will be evaluated at three different time points: prior to surgery, 6 months after surgery, and one year after surgery. It is hypothesized that following surgical intervention, the subjects will have a decrease in ankle inversion/eversion during the stance phase for each task as well as a decrease in the inversion/eversion moment. Subjects will also demonstrate an increase in movement speed as well as a decrease in pain score following surgical intervention. Statistically significant differences are expected between the three time points as well.

This study is designed to evaluate differences in lower extremity kinematics and kinetics during three different functional tasks in patients who are treated surgically for lateral ankle instability. A total of 20 subjects with unilateral ankle instability will be tested. Subjects will range in age from 18-40 years old and will be recruited from Dr. James Nunley’s patient population. Subjects will need to have a normal contralateral ankle without instability in order to participate in this study. Each of the subjects in this study will need to be recreationally active, which will be operationally defined as participation in some form of physical activity at least three times a week for approximately an hour each time. Each subject will be asked to read and sign the informed consent approved by the institutional review board. In addition, an injury history will be taken for each subject using the attached questionnaire.

After signing the informed consent, height, weight foot width, and foot length will be recorded. A total of eight infrared cameras (Motion Analysis, Inc, Santa Rosa, CA) will be positioned around the lab in order to record the trajectories of the retro-reflective markers, which will be placed on the subjects. The cameras will be sampling at 120Hz, while the ground reaction force data will be collected using four AMTI (Watertown, MA) force platforms at a rate of 1200Hz A total of 26 markers will be placed on each subject at the following anatomic landmarks: joint space between the fourth and fifth lumbar vertebrae (L4-L5), bilateral anterior superior iliac spine (ASIS), anterior thigh, lateral femoral condyle, anterior lower leg over the tibial ridge, lateral malleolus, medial heel, lateral heel, posterior heel, toe, medial malleolus, medial femoral condyle, and an offset marker on the right scapula. Following the placement of all of the markers, subjects will be asked to stand within the view of the cameras facing the direction they will be moving and a static standing trial will be recorded. Following the collection of the static standing trail, the four medial markers will be removed and the subject will be ready for the three movement tasks. The subjects will be asked to complete seven trials in each of the three movement tasks first in a barefoot condition. The first task will be normal level walking at a self-selected speed, which will be monitored with two sets of infra-red photocells. Once the walking speed has been established subjects must remain within 5% of the self-selected speed for the remaining trials. The second task will be to perform a side-cut task. The task will be demonstrated for each subject and the subject will be allowed 3 practice trials in order to become comfortable with the movement task. The final task will be to walk on a piece of foam that will be placed within the capture volume again at a self-selected speed. Once the first set of trials is completed, each subject will be fit with the correct pair of running shoes, which will be provided and the procedure will be repeated. Subjects will be given at least a 30 second rest between each trial and a two minute rest between movement conditions. This procedure will be repeated again at 6 months and 1 year following surgery. In addition to the lower extremity kinematics (hip, knee, and ankle), kinetic data (ground reaction forces and moments) will be recorded for each task and footwear condition. Testing should take approximately 1.5 hours per subject for each of the three visits.

Current Status:

Pilot testing has been completed and subjects are currently being recruited and tested.

Effect of Increased Weight on Lower Extremity Mechanics During Different Tasks

The purpose of this study is to determine the effect increased weight on lower extremity kinematics and kinetics during different functional tasks. This study will focus specifically on knee, and ankle kinematics and kinetics during the stance phase of each movement. The goal of this study is to determine whether increasing body weight alone will result in a change in ankle kinetics or kinematics during different functional tasks. The positions of the knee and ankle are important for injury prevention in sports and the military as well as attempting to delay the progression of knee and ankle osteoarthritis.

A total of 60 subjects (30 men and 30 women) will be tested. Subjects will range in age from 18-45 years and will be recruited by word of mouth and posted fliers. Subjects will have no history of lower extremity injuries in the past six months, no history of ACL reconstructive surgery within the past 3 years, no history of foot or ankle surgery, and will be physically active at least 2 times per week. Subjects who participate in some form of physical activity at least three times a week for approximately an hour each time will be considered to be physically active. Each subject will be asked to read and sign the informed consent approved by the institutional review board.

After signing the consent form, height, weight, foot length, and foot width will be recorded, to be used during data reduction. A total of eight infrared cameras (Motion Analysis, Inc, Santa Rosa, CA) will be positioned around the testing area and will be used to record the trajectories of the retro-reflective markers, which will be placed on the subjects. A total of 40 markers will be placed on each subject at different anatomic landmarks. Subjects will be asked to stand within the view of the cameras facing the direction they will move and a static standing trial will be recorded. Following the collection of the static standing trail, subjects will be ready to perform the different tasks. Participants will be asked to complete between 5 and 7 acceptable trials for each movement task. Subjects will be asked to complete a level walking trial at a self selected speed, a fast walking speed, and a standard walking speed of 1.3 m/s. In addition, subjects will be asked to complete 7 stair ascent and 7 stair descent trials and a landing from a box that is approximately 20 cm high. An acceptable trial will be defined as a trial in which the subject completes the indicated task and all of the markers are seen and the subject lands on the force plates as indicted. Subjects will be given a 30 second rest between each trial and a five minute rest between each movement condition. Each subject will be allowed to practice each task 3 times prior to the start of data collection. Subjects will first complete the testing under normal conditions, then subjects will have weights added to a vest that they are wearing in order to increase their body weight first by 10%, 15% and 20%. The testing procedure will be repeated for each weight condition. The task order will be randomized within a given weight condition in addition, the order of the weight conditions will be randomized.

Different information about the hip, knee, ankle and foot will be obtained from the three-dimensional kinematic data during the stance phase of each of the movement conditions. Both the peak and range of motion (ROM) for the hip flexion angle, knee flexion angle, knee valgus angle, hip abduction angle, foot progression angle, knee internal rotation angle, hip internal rotation angle, ankle inversion angle, and the different in-shoe pressure parameters will be determined. For each of these dependent variables series of repeated measures ANOVAs will be performed in order to determine any significant differences between the weighted conditions and across tasks.

Current Status:

Testing has been completed on this project and the data is currently being analyzed.

Second and Third Metatarsal Stress Fractures: Gender, Kinematic, Kinetic, and Plantar Pressure Differences as They Relate to Stress Fracture Incidence

This study aims to identify potential causes for the prevalence of second and third metatarsal stress fractures in female runners. It is hypothesized that women with a previous history of second and third metatarsal stress fractures will demonstrate increased loading and an increased loading rate beneath the middle forefoot when compared to men and women without a previous history of second and third metatarsal stress fractures. In addition, it is hypothesized that women with a previous history of stress fractures will demonstrate a series of differences when compared to men and women without a history of second and third metatarsal stress fractures: increased vertical and posterior ground reaction forces at foot strike, an increased inversion moment, and have significantly different body composition. Another aim of this study is to determine whether any correlations exist between any of the study variables (body composition, foot type, lower extremity kinematics, three dimensional ankle moments, vertical and anterior ground reaction forces, maximum pressure beneath the middle forefoot, and the loading rate in the middle forefoot) and the incidence of second and third metatarsal stress fractures.

Forty-five healthy male and female runners between the ages of 18 and 30 will be recruited to participate in this study. The breakdown of subjects will be as follows: 15 women with a history of second or third metatarsal stress fracture, 15 women with no history of a second or third metatarsal stress fracture and 15 men with no history of metatarsal stress fractures. Every effort will be made to match the two female groups on height, weight, age, and weekly running mileage. All participants will be asked to sign an informed consent form that has been approved by the Duke University Institutional Review Board. Prior to data collection, all subjects will be screened through a questionnaire to exclude anyone with current foot or ankle problems and to ensure that subjects are placed in the correct study group.

In addition, subjects will be asked to complete a survey of all previous injuries so that these can be reported as demographic data describing the subject population. In order to control for differences in ground reaction force due to different midsole densities in the running shoes, all subjects will be tested in the same neutral, cushioning running shoe that is free of any motion control properties.

Also prior to data collection, each subject will have a foot photo taken using the mirrored foot photo box (MFPB), to determine their foot morphology. Each subject's foot will be palpated for the following landmarks: navicular, head of the first metatarsal, and the first ray. A digital photograph will be taken of both feet while the subject is standing on the MFPB in a 90% weight bearing stance. The MFPB allows for the visualization of the medial, inferior, anterior, and posterior aspects of the foot within the same photograph. These photographs will then be analyzed using the Sigma-Scan Pro computer software to determine the subject’s foot type (pes planus, pes cavus, or normal) based on their navicular height and foot print indices obtained from the plantar image of the foot. Subjects will then have their body composition measured using the BodPod, (Life Measurement, Inc, Concord, CA) which determines body composition through air displacement in a sealed chamber.

Subjects will have reflective markers placed at 23 anatomical landmarks: sacrum (L5-S1), bilaterally on the anterior superior iliac spine (ASIS), thigh, lateral knee, shank, lateral malleolus, posterior heel, the second webspace (toes), medial heel, lateral heel, medial malleolus, and medial femoral condyle. Subjects will be a

sked to stand within the capture volume in the anatomic position, to record a static standing trial. The markers will be identified using an 8 camera real-time motion capture system (Motion Analysis Inc, Santa Rosa, CA) sampling at 240 Hz. Following the standing trial, the medial malleolus and medial femoral condyle markers will be removed. During the collection of the dynamic trials, subjects will have a pair of correctly sized plantar pressure insoles (Novel Electronics, Inc, St. Paul, MN) inserted in their shoes. The insoles will be attached by cables to a pack worn on the subject’s back, which will transmit information to the computer using Bluetooth technology. Subjects will be given a standard speed (3.3.m/s ± 5%) to maintain for the duration of the running trials, and 3 practice trials for which to become comfortable. The dynamic assessment consists of five to seven trials of over-ground running along a 40-meter runway. Plantar loading patterns throughout the foot, specifically the middle forefoot region, will be determined using the Pedar in-shoe pressure distribution system sampling at 100Hz (Novel Electronics, Inc, St. Paul, MN). For each of the five to seven trials, the following data will be collected: plantar pressure distribution, lower extremity kinematics, lower extremity kinetics, and ground reaction forces. Ground reaction force data will be collected using two AMTI force plates (AMTI, Inc, Watertown, MA), sampling at 1200Hz. All values will be compared across the three test groups (women with a history of stress fracture, women without a history of stress fracture and men without a history of stress fracture).

The plantar pressure data will be analyzed by dividing the foot into eight regions: heel, medial midfoot, lateral midfoot, medial forefoot, middle forefoot, lateral forefoot, Hallux and lesser toes. The focus of this study will be the loading beneath the middle forefoot in the region of the second and third metatarsals; however, all of the data will be analyzed in order to describe the differences in loading patterns throughout the foot between these three study groups. Ground reaction force data will be normalized to body weight, while all of the moment calculations will be normalized to body weight and height to improve the comparison between individuals.

A series of 1 X 3 between subjects ANOVAs will be completed for each of the study variables. These ANOVAs will be used to determine the differences between the three study groups. In addition, a series of correlations will be performed to determine if relationships exist between any of the study variables and the incidence of second or third metatarsal stress fractures

Publication Status:

Abstracts:

Robin M. Queen, Alicia N. Abbey, Bavornrit Chuckpaiwong, James A. Nunley. Plantar Loading Comparison between Men and Women and Women with a Previous 2^nd or 3^rd Metatarsal Stress Fracture. American Orthopaedic Foot and Ankle Society, Denver, CO, 2008

Robin M. Queen, Bavornrit Chuckpaiwong, James A. Nunley. A Comparison of Ankle Mechanics and Ground Reaction Forces in Women with a Metatarsal Stress Fracture and Matched Controls. American Orthopaedic Foot and Ankle Society, Denver, CO, 2008

Articles:

Robin M. Queen, Alicia N. Abbey, Bavornrit Chuckpaiwong, James A. Nunley. Plantar Loading Comparisons between Women with a History of Second Metatarsal Stress Fractures and Normal Controls. American Journal of Sports Medicine. (In Press)

An article on the kinematic and kinetic data that was collected is curretly being prepared for submission

Completed Projects

A Quantitative Method of Foot Type Determination using Clinical Assessment, Anthropometic Measurements and Footprint Indices

The purpose of this study is to establish a quantitative method of determining foot type using several different methods, including: clinical assessment, anthropometic measurements and footprint indices. We hypothesize that we will be able to develop a model that successfully determines the foot morphology of a subject/patient and will be able to classify them as either pes planus, normal, or pes cavus. If we can do this, then we can better educate people about the need for special shoes, orthotics, or avoiding certain activities that may put them at risk for injuries that are more common in people with their particular foot type. Also, researchers in the future will be able to classify using objective data subjects into cohorts based on foot type.

This study is designed into two parts, the first is to attract young, healthy subjects in order to develop a model using various non-invasive foot measurements to characterize subjects as being pes planus, pes cavus, or normal. A second group of subjects will then be recruited to test this model and determine if it is reliable. A total of 300 subjects will be recruited for this study, and will be chosen randomly from patients that enter the sports medicine building for a physician’s appointment or a physical therapy session for reasons other than foot-related pathology. These subjects will be between 18 and 65 years old.

Foot measurements will be obtained from both feet (n=600) in 90% of weight bearing. First, each subject’s height and weight will be recorded and 10% of their weight will be calculated. The subject will then place one foot on the scale and the other foot on the mirrored foot photo box. Subjects will then adjust the amount of weight placed on the scale foot by placing more or less of their weight on the foot resting on the mirrored foot photo box so that the scale reads 10% of their body weight, therefore, the foot on the mirrored foot photo box will be bearing 90% of the subject’s weight. The subject’s foot will then be palpated for the following bony landmarks: navicular, calcaneus, base of the first metatarsal, and the head of the first metatarsal, which will be marked with a washable marker. Once the foot has been marked, a digital photograph will be taken of the foot while the subject is still standing on the mirrored foot photo box, which will allow visualization of the posterior, anterior, medial, and plantar aspects of the foot. The marks made from the bony landmarks will allow for measurements after the picture has been digitized into the Sigma Scan Pro program. This procedure will be repeated for the other foot.

Publication Status:

Abstracts:

Bavornrit Chuckpaiwong, James A. Nunley, Robin M. Queen. Correlation between Static Foot Type Measurements and Clinical Assessment. American Orthopaedic Foot and Ankle Society, Denver, CO, 2008

Articles:

Bavornrit Chuckpaiwong, James A. Nunley, Robin M. Queen. Correlation between Static Foot Type Measurements and Clinical Assessments. Foot and Ankle International (In Press)

A Comparison of the In-shoe Plantar Pressure Distributions Generated by Normal, Pes Cavus, and Pes Planus Foot Morphology

Foot morphology has been associated with various types of lower extremity injuries. Plantar pressure measurement can be useful for predicting the development of foot ulcers in diabetics, determining the likelihood of developing stress fractures in athletes, and demonstrating alterations in biomechanics after lower extremity surgery. The purpose of this study is to determine the differences seen in plantar pressure measurements in people with planus, cavus, and normal feet.

Subjects are currently being recruited from the University population. Each subject's foot is palpated for the following landmarks: navicular, head of the first metatarsal , and the first ray. A digital photograph is taken of both feet while the subject is standing on the mirrored foot photo box (MFPB). These photographs will then be used to determine the group to which each subject will be assigned (pes planus, pes cavus, or normal).

Once the photograph is taken, each subject will be asked a series of questions about the types of activities they participated in as well as information about the type of shoes they are wearing during testing. Information will also be obtained in regards to any irregular wear patterns that might exist with the shoes that the subject was wearing at the time of testing. The subjects will then be fit with the correct size Pedar insert (used to measure plantar pressure) which will be placed within the subject's shoes for testing. The Pedar-X system was used to monitor pressure beneath the subject’s feet during the following tasks: running, walking, shuttle run, side-cut, cross-cut, and a simulated lay-up. Each task will be completed 5 times in a random order. The walking and running trials will be performed at a standardized speed and the shuttle run will be timed. In addition to determining differences in loading patterns between people with different foot morphologies, this data will also allow us to determine average pressure distribution patterns during different athletic tasks.

Publication Status:

Abstracts:

Robin M. Queen, Bavornrit Chuckpaiwong, Nathan A. Mall, James A. Nunley. The Effect of Foot Type on Plantar Pressure in Four Sport Specific Tasks. American Orthopaedic Foot & Ankle Society Annual Meeting, Toronto, ON, 2007.

Bavornrit Chuckpaiwong, James A. Nunley, Nathan A. Mall, Robin M. Queen. The Effect of Foot Type on In-shoe Plantar Pressure During Walking and Running. Medicine and Science in Sports and Exercise. Volume 39 (S5): 2007.

Articles:

Bavornrit Chuckpaiwong, James A. Nunley, Nathan A. Mall, Robin M. Queen. The Effect of Foot Type on In-shoe Plantar Pressure During Walking and Running. Gait and Posture. 28 (3): 405-411, 2008.

Robin M. Queen, Nathan A. Mall, James A. Nunley, Bavornrit Chuckpaiwong. Differences in Plantar Loading between Flat and Normal Feet During Different Athletic Tasks. Gait and Posture (In Press)

Fractures of the Proximal 5th Metatarsal: A Retrospective Case Study Analysis of Treatment Options, Surgical Fixation, and Post-operative Rehabilitation

There are multiple choices a surgeon faces when treating a proximal fifth metatarsal fracture. Once a surgeon decides on operative treatment, there are a number of ways to achieve fixation and compression across the fracture line, as well as whether or not to use a bone graft or not. The purpose of this study is to review all of the proximal fifth metatarsal injuries treated surgically at Duke University to look for correlations between surgical approaches and fixation devices with return to athletics and operative failure (nonunion, delayed union, or re-fracture). In addition, we will be reviewing post-operative management of these fractures to determine if this may or may not have a relationship with return to athletics or operative failure.

All patients with ICD-9 diagnosis codes of 825.25 (closed metatarsal fracture) or 733.94 (stress fracture of a metatarsal) charts will be pulled. A subset of these patients with surgical fixation will be separated based on the CPT code 28485 (open reduction and internal fixation of metatarsal fracture). These charts will then be reviewed for patients with a 5^th metatarsal fracture only. The patients with a 5^th metatarsal fracture will have their charts reviewed for multiple variables: sport played at time of injury, diagnostic modality, treatment, duration of treatment, functional outcome as defined by return to play, and complications.

The significance of this study is to report the outcomes of all of the proximal fifth metatarsal stress fractures treated at Duke University with operative vs. non-operative treatment. We hypothesize that the technique used by the primary investigator in this study will yield fewer complication rates and quicker return to play for athletes suffering a proximal fifth metatarsal stress fracture. This information can then be used by other surgeons caring for these patients in order to better their treatment.

Publication Status:

Abstracts:

Bavornrit Chuckpaiwong, Robin M. Queen, James A. Nunley. Jones and Proximal Diaphyseal Fractures of the 5^th Metatarsal. American Orthopaedic Foot & Ankle Society Annual Meeting, Toronto, ON, 2007.

Articles:

Bavornrit Chuckpaiwong, Robin M. Queen, Mark Easley, James A. Nunley. Distinguishing Jones and Proximal Diaphyseal Fractures of the Fifth Metatarsal: Why Bother? Clinical Orthopaedics and Related Research 446 (8): 1966-1970, 2008

The Reliability and Reproducibility of Foot Type Measurements using a Mirrored Foot Photo Box and Digital Photography Compared to Caliper Measurements.

The height of the medial longitudinal arch (MLA) is thought to be a predisposing factor to various lower extremity injuries. Discrepancy exists as to whether MLA height plays a role in injury prevention. The purpose of this study was to determine the inter-tester and intra-tester reliability, and the validity of the mirrored foot photo box (MFPB) and the caliper to radiographic measurements.

Methods:

A total of 30 subjects with equal numbers of men and women were recruited. Both feet were tested (n=60) in a 90% weight bearing stance. A set of anatomic landmarks were palpated, marked, and measured using a caliper, MFPB, and radiographs. The anatomic landmarks were the navicular, head of the first metatarsal, and two points along the first ray. The protocol was completed by two testers on two days that were approximately one week apart. Inter-tester and intra-tester reliability were determined using the intraclass correlation coefficient (ICC) (2,k) and the ICC (2,1), respectively. In addition, to the comparison between the MFPB and calipers, all of the measurements were validated to radiographic measurements and the statistical comparison was done using the ICC (2,k).

Results:

The inter-tester reliability ranged from 0.990 to 0.667, while the intra-tester reliability ranged from 0.994 to 0.542, with first metatarsal angle being the only variable with poor reliability. Most variables demonstrated acceptable validity between the MFPB and the caliper measurements, and acceptable validity between the MFPB and calipers compared to radiographic measurements. The MFPB took 51.3s ± 19.6s per foot while the caliper measurements averaged 227.4s ± 68.9s.

Discussion:

The results of this study indicate that the MFPB is as reliable as the caliper measurements, and offers better intertester reliability. In addition, both the caliper and MFPB measurements demonstrated acceptable validity to radiographic measurements and the testing time was reduced when using the MFPB compared to calipers.

Publication Status:

Abstracts:

Nathan A. Mall, W. Mack Hardaker, James A. Nunley, and Robin M. Queen. The Reliability And Reproducibility Of Foot Measurements Using a Mirrored Foot Photo Box Compared To Caliper Measurements. Presented at the American Society of Biomechanics National Meeting. Cleveland, OH.

Nathan A. Mall, Claude T. Moorman, James A. Nunley, II, Robin M. Queen. The Reliability of Measuring the Medial Longitudinal Arch: The Need for a Standardized Method. American Orthopaedic Foot & Ankle Society, La Jolla, CA.

Articles:

Robin M. Queen, Nathan A Mall, W. Mack Hardaker, James A Nunley II. Describing the Medial Longitudinal Arch Using Footprint Indices. Foot and Ankle International, 28 (4): 456-462, 2007

Nathan A. Mall, W. Mack Hardaker, James A. Nunley II, Robin M. Queen. The Reliability and Reproducibility of Foot Type Measurements using a Mirrored Foot Photo Box and Digital Photography Compared to Caliper Measurements. Journal of Biomechanics, 40 (5), 1171-1176, 2007.