• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.162-168
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• 2012

Accessory navicular is a congenital anomaly of the tuberosity of the navicular from a secondary ossification center. The accessory navicular is occasionally the source of pain and local tenderness over the medial side of midfoot. If conservative treatment fails for the painful accessory navicular, surgical treatment is required. There are several surgical option for accessory navicular, which vary from simple excision, percutaneous drilling, modified Kidner procedure and osteosynthesis of the accessory ossicle to the navicular body. In addition, symptomatic flatfoot deformity should be addressed concomitantly.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.2
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• pp.19-22
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• 2013

Background: Excessive pronation of the feet can cause excessive inner rotation of the femur, followed by increased stress in the gluteus maximum, increased front slope of the pelvis, and lumbar lordosis, which leads to lumbar pain. The aim of the present study was to use the navicular drop test to examine foot pronation that can cause lumbar lordosis and to determine whether the navicular drop is lower in patients diagnosed with lumbar disc than in patients without this diagnosis. Methods: The Navicular Drop score was set by subtracting the navicular height at a standing position from the navicular height in a sitting position. The Navicular Drop measurements for college student with and without Lumbar Herniated Intervertebral Disc were compared using an independent t-test. Results: The control group were measured right $7.44{\pm}2.96$ and left $8.04{\pm}3.23$. The experimental group were measured right $2.12{\pm}1.33$ and left $2.80{\pm}1.29$. Therefore significant difference was found between the two groups (p<0.05). Conclusions: The navicular drop affected lumbar herniated intervertebral disc.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.29-33
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• 2010

Purpose: This study was designed to investigate inter-rater and intra-rater reliability of navicular drop measurements by clinicians in sitting and standing positions. Methods: Fourteen subjects with pronated foot were recruited. Two physical therapists randomly assessed the same patients on different occasions but on the same day. Almost all patients were assessed on more than one day. The intra-rater and inter-rater reliability of navicular dropwas estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of navicular drop measurements ranged from 0.93 to 0.87, the inter-rater reliability from 0.98 to 0.70 with the patient in standing and sitting positions. These results showed good reliability for calculated variables. Intra-rater and inter-rater reliability of navicular drop in standing position was higher than those of sitting position. Conclusion: Although inter-rater and intra-rater reliability of navicular drop in the sitting position was lower than in the standing position, measurement of navicular drop in the sitting position showed good reliability and was acceptable for patients who could not stand alone without assistance. We recommend that having the patient in the standing position is appropriate in navicular drop measurement.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.222-227
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• 2019

Purpose: This study examined the influence of longitudinal arch on the strength and muscle activity of the abductor hallucis in the standing position in subjects with and without navicular drop signs. Methods: A sample of 34 subjects with and without navicular drop signs between 22 and 28 years of age were enrolled in this study. The strength and muscle activity of the abductor hallucis was measured using a tensiometer. The Smart KEMA System and electromyography device was used on the subjects with and without navicular drop signs. Two groups were classified using the navicular drop test to identify the longitudinal arch of the foot. The strength of the abductor hallucis was evaluated in standing, both with and without an external arch support condition. The two-way mixed ANOVA was used. The level of statistical significance was set to ${\alpha}=0.05$. Results: The strength and muscle activity of the abductor hallucis in standing was significantly higher with external arch support than that without the external arch support in the group with navicular drop signs. There was no significant difference in the abductor hallucis strength and muscle activity with and without external arch support in the subjects without navicular drop signs. Conclusions: The strength and muscle activity of the abductor hallucis in standing can be influenced by the external arch support in the group with navicular drop signs. The strength measurement of the abductor hallucis in standing should be separately performed in conditions with and without longitudinal arch of foot.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.161-165
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• 2004

Purpose: To analyze clinical symptom and clinical course of accessory navicular bone and to evaluation of surgery of accessory navicular bone in sports players Materials and Methods: Twenty-two patients with accessory navicular bone were identified between January 1 2001 and June 30. 2003 Results: Subjective satisfaction of 23 patients rated very satisfaction (16), satisfaction (6), common (1). Symptomatic pain were thoroughly disappeared at average 2.5 months ($1{\sim}6$ months) after operation. On one year follow-up, most of patients could maintain daily life and could go back to their sports carreer at 3 months. Conclusion: In athlete, excision of accessory navicular and reattachment of posteior tibial tendon to navicular like non-athletes is the best solution to management of symptomatic accessory navicular failed to manage conservatively.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.1
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• pp.1-8
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• 2010

Purpose : This study aimed to examine the relationships among five clinical measures for functional alignment of the lower extremity. Methods : Thirty healthy subjects (15 males and 15 females) were recruited for the study. The five clinical measures of functional alignment of the lower extremity included navicular drop, quadriceps angle, internal rotation of hip, and anterior and lateral pelvic tilt angles. The level of navicular drop was calculated by the difference between the height of the navicular bone in the sitting (non-weight bearing) and standing (weight bearing) positions. The quadriceps angle and internal rotation of hip were measured using a standard goniometer with photographic markers while the subjects were lying in a prone position on a table with their knee at $90^{\circ}$ flexion. Anterior and lateral pelvic tilt angles were determined using a inclinometer. Results : Correlation and a simple linear regression analysis were used to assess relationships between the clinical measures. There were significant correlations between navicular drop and quadriceps angle (p<.05), between navicular drop and internal rotation of hip (p<.05), and between quadriceps angle and internal rotation of hip (p<.01). In simple linear regression analysis, the navicular drop appeared to be a factor affecting the quadriceps angle and internal rotation of hip (p<.05). The findings suggest that navicular drop has a great impact on lower extremity alignment. Conclusion : This study might help us to examine lower extremity function and clarify its role as a potential injury risk factor.

• PNF and Movement
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• v.19 no.2
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• pp.279-285
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• 2021

Purpose: This study aimed to develop new digital navicular drop test (ND-NDT) equipment and to determine its validity and reliability. Methods: A total of 24 healthy male and female adults, who fully understood the purpose of the study and gave consent to participate in the study, were selected as participants. The NDT and ND-NDT were conducted in the dominant foot of the participants in a random order. For the NDT, the position of the navicular bone was marked with a pen first; then, the height of the navicular bone from the ground was measured in both sitting and standing positions. For the ND-NDT, after the sticker-type reflection markers were attached to the position of the navicular bone, the height of the navicular bone from the ground was measured in both sitting and standing positions. To assess the validity of the diagnostic tests, the same examiner measured the height of the medial longitudinal arch (MLA) three times in both the sitting and standing positions. To assess the inter-rater reliability of the ND-NDT, three examiners, in a random order, attached the sticker-type reflection markers to the position of the navicular bone and then measured the height of the MLA in both positions. Results: In the sitting position, the Pearson correlation coefficient (r) between the two diagnostic tests was very high (r = 0.97) and statistically significant. In the standing position, the Pearson correlation coefficient (r) between the two tests was 0.95, which was also statistically significant. The ICC_2,1 values in the sitting and standing positions were 0.93 and 0.95, respectively, indicating significantly high inter-rater reliability. Conclusion: The ND-NDT equipment showed very high diagnostic validity, as well as excellent inter-rater reliability, indicating the clinical usefulness of the equipment as a diagnostic system for confirming pes planus.

• Journal of Korean Physical Therapy Science
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• v.26 no.1
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• pp.9-14
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• 2019

Background: Pes planus, or flat foot, causes lower limb malalignment and foot pain during walking or exercise. Therefore, a highly reliable evaluation method to accurately diagnose flat feet is necessary. This study investigated the intra-and inter-rater reliability of the navicular drop test in different postures. Design: Cross sectional study. Methods: Forty healthy volunteers performed the navicular drop test in three different combinations of non-weight-bearing and weight-bearing postures (standing/standing, sitting/sitting, and sitting/standing). Two examiners alternately performed the measurements five times in each subject, and in each posture. Significant differences in measurements were obtained among the three postures, with the highest navicular drop being observed in the sitting/standing posture. Results: Inter-rater reliability was high in the sitting/standing and sitting/sitting postures. Intra-rater reliability was high in all three postures. In the sitting/sitting and sitting/standing postures, large navicular drop values and high inter- and intra-rater reliability were observed. Conclusion: Therefore, the sitting/standing and sitting/sitting postures are recommended for use in navicular drop tests to diagnose flat feet.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.36-40
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• 2010

Purpose: To investigate the results of surgical treatment of the symptomatic accessory navicular in adolescent. Materials and Methods: 11 patients who were 11-16 years old with symptomatic accessory navicular were identified between 2001 and 2009. Six cases were diagnosed after trauma and 8 cases were diagnosed by accident with painful bony protrusion on medial aspect of foot. In cases after at least 3 months of ineffective conservative treatment, patients were treated by resection of accessory navicular and reattachment of tibialis posterior tendon to the apex of the medial longitudinal arch using periosteum and ligamentous soft tissue without transposition of its course. And then short leg cast was applied for correction of the flat foot (if it is combined) which was molded into the longitudinal arch with the talonavicular joint released and foot inverted during about 6 weeks. Results: All were type II accessory navicular without tibialis posterior tendon lesions. In most cases pain was improved, results were excellent in seven and good in four. Calcaneal pitch angle and talus-first metatarsal angle was improved about $4.64^{\circ}$ and $5.79^{\circ}$ in average. Conclusion: Symptomatic accessory navicular in adolescent might not be associated with the tibialis posterior tendon lesions. The surgical treatment composed of excision of the accessory navicular with simple replication of the tibialis posterior tendon without altering its course led to good results in most cases. The procedure has a low rate of complications. And it is easy to be performed with a good satisfaction.

• Korean Journal of Applied Biomechanics
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• v.16 no.1
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• pp.65-79
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• 2006

The purpose of this study was firstly to investigate correctional function of custom semi-rigid foot orthotics for excessively pronated people during gait by observing comfort, navicular movement and leg muscles' activity according to short-term and mid-term wearing duration and secondly to understand positive and/or negative point of view of a recently proposed paradigm related to foot orthotics more profoundly. Sixteen subjects who showed excessive pronation at navicular drop test were recruited for this study. Custom semi-rigid foot orthotics were made fitting for foot characteristics of the subjects by podiatry division of Otto Bock Korea company. While wearing the foot orthotics for two months, comfort of wearing were questioned and vertical navicular movement and electromyography of leg muscles during gait were measured at the condition of both immediately after and 2 months after including a control condition, respectively. The subjects were required to walk on a treadmill at the speed of 1.5m/s and four digital video camera filmed the movement of navicular process at the speed of 60 frames/s. In conclusion, in excessively pronated group continuous increase of comfort from short-term to mid-term wearing of custom foot orthotics is assumed to be closely related with short-term and mid term correctional action, of which are consisted the decrease of the range of navicular drop and navicular raisins- the faster timing of minimum navicular position occurring, and the decrease of leg muscles' activities. This conclusion could lead to positively accept new paradigm related to foot orthotics suggested by Nigg and the author suggest that in the future study the variable which could observe navicular movement would be one of major variables to study preferred path of skeleton in the paradigm.