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A Quick and Reliable Procedure for Assessing Foot Alignment in Athletes

by MASS4D® Prescription Orthotics October 07, 2018


The aims of the present study were 1) to develop standardised measurements of forefoot, rearfoot, and shank-forefoot alignments for quick and reliable use during athletes’ assessment processes and 2) to report the normative values of foot-ankle complex alignment for an athletic population.

This study was divided into two parts – in the first part, a reliability study was developed to assess the psychometric properties of the measure.

In the second part, a larger number of individuals were assessed to obtain normative data of the values obtained with the proposed method.

Initially, 11 soccer and volleyball athletes, 3 males and 8 females, were assessed for investigation of the intratester and intertester reliability of the measures.

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A digital photographic camera was placed on a leveled support positioned at 90 degrees in relation to the right lower extremity of a treatment table.

To guarantee this positioning, an inclinometer and a goniometer were used. The viewing volume was defined, and marking tape was used to indicate on the table the correct placement of the athlete’s foot.

The athlete was positioned prone with the feet off the table but with one of them between the tape marks. The medial malleolus was at the level of the table end to guarantee adequate visualisation of the foot and shank in the pictures.

The assessed lower limb was positioned with the calcaneus surface facing upward in a way that all of the marks could be seen at the center of the camera display.

The pictures were analysed to determine the forefoot, rearfoot, and shank-forefoot alignment angles.

The results showed that the intratester and intertester reliabilities of these measures are good to excellent.

The results also showed that the values obtained for shank-forefoot alignment are similar to values corresponding to the sum of the forefoot and rearfoot alignments.

This study describes a reliable and practical measurement procedure for rearfoot, forefoot, and shank-forefoot alignments that can be applied to clinical and research situations as a screening procedure for risk factors for lower-limb injuries in athletes.

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  1. Mendonça, L. M., Bittencourt, N. F. N., Amaral, G. M., Diniz, L. S., Souza, T. R., Fonseca, S. T. (2013) A Quick and Reliable Procedure for Assessing Foot Alignment in Athletes. Journal of the American Podiatric Medical Association: September/October 2013, Vol. 103, No. 5, pp. 405-410

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