aluation is carried out through the use of one hand to stabilize the four lateral metatarsals while the other hand of the examiner applies pressure on the head of the first metatarsals to cause a plantar or dorsal displacement. Even though this method is vague with reference only to inter-examiner reliability, manual testing could be adequate enough for a personal clinician to categorise the motion of the foot as being hypermobile, normal or stiff. Several comparisons with other patients are beneficial in assisting the clinician to determine whether the first foot is normal or not.
First Ray Examination: essentially, the first ray is an important part of the foot as it contributes to the movement and gait of a person. Since clinical evaluations have often found first ray abnormalities to be associated with the hillux rigidus, hallux valgus and metatarsus primus varus. Medical practitioners believe that there is a mechanical explanation for these pathologic conditions (Glasoe et al 1999). The mechanical movement of the foot is imperative to locomotion and therefore, abnormality will cause difficulties in movement.
Diagnosing a problem in the mobility of the first ray by using the manual model is achieved in this manner; with the ankle placed at a neutral position, a slight pressure is applied to dorsiflxion just below the first ray metatarsal head, there will be an inferior portion of the first metatarsal brought to the sagittal plane level of the smaller metatarsal heads (Cornwall et al (2004). In case the inferior element of the heads of the first ray metatarsal do not contact the smaller metatarsals’ plane, then the first ray is considered as stiff. However, in case the features of the first metatarsal head go beyond the smaller metatarsals plane, then the first Ray can be described as hypermobile (Voellmicke & Deland 2002).
Since theses diagnoses are critical in a clinical setting, their reliability and validity is equally important. This is because