Hello to all again,
It is great to see that the mailbase is slowly getting out of hibernation
and enjoying a new swing of discussions
Jeff said:
>>>
Therefore any test used to evaluate the presence and especially
the degree of functional hallux limitus would seem to need to be done in a
functional environment, which is extremely difficult since we are attempting
to evaluate ROM, not pressure. Pressure may be indicative of ROM but is
there an absolute correlation and if so, to what degree does increased
pressure translate to decreased ROM?
>>>
Reply:
It is indeed our purpose to define FUNCTIONAL hallux limitus using the
amount of 1st MTP dorsiflexion as reflected by the recorded kinematics
during walking, thus in a functional environment. But as pressure
measurement devices are cheaper and therefore more affordable than the
rather expensive optoelectronic devices we use to extract kinematic data,
we will try to find and prove some useful correlations between kinematics
of the hallux limitus and plantar foot pressure.
Jeff concludes:
>>>
Short of the extensive work that you have done
and described, how can the average clinician proved you with ex/inclusion
criteria?
>>>
One has to start somewhere, Jeff, and clinical definitions on hallux
limitus are the only ones available now (except for Graigs recent concept
of a continuum based on a dynamic approach, but unfortunately, we do not
have his machine available)
But, anyway, the relation between clinical and scientific knowledge is
frequently recurrent in nature. Scientific research, when used to check
clinical concepts or statements, is mostly an a-posteriori affair and may
(if successful) modify or refine existing clinical definitions. This will
rekindle the discussions about the clinical implications of these new
definitions which in turn will raise new questions, where science will jump
in again etc. At least that is how I see it Š and at the same time it
provides a good excuse to feel useful to the clinical community Š and the
tax payer.
Regards to all,
Bart
*******************************************************************
Bart Van Gheluwe
Laboratory of Biomechanics
Vrije Universiteit Brussel -Fac. LK
Vakgroep BIOM
Pleinlaan 2, 1050 Brussel, Belgium
Tel.: 02/629.27.33 (31)
Fax: 02/629.27.36
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