An objective and standardized test of foot function: Normative values and validation in patients with reflex sympathetic dystrophy

Objective: To describe and obtain normative values for an objective and standardized test of foot function, and to validate the test in patients with impaired function of 1 leg. Design: A series of 4 standardized and objectively measured subtests, representing common foot activities in daily living, was devised. Setting: University hospital. Participants: Normative values were obtained for 100 healthy patients between 20 and 70 years of age. For validation purposes, the test was also performed by 20 patients diagnosed with reflex sympathetic dystrophy of 1 foot. Main Outcome Measures: Several basic aspects of individual foot function were evaluated: (1) forward and backward shifting (FBS) of a foot panel; (2) lateral shifting (LS) of a foot panel; (3) alternately touching 2 bells (TB); and (4) depressing a pedal (DP). (The tests were performed while seated; hence, they are applicable to patients unable to walk.) Comparison with results on a battery of other clinical function tests was assessed. Results: The intrarater and interrater reliabilities of the test were high (eg, intrarater correlation coefficients ranged from .74 to .93; interrater from .85 to .99). Results were influenced by sex and dominance, but were not influenced by height, weight, or shoe size. Age and leisure activities involving foot function influenced 1 subtest only (depressing a pedal). Results of the affected side in patients were higher than normative values although, to a lesser extent, the same was true for the unaffected side. Footboard results did not correlate with results of other function tests, except myometry, suggesting that it provides additional information. In contrast to the other tests, and like myometry, the footboard distinguished patients who were crutch dependent from those who were not. Conclusion: The footboard is a valuable addition to current tests for assessing foot function.