title: Foot kinematics during a bilateral heel rise test in participants with stage II posterior tibial tendon dysfunction.
abstract: METHODS
  Experimental laboratory study using a cross-sectional design.
  
  
  OBJECTIVE
  To compare foot kinematics, using 3-dimensional tracking methods, during a bilateral heel rise between participants with posterior tibial tendon dysfunction (PTTD) and participants with a normal medial longitudinal arch (MLA).
  
  
  BACKGROUND
  The bilateral heel rise test is commonly used to assess patients with PTTD; however, information about foot kinematics during the test is lacking.
  
  
  METHODS
  Forty-five individuals volunteered to participate, including 30 patients diagnosed with unilateral stage II PTTD (mean +/- SD age, 59.8 +/- 11.1 years; body mass index, 29.9 +/- 4.8 kg/m2) and 15 controls (mean +/- SD age, 56.5 +/- 7.7 years; body mass index, 30.6 +/- 3.6 kg/m2). Foot kinematic data were collected during a bilateral heel rise task from the calcaneus (hindfoot), first metatarsal, and hallux, using an Optotrak motion analysis system and Motion Monitor software. A 2-way mixed-effects analysis of variance model, with normalized heel height as a covariate, was used to test for significant differences between the normal MLA and PTTD groups.
  
  
  RESULTS
  The patients in the PTTD group exhibited significantly greater ankle plantar flexion (mean difference between groups, 7.3 degrees ; 95% confidence interval [CI]: 5.1 degrees to 9.5 degrees ), greater first metatarsal dorsiflexion (mean difference between groups, 9.0 degrees ; 95% CI: 3.7 degrees to 14.4 degrees ), and less hallux dorsiflexion (mean difference, 6.7 degrees ; 95% CI: 1.7 degrees to 11.8 degrees ) compared to controls. At peak heel rise, hindfoot inversion was similar (P = .130) between the PTTD and control groups.
  
  
  CONCLUSIONS
  Except for hindfoot eversion/inversion, the differences in foot kinematics in participants with stage II PTTD, when compared to the control group, mainly occur as an offset, not an alteration in shape, of the kinematic patterns.
authors: Ithaca College-Rochester Campus, Department of Physical Therapy, Rochester, NY, USA. jhouck@ithaca.edu
authors: Jeff R
authors: JR
authors: Houck
authors: Christopher
authors: C
authors: Neville
authors: Josh
authors: J
authors: Tome
authors: A Samuel
authors: AS
authors: Flemister
mesh_terms: D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D037081:Posterior Tibial Tendon Dysfunction / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology