PURPOSE This study examined the validity of standard clinical measures of arch height mobility (AHM), midfoot width mobility (MWM) and foot mobility magnitude (FMM) relative to skin-based and osseous measures derived from radiographs. METHODS Skin-based clinical indices of foot mobility were calculated from standard, caliper-based measures of foot length, midfoot width and dorsal arch height of the left limb of 20 healthy participants (8-71 years) during nonweightbearing and weightbearing. Skin-based radiographic and osseous indices were derived from concurrent antero-posterior and lateral radiographs. Agreement between skin-based clinical and skin-based radiographic measures of foot mobility with those of osseous measures were investigated using the Bland and Altman approach. RESULTS Foot mobility indices derived from clinical measures were significantly higher (20%-50%) than skin-based radiographic measures (P < .01), which were, in turn, significantly higher (200%-250%) than osseous measures (P < .01). Clinical measures demonstrated significant levels of proportional bias compared to radiographic measures of foot mobility (P < .01). The contribution of osseous movement to skin-based clinical measures of mobility was highly variable between individuals, ranging between 19-81% for AHM, 4-87% for MWM and 14-75% for FMM. The limits of tolerance for clinical measures of foot mobility, ranged from ±3.2 mm for MWM to ±6.6 mm for measures of FMM. The limits of tolerance for skin-based clinical and skin-based radiographic measures were generally larger than osseous movement with weightbearing. CONCLUSIONS Skin-based measures of foot mobility, whether clinical or radiographic methods, are not interchangeable and are poor indicators of osseous mobility. Although further research regarding the utility of osseous measures is warranted, these findings strongly caution against the use of skin-based clinical measures of foot mobility in clinical and research settings.

中文翻译：

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方法比较研究强调了基于骨和皮肤的足部活动度测量之间的差异。

目的本研究检验了足弓高度活动度（AHM）、中足宽度活动度（MWM）和足部活动度（FMM）标准临床测量相对于基于X光片的皮肤和骨骼测量的有效性。方法 对 20 名健康参与者（8-71 岁）在非负重和负重期间的足长、中足宽度和左肢背弓高度进行标准、基于卡尺的测量，计算基于皮肤的足部活动度临床指数。基于皮肤的放射线照相和骨指数源自同时的前后位和侧位放射线照片。使用 Bland 和 Altman 方法研究了足部活动性的基于皮肤的临床和基于皮肤的放射学测量与骨骼测量之间的一致性。结果 临床测量得出的足部活动指数显着高于（20%-50%）基于皮肤的放射学测量（P < .01），而后者又显着高于（200%-250%）骨测量（ P < .01)。与足部活动度的放射学测量相比，临床测量显示存在显着的比例偏差 (P < .01)。骨运动对基于皮肤的临床活动测量的贡献在个体之间差异很大，AHM 为 19-81%，MWM 为 4-87%，FMM 为 14-75%。足部活动度临床测量的公差范围为 MWM 的 ±3.2 毫米到 FMM 测量的 ±6.6 毫米。基于皮肤的临床和基于皮肤的放射学测量的耐受限度通常大于负重时的骨移动。结论 基于皮肤的足部活动度测量，无论是临床方法还是放射学方法，都不可互换，并且是骨活动度的不良指标。尽管有必要对骨测量的实用性进行进一步研究，但这些发现强烈警告不要在临床和研究环境中使用基于皮肤的足部活动度临床测量。