![]() Based on intraclass correlation coefficients, the intra-rater reliability ranged from 0.91 to 0.97 for the four raters. Four raters had from one to six years of clinical experience and were trained by a single instructor with two years experience performing the NDT. In a more recent study, Shultz et al attempted to determine whether multiple raters with varying years of clinical experience could be trained to perform the NDT with acceptable reliability and precision. Using intraclass correlation coefficients, the intra-rater reliability for the four raters ranged from 0.51 to 0.77 with the inter-rater reliability 0.46. The mean navicular drop was 7.2 mm with the range from 0 to 20 mm. To investigate whether examiner experience influenced intra-rater reliability of the NDT, Evans et al assessed the reliability of the NDT in 30 adults using four different podiatric physicians who had previous experience performing the NDT. A possible issue with these previous studies was that all examiners were inexperienced in performing the NDT. Intra-rater reliability of the NDT, assessed using the intraclass correlation coefficient (ICC) has been reported to be between 0.61 and 0.79. The mean NDT value for these studies was 7.3 ± 3.8 mm. Studies have reported NDT values ranging from 6 to 9 mm with standard deviations of between 3.4 and 4.2 mm. ![]() Since Brody's initial description of the NDT, several authors have attempted to determine the reliability of the measurement as well as establish normative values in a healthy population. In addition, he did not indicate whether the NDT demonstrated high levels of intra-rater and inter-rater reliability. While Brody indicated that the NDT was an office procedure that he used to assess the amount of foot pronation, he failed to provide any normative data to explain the navicular drop values he provided in his paper. Brody further noted that a normal amount of navicular drop was approximately 10 mm and that a drop or change in navicular height of 15 mm or more was abnormal. To determine the degree of navicular drop, Brody stated that the height of the navicular bone in subtalar joint neutral position is subtracted from the height of the navicular bone in relaxed standing posture. The patient was then asked to relax their feet and the resulting lower position of the navicular bone was also marked on the card. The patient's subtalar joint was first placed in neutral position using palpation and the height of the navicular bone from the floor was marked on an index card placed on the medial aspect of the foot. Brody stated that the NDT was performed with the patient standing on a firm surface with the navicular bone marked bilaterally. Brody was one of the first to describe the NDT and he noted that it was helpful in evaluating the amount of foot mobility, specifically pronation, in runners. The NDT has also been associated with lower limb musculoskeletal injuries. The navicular drop test (NDT) has been widely used as a clinical method to assess foot mobility. The results of the current study suggest that the change in dorsal arch height during the Sit-to-Stand test offers the clinician a reliable and valid alternative to the navicular drop test. While the navicular drop test has been widely used as a clinical method to assess foot mobility, poor levels of inter-rater reliability have been reported. ![]() The change in arch height during the Sit-to-Stand test was shown to have good to high levels of intra- and inter-reliability as well as validity using x-rays as the criterion measure. ![]() The mean difference in dorsal arch height between non-weight bearing and weight bearing was 10 millimeters. The reliability and validity of the measurements were then determined. The dorsal arch height was measured at 50% of the total length of the foot on both weight bearing and non-weight bearing images to determine the change in dorsal arch height. The medial aspect of each foot was photographed with a digital camera while each participant stood with 50% body weight on each foot as well as in sitting for a non-weight bearing image. Two hundred – seventy five healthy participants participated in the study. A study was conducted to determine the reliability and validity of a new foot mobility assessment method that utilizes digital images to measure the change in dorsal arch height measured at 50% of the length of the foot during the Sit-to-Stand test. ![]()
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