A minimal markerset for three-dimensional foot function assessment: Measuring navicular drop and drift under dynamic conditions

Abstract

Background: The validity of predicting foot pronation occurring mainly at the midfoot by surrogate measures from the rearfoot, like eversion excursion, is limited. The dynamic navicular mobility in terms of vertical navicular drop (dNDrop) and medial navicular drift (dNDrift) may be regarded as meaningful clinical indicators to represent overall foot function. This study aimed to develop a minimal approach to measure the two parameters and to examine their intra- and interday reliability during walking. Methods: The minimal markerset uses markers at the lateral and medial caput of the 1st and 5th metatarsals, respectively, at the dorsal calcaneus and at the tuberosity of the navicular bone. Dynamic navicular drop and drift were assessed with three-dimensional motion capture in 21 healthy individuals using a single-examiner test-retest study design. Results: Intra- and interday repeatability were 1.1 mm (ICC 21 0.97) and 2.3 mm (ICC 21 0.87) for dynamic navicular drop and 1.5 mm (ICC 21 0.96) and 5.3 mm (ICC 21 0.46) for dynamic navicular drift. The contribution of instrumental errors was estimated to 0.25 mm for dynamic navicular drop and 0.86 mm for dynamic navicular drift. Conclusions: Interday reliability was generally worse than intraday reliability primary due to day-to-day variations in movement patterns and the contribution of instrumental errors was below 23% for dynamic navicular drop but reached 57% for dynamic navicular drift. The minimal markerset allows to simply transfer the known concepts of navicular drop and drift from quasi-static clinical test conditions to functional tasks, which is recommended to more closely relate assessments to the functional behavior of the foot.