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Colleagues,
I am currently trying to put together a research proposal for an MSc dissertation which I hope to start relatively soon.

I am aware of and have read some of the previous threads related to 1st mtpj range of motion (ROM) and these have been most helpful.

I still have a few questions which I would greatly appreciate any help with.
I intend to carry out a study to compare reliability and/or repeatability of probably two devices used to measure 1st MTPJ ROM. (Apologies for the lack of detail, I am still in the early stages of developing this).

What I am unsure about is if there are any devices regarded as superior to others. I have taken note of a few studies where the O'Brien goniometer has been used but I am unable to find any information on the validation of this tool or if it has been compared to any other.

An early intention was to possibly compare the O'Brien with a simple tractograph. At present, I do not have any preferences as to which tools to use.

My reason for choosing this as topic is that I am in the early stages of embarking on a career in podiatric surgery. 1st MTPJ is therefore something which I look at on a daily basis (as I am sure many other clinicians in the various fields of podiatry do). At present, I 'measure' 1st MTPJ by simply eyeballing and this is something I have become less happy about doing, especially where this is often an important outcome measure post operatively. I hope that this study will provide at least a starting block on which I can investigate this area in greater detail and if possible, identify a tool which I can use with confidence in clinical practice and in further research.

Anyone's thoughts on this would be great and I very much appreciate any advice anyone can offer.
Apologies for the lengthy post
Regards,
Ryan.

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Ryan,
It may be of some help to tell this forum what facilities are available to you. You mentioned the O'Brien goniometer and a tractograph. I presume from this you are measuring range of motion (/max dorsiflexion) at the 1st MTPJ in a non-weightbearing clinical situation. Of course, we make assumptions about how this relates to motion at the joint during gait, and how your proposed intervention (in your case, I guess surgery) will effect this motion.

I also presume that you will be performing this on a non-pathological study group?
What sort of time frame have you got for project proposal, design, recruitment, carrying out, analysis and writing it up?

It would definitely be worthwhile looking at the practicalities of your proposed research and ideas prior to starting down the track.

A repeatability study on each of those measurement tools might be easy to perform - you could look at inter and intra rater repeatability of each tool. But how useful would the results be? Does either of the tools really represent how the joint moves when it's performing its natural function? Do they reflect alteration in function in pathology?

I'm interested in 3d motion of the joint during gait and how this relates to some clinical assessments (including non-weightbearing passive dorsiflexion). If you're interested in seeing my project and for further discussion, you can pm me on here or email (pm'd to you).
Lee

Lee,
apologies for the lack of detail in my post and thank you for your input.
I work in a busy unit within an acute hospital with a good range of facilities. The availability of the actual tools that I decide to use should not present as a problem (I hope!). The time frame should be approximately 1 year from start to finish.

The intention is to measure maximum dorsiflexion about the 1st MTPJ although in this early stage, I have not determined whether or not I will limit the study to non weight-bearing subjects. I have not intended to look at the effect of surgery (as part of this project) on ROM and am just aiming to look at the repeatability of the instruments. I will be carrying out the tests on non-pathological joints and intend to recruit the help of the team I work with so that I can determine intra and inter repeatability. I think it is unlikely that I will recruit patients and will probably keep this limited to my colleagues. My intention was to keep this relatively simple if possible.

The usefulness of the results is also a question I am asking myself (one of the many questions!!). This is just the early stages of the planning with plenty of work still to go.
This is the 1st piece of research I have been involved in and my inexperience clearly shows! Your advice and input is certainly greatly appreciated!
Many thanks and kind regards,
Ryan.

I will definitely contact you via email and thanks for this offer.

Have a look at this related thread:
http://www.podiatry-arena.com/podiat...ead.php?t=9980

Shannon Munteanu refined a static technique for measuring with a goniometer in this paper: HOWEVER, are you sure its really 1st MPJ ROM that you want to measue ... the world is moving on to the importance of stiffness as opposed to ROM of joint. See these threads:
Reconceptualising FnHL as a disorder of variable stiffness of the first MPJ
First Metatarsophalangeal Joint Dorsiflexion Stiffness
Bending stiffness in the 1st metatarsophalangeal joint

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