RELIABILITY OF CLINICAL MEASUREMENT OF SUBTALAR JOINT MOVEMENT

This study was designed to evaluate the intra- and interexaminer relia bility during repeated clinical measurements of subtalar movement. The study was a blinded experimental model in which 11 Royal College cert ified orthopaedic surgeons measured the subtalar movement of the 10 lo wer extremities of five normal subjects. The measurements were perform ed in accordance with previously published recommendations. Measuremen ts of both inversion and eversion were recorded in degrees. Employing a variance component analysis, a coefficient of agreement between exam iner measures was established. The coefficient of agreements were 0.10 7 for right lower extremities and 0.0656 for left lower extremities. A n evaluation of means and ranges of individual examiner measures demon strated a potential average loss of range of motion of 20% simply beca use of variability in measurement. It was also determined that a learn ing curve did not exist within examiners in this study. The reliabilit y of clinical estimates of subtalar movement by this method is extreme ly poor. Both inter- and intraexaminer reliability are so poor as to s uggest that this method of examination no longer be used to determine or document the measurement of subtalar movement.