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Test-retest reliability of a clinical foot assessment device for measuring first metatarsophalangeal joint quasi-stiffness

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journal contribution
posted on 2020-09-04, 14:49 authored by Yixuan Leow, Pui Wah Kong, Yimin Liu, Jing W Pan, Daniel FongDaniel Fong, Chi C Chan, Marabelle L Heng
Background: The stiffness of the first metatarsophalangeal joint (MTPJ) is of interest in cases such as hallux rigidus and apropulsive gait. Subjective rating of joint mobility as ‘hypermobile, normal, or stiff’ is an unreliable method. Previous instruments for the assessment of first MTPJ stiffness can be too hard and uncomfortable for test subjects. Recently, a new device using a load cell and optical fiber with fiber Bragg grating (FBG) sensors was developed to provide a comfortable means of clinical foot assessment. This study aimed to evaluate the test-retest reliability of this FBG-load cell device in measuring the first MTPJ quasi-stiffness.
Methods: The left foot of 13 female subjects were measured twice for their first MTPJ quasistiffness, approximately seven days apart. The FBG-load cell device measured the MTPJ range of motion from a resting position to maximum dorsiflexion and then returning to the resting start-position. The force applied by a clinician to displace the toe was simultaneously recorded using a load cell. The quasi-stiffness over the “working range” in loading and unloading directions were determined from the slope of the torque-angular displacement graph. The test-retest reliability of the MTPJ quasi-stiffness was evaluated using intra-class correlation coefficient [ICC (2,1)].
Results: The reliability was almost perfect for MTPJ quasi-stiffness over the loading phase (ICC = 0.814), moderate for MTPJ quasi-stiffness over the unloading phase (ICC = 0.477) and moderate for MTPJ maximum range (ICC = 0.486).
Conclusion: The foot assessment device based on FBG and load cell was able to reliably measure the first MTPJ quasi-stiffness in a clinical setting. The measurement reliability was higher during the loading phase than the unloading phase.


Singapore Ministry of Education Academic Research Fund, Tier 1 Grant.



  • Sport, Exercise and Health Sciences

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The Foot






  • AM (Accepted Manuscript)

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This paper was accepted for publication in the journal The Foot and the definitive published version is available at https://doi.org/10.1016/j.foot.2020.101742.

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Dr Daniel Fong. Deposit date: 2 September 2020

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