Inverted
posture
‘A Rearfoot
good fit?’
in lateral view. We have previously reported
excellent intra-rater reliability for such
radiographic evaluation (Kappa: 0.80) [21].
Static Rearfoot posture
Prior to each capture session, the patient was
asked to stand on bare feet with shoulder-width
apart. This allowed 50% of their body weight
to be placed on each foot during assessment.
Round, black seal markers, which corresponded
to 2 anatomical landmarks (i.e., bottom of the
calcaneal tuberosity and enthesis of the Achilles
tendon) to detect foot alignment, were attached
to the skin (Fig. 1). After the measurements, foot
length and calcaneus inverted angle relative to
the floor were automatically calculated by the
system according to the attached round black
seal markers. As a clinical frame of reference,
calcaneus inverted angle relative to the floor
were categorized based on value of foot posture
index subcategory “inversion/eversion of the
calcaneus” [30] as follows: everted calcaneus
Photo/Illustration: Provided
Static foot posture was evaluated in January
2015 using a three-dimensional automatic
footprint measurement apparatus (CUTE,
JMS-2100CU; Dream GP Inc., Osaka, Japan)
[27, 28]. This foot scanning system is based on
laser line triangulation, where the measuring
head moves around a single foot in an oval-
shaped trajectory [29]. The laser scanner
rotates around the patient’s foot and measures
more than 30,000 points, including the ankle,
instep, heel, toes, as well as the sole, thereby
precisely re-creating the patient’s foot shape.
This scanning system has a high accuracy for
measuring foot posture. The measurement
errors of foot length and foot width are − 0.27-
0.36 mm (accuracy ±0.2%) and 0.51–1.22 mm
(accuracy ±0.5%), respectively [29].
Figure 1: Measurement of calcaneus inverted angle relative to the floor (q). Calcaneus inverted angle relative to the floor
was automatically calculated by the system according to the attached round black seal markers (a bottom of the calcaneal
tuberosity; b enthesis of the Achilles tendon).
28
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