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Foot (Edinb). 2014 Jun;24(2):62-5. doi: 10.1016/j.foot.2014.03.001. Epub 2014 Mar 20.

Severity of pronation and classification of first metatarsophalangeal joint dorsiflexion increases the validity of the Hubscher Manoeuvre for the diagnosis of functional hallux limitus.

Author information

1
Faculty of Health Sciences, University of Malta, Malta; Faculty of Health Sciences, Staffordshire University, UK. Electronic address: Alfred.gatt@um.edu.mt.
2
Department of Health, Malta.
3
Faculty of Health Sciences, University of Malta, Malta; Faculty of Health Sciences, Staffordshire University, UK.

Abstract

BACKGROUND:

Functional hallux limitus (FHL) is diagnosed with a static test known as the Hubscher Manoeuvre, the validity of which has been previously questioned.

OBJECTIVES:

To investigate the validity of this Manoeuvre and whether introducing severity of pronation as a second concurrent test would increase this validity.

METHOD:

30 participants with a hallux dorsiflexion <12° were divided into 2 equal groups, depending on their severity of pronation according to the Foot Posture Index. A single video camera, placed perpendicular to the plane of motion of the 1st MPJ, captured its movement, from which the angle of maximum dorsiflexion of this joint was measured.

RESULTS:

10 males and 20 females, aged 18-56 years (mean 28 yrs, SD ± 12.1 yrs) participated. There was no significant relationship between non-weight bearing and dynamic maximum dorsiflexion (p=0.160), and between weight bearing and dynamic maximum dorsiflexion (p=0.865). A significant relationship between 1st MPJ dynamic maximum dorsiflexion and severity of pronation (p=0.004) was found.

CONCLUSIONS:

None of the participants exhibited a complete lack of hallux dorsiflexion. A positive Hubscher Manoeuvre test, on its own, is not a good indicator of limited 1st MPJ dorsiflexion during dynamic motion. However, as pronation increases, 1st MPJ maximum dorsiflexion during gait decreases.

KEYWORDS:

First metatarsophalangeal joint; Functional hallux limitus; Hubscher Manoeuvre; Maximum hallux dorsiflexion

PMID:
24703511
DOI:
10.1016/j.foot.2014.03.001
[Indexed for MEDLINE]

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