Effect of patient position on the consistency of placing the rearfoot at subtalar neutral

The ability of foot care specialists to place a rearfoot at the subtalar neutral position is important for the care of patients who require foot orthosis prescription, fabrication, and management. Although some clinicians perform this procedure with the patient in the prone position, others prefer a seated or standing approach. This study examined whether patient position and preferred patient position influence the ability of clinicians to place a subject's rearfoot at the subtalar neutral position. The results suggest the following: a clinician's ability to find the subtalar neutral position is better with a seated subject; clinicians do not necessarily perform better assessments on a subject in a position corresponding to their patient position preference; and clinicians who prefer their patients prone generally have more flexible and reproducible observations. In addition, the findings suggest that the nature and relative importance of the tactile and visual cues used by clinicians to place a rearfoot at the subtalar neutral position warrant further exploration.