Inter-professional assessment of Posterior Tibial Tendon Dysfunction and its timely diagnosis.

Posterior tibial tendon dysfunction (PTTD) is a progressive deformity which can result in the development of a pathological flat foot deformity. A mixed methods approach has been adopted for this study. This blended philosophical stance has embodied both inductive and deductive paradigms to provide a robust exploration, not possible when adopting just one approach.
The results presented within this thesis clearly demonstrates that there is inconsistency in the way in which clinicians practise when it comes to the assessment and diagnosis of PTTD. The tests that clinicians select for inclusion in the assessment of PTTD is problematic and differ significantly both within and across different professional groups.
The results provide a unique insight into the approaches to assessment and diagnosis among podiatry and physiotherapy advanced musculoskeletal practitioners. Following quantitative data acquisition and investigation of some of the most popularised clinical tests referred to by clinicians and highlighted as important during the content and thematic analysis sections, a novel contribution to this research foci is provided.
Findings clearly illustrate a lack of standardisation of the assessment and diagnosis of PTTD and with aligning evidence and research findings to clinical practice. The quantitative investigation and results have shown that reliance on these clinical tests in providing worthwhile and informative clinical information to aid in the assessment and diagnosis of PTTD is lacking. Navicular drift and navicular drop have been investigated and found not to be significantly different to a non-PTTD population. The single heel rise test, often used in a diagnostic capacity for PTTD, has been investigated and the results are not statistically dissimilar between PTTD and control participants.
Overall the results of this study confirm that PTTD receives a varied response to identification, assessment and diagnosis from specialist practitioners. Furthermore some of the tests confirmed by qualitative inquiry as being important to clinicians in the assessment process should not be relied on to differentiate pathology from non-pathological.