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Effect of a modified, low-dye medial longitudinal arch taping procedure on the subtalar joint neutral position before
Clayton F Holmes1, Donald Wilcox, James P Fletcher
1Department of Physical Therapy, University of Central Arkansas, Conway 72035-0001, USA. holmesc@mail.uca.edu
Study Design:
Single-group repeated measures design pre- and postintervention.
Objectives:
To determine if the modified low-Dye medial longitudinal arch (MLA) taping procedure places the subtalar joint into the neutral position and maintains the subtalar joint neutral (STJN) position following 10 minutes of walking.
Background:
Subtalar malalignment in excessive pronation is commonly accepted as a contributing factor to a variety of musculoskeletal pathologies. The modified low-Dye MLA taping procedure is often used on the plantar surface of the foot as a short-term corrective tool for excessive foot pronation. However, research that evaluates the efficacy of this taping technique during light exercise is lacking. Measurement of navicular height is commonly used as a measure of subtalar position.
Methods And Measures:
Prior to the study, one tester-established reliability in the navicular drop technique measurement by initially practicing the measurements on 400 feet, followed by a reliability study performed on 29 subjects. In this study, a screening procedure excluded subjects with ankle or foot pathology, supinated feet, or neutral feet, and included only subjects with pronated feet. The study, which included 40 subjects, involved four steps: (1) measuring navicular height in the relaxed position; (2) measuring navicular height in the STJN position; (3) measuring navicular height after application of the modified low-Dye MLA taping procedure; and (4) measuring navicular height after subjects had walked for 10 minutes with the taping.
Results:
Results indicated an intrarater intraclass correlation coefficient (ICC) for measuring navicular height of 0.96 for the right foot and 0.94 for the left foot. Repeated measures ANOVA revealed that significant differences existed (P < 0.05) among the 4 measures. A Bonferroni post hoc analysis showed a difference between relaxed stance measurements and all other measurements, and between taped-prewalking measurements and taped-postwalking measurements. In addition, no significant difference was observed between navicular height measured in STJN and the taped-prewalking and taped-postwalking conditions. The average navicular height for the taped-prewalking condition was 1.6 mm higher than that for the STJN position. For the taped-postwalking condition, the average height of the navicular was 1.2 mm lower than that of the STJN position.
Conclusion:
These results demonstrate that the modified low-Dye MLA taping procedure places the subtalar joint near the neutral position. Despite a significant reduction in the height of the navicular after the subjects walked for 10 minutes with the tape on, the height of the navicular was still not significantly different than that of the STJN position.