Skip to main content
Top
Published in: Journal of Foot and Ankle Research 1/2016

Open Access 01-12-2016 | Research

Clinical measures of static foot posture do not agree

Authors: Ben Langley, Mary Cramp, Stewart C. Morrison

Published in: Journal of Foot and Ankle Research | Issue 1/2016

Login to get access

Abstract

Background

The aim of this study was to determine the level of agreement between common clinical foot classification measures.

Methods

Static foot assessment was undertaken using the Foot Posture Index (FPI-6), rearfoot angle (RFA), medial longitudinal arch angle (MLAA) and navicular drop (ND) in 30 participants (29 ± 6 years, 1.72 ± 0.08 m, 75 ± 18 kg). The right foot was measured on two occasions by one rater within the same test environment. Agreement between the test sessions was initially determined for each measure using the Weighted Kappa. Agreement between the measures was determined using Fleiss Kappa.

Results

Foot classification across the two test occasions was almost perfect for MLAA (Kw = .92) and FPI-6 (Kw = .92), moderate for RFA (Kw = .60) and fair for ND (Kw = .40) for comparison within the measures. Overall agreement between the measures for foot classification was moderate (Kf = .58).

Conclusion

The findings reported in this study highlight discrepancies between the chosen foot classification measures. The FPI-6 was a reliable multi-planar measure whereas navicular drop emerged as an unreliable measure with only fair agreement across test sessions. The use of this measure for foot assessment is discouraged. The lack of strong consensus between measures for foot classification underpins the need for a consensus on appropriate clinical measures of foot structure.
Literature
1.
go back to reference Razeghi M, Batt ME. Foot type classification: a critical review of current methods. Gait Posture. 2002;15:282–91.CrossRefPubMed Razeghi M, Batt ME. Foot type classification: a critical review of current methods. Gait Posture. 2002;15:282–91.CrossRefPubMed
2.
go back to reference Song J, Hillstrom HJ, Secord D, et al. Foot type biomechanics: comparison of planus and rectus foot types. J Am Podiatr Med Assoc. 1996;86:16–23.CrossRefPubMed Song J, Hillstrom HJ, Secord D, et al. Foot type biomechanics: comparison of planus and rectus foot types. J Am Podiatr Med Assoc. 1996;86:16–23.CrossRefPubMed
3.
go back to reference Cobb SC, Bazett-Jones DM, et al. The relationship among foot posture, core and lower extremity muscle function, and postural stability. J Athl Train. 2014;49:173–80.CrossRefPubMedPubMedCentral Cobb SC, Bazett-Jones DM, et al. The relationship among foot posture, core and lower extremity muscle function, and postural stability. J Athl Train. 2014;49:173–80.CrossRefPubMedPubMedCentral
4.
go back to reference Nakhaee Z, Rahimi A, Abaee M, et al. The relationship between the height of the medial longitudinal arch (MLA) and the ankle and knee injuries in professional runners. Foot. 2008;18:84–90.CrossRef Nakhaee Z, Rahimi A, Abaee M, et al. The relationship between the height of the medial longitudinal arch (MLA) and the ankle and knee injuries in professional runners. Foot. 2008;18:84–90.CrossRef
5.
go back to reference Tong JW, Kong PW. Association between foot type and lower extremity injuries: systematic literature review with meta-analysis. J Orthop Sports Phys Ther. 2013;43:700–14.CrossRefPubMed Tong JW, Kong PW. Association between foot type and lower extremity injuries: systematic literature review with meta-analysis. J Orthop Sports Phys Ther. 2013;43:700–14.CrossRefPubMed
6.
go back to reference Root ML, Orien WP, Weed JH. Normal and Abnormal Function of the Foot. Clinical Biomechanics – Volume II. Los Angeles: Clinical Biomechanics Corporation; 1977. Root ML, Orien WP, Weed JH. Normal and Abnormal Function of the Foot. Clinical Biomechanics – Volume II. Los Angeles: Clinical Biomechanics Corporation; 1977.
7.
go back to reference Root ML, Orien WP, Weed JH, Hughes RJ. Biomechanical Examination of the Foot. Clinical Biomechanics– Volume I. Los Aangeles: Clinical Biomechanics Corporation; 1971. Root ML, Orien WP, Weed JH, Hughes RJ. Biomechanical Examination of the Foot. Clinical Biomechanics– Volume I. Los Aangeles: Clinical Biomechanics Corporation; 1971.
8.
go back to reference Piccano AM, Rowlands MS, Worrell T. Reliability of Open and Closed Kinetic Chain Subtalar Joint Neutral Positions and Navicular Drop Test. J Orthop Sports Phys Ther. 1993;18:553–8.CrossRef Piccano AM, Rowlands MS, Worrell T. Reliability of Open and Closed Kinetic Chain Subtalar Joint Neutral Positions and Navicular Drop Test. J Orthop Sports Phys Ther. 1993;18:553–8.CrossRef
9.
go back to reference Griffiths I. Overpronation: Accurate or parachronistic terminology? SportEx Dynamics. 2012;32:10–3. Griffiths I. Overpronation: Accurate or parachronistic terminology? SportEx Dynamics. 2012;32:10–3.
10.
go back to reference McPoil TG, Hunt GC. Evaluation and Management of Foot and Ankle Disorders: Present Problems and Future Directions. J Orthop Sports Physl Ther. 1995;21:381–8.CrossRef McPoil TG, Hunt GC. Evaluation and Management of Foot and Ankle Disorders: Present Problems and Future Directions. J Orthop Sports Physl Ther. 1995;21:381–8.CrossRef
11.
go back to reference Xiong S, Goonetilleke RS, Witana CP, et al. Foot arch characterization: a review, a new metric, and a comparison. J Am Podiatr Med Assoc. 2010;100:14–24.CrossRefPubMed Xiong S, Goonetilleke RS, Witana CP, et al. Foot arch characterization: a review, a new metric, and a comparison. J Am Podiatr Med Assoc. 2010;100:14–24.CrossRefPubMed
12.
go back to reference McPoil TG, Cornwall MW. Use of the Longitudinal Arch Angle to Predict Dynamic Foot Posture in Walking. J Am Podiatr Med Assoc. 2005;95:114–20.CrossRefPubMed McPoil TG, Cornwall MW. Use of the Longitudinal Arch Angle to Predict Dynamic Foot Posture in Walking. J Am Podiatr Med Assoc. 2005;95:114–20.CrossRefPubMed
13.
go back to reference Redmond AC, Crosbie AC, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech. 2006;21:89–98.CrossRef Redmond AC, Crosbie AC, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech. 2006;21:89–98.CrossRef
14.
go back to reference Murley GS, Menz HB, Landorf KB. A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements. J Foot Ankle Res. 2009;2:22.CrossRefPubMedPubMedCentral Murley GS, Menz HB, Landorf KB. A protocol for classifying normal- and flat-arched foot posture for research studies using clinical and radiographic measurements. J Foot Ankle Res. 2009;2:22.CrossRefPubMedPubMedCentral
15.
go back to reference Menz HB, Munteanu SE. Validity of 3 clinical techniques for the measurement of static foot posture in older people. J Orthop Sports Phys Ther. 2005;35:479–86.CrossRefPubMed Menz HB, Munteanu SE. Validity of 3 clinical techniques for the measurement of static foot posture in older people. J Orthop Sports Phys Ther. 2005;35:479–86.CrossRefPubMed
16.
go back to reference Billis E, Katsakiori E, Kapodistrias C, Kapreli E. Assessment of foot posture: Correlation between different clinical techniques. Foot. 2007;17:65–72.CrossRef Billis E, Katsakiori E, Kapodistrias C, Kapreli E. Assessment of foot posture: Correlation between different clinical techniques. Foot. 2007;17:65–72.CrossRef
17.
go back to reference Mathieson I, Upton D, Prior TD. Examining the validity of selected measures of foot type: a preliminary study. J Am Podiatr Med Assoc. 2004;94:275–81.CrossRefPubMed Mathieson I, Upton D, Prior TD. Examining the validity of selected measures of foot type: a preliminary study. J Am Podiatr Med Assoc. 2004;94:275–81.CrossRefPubMed
18.
go back to reference Cobey JC, Sella E. Standardizing methods of measurement of foot shape by including the effects of subtalar rotation. Foot Ankle. 1981;2:30–6.CrossRefPubMed Cobey JC, Sella E. Standardizing methods of measurement of foot shape by including the effects of subtalar rotation. Foot Ankle. 1981;2:30–6.CrossRefPubMed
19.
go back to reference Hawes MR, Nachbauer W, Sovak D, et al. Footprint parameters as a measure of arch height. Foot Ankle. 1992;13:22–6.CrossRefPubMed Hawes MR, Nachbauer W, Sovak D, et al. Footprint parameters as a measure of arch height. Foot Ankle. 1992;13:22–6.CrossRefPubMed
20.
go back to reference Jarvis HL, Nester CJ, Jones RK, et al. Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle. J Foot Ank Res. 2012;5:14.CrossRef Jarvis HL, Nester CJ, Jones RK, et al. Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle. J Foot Ank Res. 2012;5:14.CrossRef
21.
go back to reference Menz HB. Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine. Foot. 2004;14:2–5.CrossRef Menz HB. Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine. Foot. 2004;14:2–5.CrossRef
24.
go back to reference Jonson SR, Gross MT. Intraexaminer reliability, interexaminer reliability and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther. 1997;25:253–63.CrossRefPubMed Jonson SR, Gross MT. Intraexaminer reliability, interexaminer reliability and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther. 1997;25:253–63.CrossRefPubMed
25.
go back to reference Brody DM. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982;13:541–58.PubMed Brody DM. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982;13:541–58.PubMed
26.
go back to reference Keenan AM, Redmond AC, Horton M, et al. The Foot Posture Index: Rash analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007;88:88–93.CrossRefPubMed Keenan AM, Redmond AC, Horton M, et al. The Foot Posture Index: Rash analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007;88:88–93.CrossRefPubMed
27.
go back to reference Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33:159–74.CrossRefPubMed Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33:159–74.CrossRefPubMed
28.
go back to reference McPoil TG, Cornwall MW, Abeler MG, et al. The optimal method to assess the vertical mobility if the midfoot: Navicular drop versus dorsal arch height difference? Clin Res Foot Ankle. 2013;1:104.CrossRef McPoil TG, Cornwall MW, Abeler MG, et al. The optimal method to assess the vertical mobility if the midfoot: Navicular drop versus dorsal arch height difference? Clin Res Foot Ankle. 2013;1:104.CrossRef
29.
go back to reference Evans AM, Copper AW, Scharfbillig RW, Scutter SD, Williams MT. Reliability of the Foot Posture Index and Traditional Measures of Foot Position. J Am Podiatr Med Assoc. 2003;93:203–13.CrossRefPubMed Evans AM, Copper AW, Scharfbillig RW, Scutter SD, Williams MT. Reliability of the Foot Posture Index and Traditional Measures of Foot Position. J Am Podiatr Med Assoc. 2003;93:203–13.CrossRefPubMed
30.
go back to reference Langley B, Cramp M, Morrison SC. Selected static foot assessments do not predict medial longitudinal arch motion during running. J Foot Ank Res. 2015;8:56.CrossRef Langley B, Cramp M, Morrison SC. Selected static foot assessments do not predict medial longitudinal arch motion during running. J Foot Ank Res. 2015;8:56.CrossRef
Metadata
Title
Clinical measures of static foot posture do not agree
Authors
Ben Langley
Mary Cramp
Stewart C. Morrison
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2016
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-016-0180-3

Other articles of this Issue 1/2016

Journal of Foot and Ankle Research 1/2016 Go to the issue