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Hi all

Does anyone have an opinion on if there is a more appropriate time of day (or night!! ) to measure ROM or cast feet? Do you think this would have any bearing on measurement outcomes or presciption?

Ian

Hi Ian,
In my opinion there is no best time of day to cast.
We are only really able to accurately measure gross ROM (ie not in degree-increments, although this still goes on in both physio and podiatric circles, in spite of robust evidence that ROM does change over the course of one day due to circadian variation), so no best time of day for this either.

I don't believe measuring or casting at a specific time of day would have any bearing whatsoever on outcomes. It certainly would not influence my prescription protocols.
Cheers,
David

I have a young university student who has pes cavus a 6 degree high arch combined with small toes and a very narrow heel. The patient had previously complained of having a shorter left leg. On measuring limb length it was revealed that both legs are the same size in length.
Whilst analysing gait the patient appeared to use the lateral edge on the 4th and 5th metatarsophalangeal joints of both feet rather than toe off during the propulsion phase of walking gait. During the end of range motion tests on the talonavicular joint it was revealed that the foot could invert and evert. Measurements on the ankle joint revealed a dorsiflexion of 10 degrees with the knee joint straight. Is the flexible comfort orthotic the only answer for a patient that strongly refuses surgery?

Ian
I always assess and cast all my sports patient post sport.
I got caught out once by a patient whose gastrocs tightened post sport and when my casts produced a high arched device, arch pain and blistering ocurred.
I suppose this should also be done on any patient where fatigue is considered to be part of the etiology.

Phil