Browsing by Person "De Schepper, Joris"

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The subtalar joint axis palpation technique part 2: Reliability and validity results using cadaver feet
(2014-07) Van Alsenoy, Ken K.; D'Aot, Kristiaan; Vereecke, Evie E.; De Schepper, Joris; Santos, Derek
Background: Clinically locating the point of no rotation to determine the subtalar joint axis location by applying pressure on the plantar surface of the foot was described by Kirby in 1987 but was never validated. We sought to extend a previously validated mechanical model to cadaver feet and to examine the intratester and intertester reliability. Methods: Four testers with different levels of experience determined the subtalar joint axis location and moved the subtalar joint through its range of motion, capturing the movement using kinematic analysis. The comparison of the spatial subtalar joint axis location as determined by palpation between and within testers determined the intertester and intratester reliability. The helical axis method was performed to validate the model. Results: The intrarater reliability varied from a high of = 0.96 to a low of = 0.26 for the slope and was, in general, high ( = 0.78-0.95) for the intersection. The interrater reliability scored moderate to high, depending on the specific cadaver specimen. Concerning the exact location of the subtalar joint axis, no significant difference was found between the results determined by different testers and the helical axis method. Conclusions: The palpation technique as part of the subtalar joint axis location and rotational equilibrium theory proposed by Kirby is a reliable and valid clinical tool. Experience in performing the palpation technique has a positive influence on the accuracy of the results. In the context of evidence-based practice, this technique could be a standard tool in the examination of patients with lower-limb-related pathologic disorders.
The Subtalar Joint Axis Palpation Technique-Part 1
(2014-05) Van Alsenoy, Ken K.; De Schepper, Joris; Santos, Derek; Vereecke, Evie E.; D'Aot, Kristiaan
Background: Locating the position of the subtalar joint axis can be a predictive clinical variable in biomechanical analysis and a valuable tool in the design of functional foot orthoses. Before testing Kirby's palpation technique to locate the subtalar joint axis in cadavers, it was important to develop and test the experimental methods in a mechanical model in which the exact location of the hinge joint can be controlled. Methods: Four testers determined the hinge joint location and moved it through its range of motion, capturing the movement of the joint axis using a kinematic model. The joint axis location was determined and validated by comparing the actual hinge joint location on the mechanical model with the location determined by the palpation technique described by Kirby in 1987 and the location determined by the helical joint axis method using three-dimensional kinematic data. Results: The overall angles result in mean slopes and intersections of 87 and 92 mm, 86 and 97 mm, 85 and 92 mm, and 88 and 91 mm for testers 1, 2, 3, and 4, respectively. Testers 1 and 3 were able to determine the location to 1 and 1 mm accuracy, tester 2 to 0 and 4 mm, and tester 4 to 2 and 2 mm compared with the kinematic data. Conclusions: The technique of determining the points of no rotation as described by Kirby could be validated by using a three-dimensional kinematic model to determine the helical axis.