Reliability and Validity of Shore Hardness in Plantar Soft Tissue Biomechanics

TY - JOUR

T1 - Reliability and Validity of Shore Hardness in Plantar Soft Tissue Biomechanics

AU - Tonna, Redent

AU - Chatzistergos, Panagiotis E.

AU - Wyatt, Otis

AU - Chockalingam, Nachiappan

N1 - Publisher Copyright: © 2024 by the authors.

PY - 2024/1

Y1 - 2024/1

N2 - Shore hardness (SH) is a cost-effective and easy-to-use method to assess soft tissue biomechanics. Its use for the plantar soft tissue could enhance the clinical management of conditions such as diabetic foot complications, but its validity and reliability remain unclear. Twenty healthy adults were recruited for this study. Validity and reliability were assessed across six different plantar sites. The validity was assessed against shear wave (SW) elastography (the gold standard). SH was measured by two examiners to assess inter-rater reliability. Testing was repeated following a test/retest study design to assess intra-rater reliability. SH was significantly correlated with SW speed measured in the skin or in the microchamber layer of the first metatarsal head (MetHead), third MetHead and rearfoot. Intraclass correlation coefficients and Bland–Altman plots of limits of agreement indicated satisfactory levels of reliability for these sites. No significant correlation between SH and SW elastography was found for the hallux, 5th MetHead or midfoot. Reliability for these sites was also compromised. SH is a valid and reliable measurement for plantar soft tissue biomechanics in the first MetHead, the third MetHead and the rearfoot. Our results do not support the use of SH for the hallux, 5th MetHead or midfoot.

AB - Shore hardness (SH) is a cost-effective and easy-to-use method to assess soft tissue biomechanics. Its use for the plantar soft tissue could enhance the clinical management of conditions such as diabetic foot complications, but its validity and reliability remain unclear. Twenty healthy adults were recruited for this study. Validity and reliability were assessed across six different plantar sites. The validity was assessed against shear wave (SW) elastography (the gold standard). SH was measured by two examiners to assess inter-rater reliability. Testing was repeated following a test/retest study design to assess intra-rater reliability. SH was significantly correlated with SW speed measured in the skin or in the microchamber layer of the first metatarsal head (MetHead), third MetHead and rearfoot. Intraclass correlation coefficients and Bland–Altman plots of limits of agreement indicated satisfactory levels of reliability for these sites. No significant correlation between SH and SW elastography was found for the hallux, 5th MetHead or midfoot. Reliability for these sites was also compromised. SH is a valid and reliable measurement for plantar soft tissue biomechanics in the first MetHead, the third MetHead and the rearfoot. Our results do not support the use of SH for the hallux, 5th MetHead or midfoot.

KW - diabetic foot

KW - elasticity imaging techniques

KW - foot

KW - hardness tests

KW - mechanical tests

KW - reliability and validity

KW - shear wave elastography

KW - soft tissue injuries

UR - https://www.scopus.com/pages/publications/85183228898

U2 - 10.3390/s24020539

DO - 10.3390/s24020539

M3 - Article

C2 - 38257632

AN - SCOPUS:85183228898

SN - 1424-8220

VL - 24

JO - Sensors

JF - Sensors

IS - 2

M1 - 539

ER -