title: Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain.
abstract: BACKGROUND
  Some practitioners believe mechanical low back pain may be caused or aggravated by a stiff ankle, stiff great toe or flat feet. This study investigates subjects with and without mechanical low back pain and measures ankle and great toe range of motion and flattening of the medial longitudinal arch in both groups.
  
  
  METHODS
  The study was a blinded, 2-arm, non- randomized clinical study involving 100 subjects with chronic or recurrent mechanical low back pain (intervention group) and 104 subjects without chronic mechanical low back pain (control group) between the ages of 18 and 45. A blind assessor performed weight-bearing goniometry of the ankle and big toe and the navicular drop test on all subjects in both groups.
  
  
  RESULTS
  An independent t-test (inter-group) revealed a statistically significant decrease (p </= 0.05) in ankle dorsiflexion range of motion in individuals with chronic mechanical low back pain. The independent t-test suggested individuals with chronic mechanical low back pain have a significantly smaller navicular drop and higher arches (p < 0.05).
  
  
  CONCLUSIONS
  This study supports previous reports suggesting decreased ankle dorsiflexion may be a factor in chronic mechanical low-back pain. Further research and replication of this study is necessary before firm conclusions or recommendations can be made.
authors.affiliation: Director for Research and Associate Professor, Cleveland Chiropractic College Los Angeles.
authors.forename: James W
authors.initials: JW
authors.lastname: Brantingham
authors.forename: Joanne
authors.initials: J
authors.lastname: Lee Gilbert
authors.forename: Junaid
authors.initials: J
authors.lastname: Shaik
authors.forename: Gary
authors.initials: G
authors.lastname: Globe
references.citation: J Am Podiatr Med Assoc. 2001 May;91(5):262-8
references.pmid: 11359892
references.citation: J Orthop Sports Phys Ther. 1993 Oct;18(4):553-8
references.pmid: 8220414
references.citation: Lancet. 1999 Aug 14;354(9178):581-5
references.pmid: 10470716
references.citation: Phys Ther. 1988 May;68(5):672-7
references.pmid: 3362980
references.citation: J Orthop Sports Phys Ther. 1990;12(1):10-5
references.pmid: 18796888
references.citation: J Orthop Sports Phys Ther. 2005 Aug;35(8):479-86
references.pmid: 16187508
references.citation: J Am Podiatr Med Assoc. 1998 Mar;88(3):119-29
references.pmid: 9542353
references.citation: J Am Podiatr Med Assoc. 1993 Apr;83(4):198-202
references.pmid: 8473991
references.citation: J Manipulative Physiol Ther. 2002 Jul-Aug;25(6):384-90
references.pmid: 12183696
references.citation: J Manipulative Physiol Ther. 2002 Jun;25(5):326-31
references.pmid: 12072853
references.citation: Clin Podiatr Med Surg. 1997 Jul;14(3):407-26
references.pmid: 9257031
references.citation: J Orthop Sports Phys Ther. 1994 Oct;20(4):200-6
references.pmid: 7987380
references.citation: Spine (Phila Pa 1976). 1998 May 1;23(9):1009-15
references.pmid: 9589539
references.citation: Orthop Clin North Am. 1982 Jul;13(3):541-58
references.pmid: 6124922
references.citation: J Am Podiatr Med Assoc. 1999 Mar;89(3):109-17
references.pmid: 10095332
references.citation: J Orthop Sports Phys Ther. 1996 Nov;24(5):309-14
references.pmid: 8902683
references.citation: J Manipulative Physiol Ther. 1988 Oct;11(5):373-9
references.pmid: 2976805