Test de descenso del navicular / Navicular descent test

Objetivo: revisar críticamente la literatura sobre la validez y fiabilidad del test de descenso del navicular como herramienta clínica de evaluación de la pronación del pie. Método: Se ha realizado una revisión de la literatura existente sobre el tema en las principales bases de datos de ciencias de la salud. Para realizar la búsqueda se emplearon los terminos MeSH (navicular drop, pronation, foot) interconectados con los respectivos conectores booleanos. Resultados: Se seleccionaron finalmente un total de 38 artículos científicos en castellano e inglés sobre la fiabilidad y validez interna del test. Conclusiones: El test de descenso del navicular es una herramienta ampliamente utilizada en estudios de investigación. Sin embargo, con la evidencia disponible, podemos afirmar que la fiabilidad y validez interna del test es cuanto menos cuestionable para que este pueda ser usado con fines de investigación. (AU)

Combined Chiropractic and Podiatric Treatment for Chronic Low Back Pain Concomitant With a Unilateral Pronated Foot: Protocol for a Multicenter Pilot Randomized Controlled Trial.

Objective: The purpose of this article is to describe a protocol to examine the feasibility of combining podiatric orthotic treatment with multimodal chiropractic treatment to treat chronic low back pain (CLBP) in those with a functional short leg on the same side as a unilateral pronated foot. Methods: This is a protocol for a multicenter feasibility 2-arm parallel randomized controlled trial. One hundred and thirty-two adults with CLBP and a functional short leg on the same side as a unilateral pronated foot are to be recruited in Melbourne, Australia, and Madrid and Seville, Spain. Forty-four participants at each site are to be randomized to multimodal chiropractic treatment including spinal manipulation or to multimodal chiropractic treatment also involving spinal manipulation, together with podiatric custom-made orthoses. Chiropractic visits are to comprise 12 treatments over 4 weeks. Outcome measures will be recruitment, compliance, costs, CLBP-related disability, and perceived low back pain. Results: Feasibility results will be reported in text format and the clinical data reported using descriptive statistics focusing on any clinically significant results. Conclusion: This protocol describes a feasibility study for assessing the combination of podiatric orthotic treatment with multimodal chiropractic treatment to treat CLBP in those with a functional short leg on the same side as a unilateral pronated foot.

Association of Mild Leg Length Discrepancy and Degenerative Changes in the Hip Joint and Lumbar Spine.

OBJECTIVE: The purpose of this study was to evaluate the correlation between mild leg length discrepancy (LLD) and degenerative joint disease (DJD) or osteoarthritis. METHODS: We evaluated standard postural lumbopelvic radiographs from 255 adults (121 women and 134 men) who had presented with spinal pain for chiropractic care. Symmetry of femoral head diameters was used to exclude magnification errors. Pearson's partial correlation was used to control for age and derive effect sizes for LLD on DJD in the hip and lower lumbar motion segments. Krippendorff's α was used for intraobserver and interobserver reliability. RESULTS: A strong correlation was found between LLD and hip DJD in men (r = 0.532) and women (r = 0.246). We also found a strong correlation between LLD and DJD at the L5-S1 motion segment in men (r = 0.395) and women (r = 0.246). At the L4-5 spinal level this correlation was much attenuated in men (r = 0.229) and women (r = 0.166). CONCLUSIONS: These findings suggest an association between LLD and hip and lumbar DJD. Cause-effect relationships between mild LLD and DJD deserve to be properly evaluated in future longitudinal cohort studies.