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Published in: Journal of Foot and Ankle Research 1/2012

Open Access 01-12-2012 | Research

The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study

Authors: Angela M Evans, Keith Rome, Lauren Peet

Published in: Journal of Foot and Ankle Research | Issue 1/2012

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Abstract

Background

Outcome measures are important when evaluating treatments and physiological progress in paediatric populations. Reliable, relevant measures of foot posture are important for such assessments to be accurate over time. The aim of the study was to assess the intra- and inter-rater reliability of common outcome measures for paediatric foot conditions.

Methods

A repeated measures, same-subject design assessed the intra- and inter-rater reliability of measures of foot posture, joint hypermobility and ankle range: the Foot Posture Index (FPI-6), the ankle lunge test, the Beighton scale and the lower limb assessment scale (LLAS), used by two examiners in 30 healthy children (aged 7 to 15 years). The Oxford Ankle Foot Questionnaire (OxAFQ-C) was completed by participants and a parent, to assess the extent of foot and ankle problems.

Results

The OxAFQ-C demonstrated a mean (SD) score of 6 (6) in adults and 7(5) for children, showing good agreement between parents and children, and which indicates mid-range (transient) disability. Intra-rater reliability was good for the FPI-6 (ICC = 0.93 - 0.94), ankle lunge test (ICC = 0.85-0.95), Beighton scale (ICC = 0.96-0.98) and LLAS (ICC = 0.90-0.98). Inter-rater reliability was largely good for each of the: FPI-6 (ICC = 0.79), ankle lunge test (ICC = 0.83), Beighton scale (ICC = 0.73) and LLAS (ICC = 0.78).

Conclusion

The four measures investigated demonstrated adequate intra-rater and inter-rater reliability in this paediatric sample, which further justifies their use in clinical practice.
Literature
1.
go back to reference Rome K, Ashford RL, Evans AM: Non-surgical interventions for paediatric pes planus (Review). Cochrane Database Syst Rev. 2010, 7: DOI:10.1002/14651858.CD006311.pub2 Rome K, Ashford RL, Evans AM: Non-surgical interventions for paediatric pes planus (Review). Cochrane Database Syst Rev. 2010, 7: DOI:10.1002/14651858.CD006311.pub2
2.
go back to reference Evans AM: The flat-footed child - to treat or not to treat, what is the clinician to do?. J Am Podiatr Med Assoc. 2008, 98: 386-393.CrossRefPubMed Evans AM: The flat-footed child - to treat or not to treat, what is the clinician to do?. J Am Podiatr Med Assoc. 2008, 98: 386-393.CrossRefPubMed
3.
go back to reference Rose KJ, Burns J, North KN: Factors associated with foot and ankle strength in healthy pre-school aged children and age-matched cases of Charcot-Marie-Tooth disease type 1A. J Child Neurol. 2010, 25: 463-468. 10.1177/0883073809340698.CrossRefPubMed Rose KJ, Burns J, North KN: Factors associated with foot and ankle strength in healthy pre-school aged children and age-matched cases of Charcot-Marie-Tooth disease type 1A. J Child Neurol. 2010, 25: 463-468. 10.1177/0883073809340698.CrossRefPubMed
4.
go back to reference Redmond AC, Crane YZ, Menz HB: Normative values for the Foot Posture Index. J Foot Ankle Res. 2008, 1: Redmond AC, Crane YZ, Menz HB: Normative values for the Foot Posture Index. J Foot Ankle Res. 2008, 1:
5.
go back to reference Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M: Prevalence of flat foot in preschool-aged children. Pediatrics. 2006, 118: 634-639. 10.1542/peds.2005-2126.CrossRefPubMed Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M: Prevalence of flat foot in preschool-aged children. Pediatrics. 2006, 118: 634-639. 10.1542/peds.2005-2126.CrossRefPubMed
6.
go back to reference Murray KJ: Hypermobility disorders in children and adolescents. Best Pract Res Clin Rheumatol. 2006, 20: 329-351s. 10.1016/j.berh.2005.12.003.CrossRefPubMed Murray KJ: Hypermobility disorders in children and adolescents. Best Pract Res Clin Rheumatol. 2006, 20: 329-351s. 10.1016/j.berh.2005.12.003.CrossRefPubMed
7.
go back to reference Evans AM, Rome K: A Cochrane review of the evidence for non-surgical interventions for flexible pediatric flat feet. Eur J Phys Rehabil Med. 2011, 47: 69-89.PubMed Evans AM, Rome K: A Cochrane review of the evidence for non-surgical interventions for flexible pediatric flat feet. Eur J Phys Rehabil Med. 2011, 47: 69-89.PubMed
8.
go back to reference Morris C, Doll HA, Wainwright A, Theologis T, Fitzpatrick R: The Oxford ankle foot questionnaire for children: scaling, reliability and validity. J Bone Joint Surg Br. 2008, 90: 1451-1456. 10.1302/0301-620X.90B11.21000.CrossRefPubMed Morris C, Doll HA, Wainwright A, Theologis T, Fitzpatrick R: The Oxford ankle foot questionnaire for children: scaling, reliability and validity. J Bone Joint Surg Br. 2008, 90: 1451-1456. 10.1302/0301-620X.90B11.21000.CrossRefPubMed
9.
go back to reference Sim J, Wright CC: The Kappa Statistic in Reliability Studies: Use, Interpretation, and Sample Size Requirements. Phys Ther. 2005, 85: 257-268.PubMed Sim J, Wright CC: The Kappa Statistic in Reliability Studies: Use, Interpretation, and Sample Size Requirements. Phys Ther. 2005, 85: 257-268.PubMed
10.
go back to reference Macfarlane TS, Larson CA, Stiller C: Lower extremity muscle strength in 6- to 8-year-old children using hand-held dynamometry. Pediatr Phys Ther. 2008, 20: 128-136. 10.1097/PEP.0b013e318172432d.CrossRefPubMed Macfarlane TS, Larson CA, Stiller C: Lower extremity muscle strength in 6- to 8-year-old children using hand-held dynamometry. Pediatr Phys Ther. 2008, 20: 128-136. 10.1097/PEP.0b013e318172432d.CrossRefPubMed
11.
go back to reference Gilmour JC, Burns Y: The measurement of the medial longitudinal arch in children. Foot Ankle Int. 2001, 22: 493-498.PubMed Gilmour JC, Burns Y: The measurement of the medial longitudinal arch in children. Foot Ankle Int. 2001, 22: 493-498.PubMed
12.
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: 203-213.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: 203-213.CrossRefPubMed
13.
go back to reference Evans AM, Nicholson H, Zakaris N: The paediatric flat foot proforma (p-FFP): improved and abridged following a reproducibility study. J Foot Ankle Res. 2009, 2: 25-10.1186/1757-1146-2-25.CrossRefPubMedPubMedCentral Evans AM, Nicholson H, Zakaris N: The paediatric flat foot proforma (p-FFP): improved and abridged following a reproducibility study. J Foot Ankle Res. 2009, 2: 25-10.1186/1757-1146-2-25.CrossRefPubMedPubMedCentral
14.
go back to reference Morrison SC, Durward BR, Watt GF, Donaldson MDC: The intra-rater reliability of anthropometric data collection conducted on the peripubescent foot: A pilot study. Foot. 2005, 15: 180-184. 10.1016/j.foot.2005.07.003.CrossRef Morrison SC, Durward BR, Watt GF, Donaldson MDC: The intra-rater reliability of anthropometric data collection conducted on the peripubescent foot: A pilot study. Foot. 2005, 15: 180-184. 10.1016/j.foot.2005.07.003.CrossRef
15.
go back to reference Morrison SC, Ferrari J: Inter-rater reliability of the Foot Posture Index (FPI-6) in the assessment of the paediatric foot. J Foot Ankle Res. 2009, 2: 26-10.1186/1757-1146-2-26.CrossRefPubMedPubMedCentral Morrison SC, Ferrari J: Inter-rater reliability of the Foot Posture Index (FPI-6) in the assessment of the paediatric foot. J Foot Ankle Res. 2009, 2: 26-10.1186/1757-1146-2-26.CrossRefPubMedPubMedCentral
16.
go back to reference Evans AM, Scutter S: Sagittal Plane Range of Motion of the Pediatric Ankle Joint. A Reliability Study. J Am Podiatr Med Assoc. 2006, 96: 418-422.CrossRefPubMed Evans AM, Scutter S: Sagittal Plane Range of Motion of the Pediatric Ankle Joint. A Reliability Study. J Am Podiatr Med Assoc. 2006, 96: 418-422.CrossRefPubMed
17.
go back to reference Bennell K, Talbot R, Wajsweiner H, Techovanich W, Kelly DH, Hall AJ: Intra-rater and Inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998, 44: 175-179.CrossRefPubMed Bennell K, Talbot R, Wajsweiner H, Techovanich W, Kelly DH, Hall AJ: Intra-rater and Inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998, 44: 175-179.CrossRefPubMed
18.
go back to reference Bennell K, Khan KM, Matthews B, De Gruyter M, Cook E, Holzer K, Wark JD: Hip and ankle range of motion and hip muscle strength in young female ballet dancers and controls. Br J Sports Med. 1999, 33: 340-346. 10.1136/bjsm.33.5.340.CrossRefPubMedPubMedCentral Bennell K, Khan KM, Matthews B, De Gruyter M, Cook E, Holzer K, Wark JD: Hip and ankle range of motion and hip muscle strength in young female ballet dancers and controls. Br J Sports Med. 1999, 33: 340-346. 10.1136/bjsm.33.5.340.CrossRefPubMedPubMedCentral
19.
go back to reference Bennell K, Khan K, Matthews B, Singleton C: Changes in hip and ankle range of motion and muscle strength in 8 - 11 year old novice female ballet dancers and controls: a 12 month follow up study. Br J Sports Med. 2001, 35: 54-59. 10.1136/bjsm.35.1.54.CrossRefPubMedPubMedCentral Bennell K, Khan K, Matthews B, Singleton C: Changes in hip and ankle range of motion and muscle strength in 8 - 11 year old novice female ballet dancers and controls: a 12 month follow up study. Br J Sports Med. 2001, 35: 54-59. 10.1136/bjsm.35.1.54.CrossRefPubMedPubMedCentral
20.
go back to reference Ferrari J, Parslow C, Lim E, Hayward A: Joint hypermobility: the use of a new assessment tool to measure lower limb hypermobility. Clin Exp Rheumatol. 2005, 23: 413-420.PubMed Ferrari J, Parslow C, Lim E, Hayward A: Joint hypermobility: the use of a new assessment tool to measure lower limb hypermobility. Clin Exp Rheumatol. 2005, 23: 413-420.PubMed
21.
go back to reference Remvig L, Jensen DV, Ward RC: Are diagnostic criteria for general joint hypermobility and benign joint hypermobility syndrome based on reproducible and valid tests? A review of the literature. J Rheumatol. 2007, 34: 798-803.PubMed Remvig L, Jensen DV, Ward RC: Are diagnostic criteria for general joint hypermobility and benign joint hypermobility syndrome based on reproducible and valid tests? A review of the literature. J Rheumatol. 2007, 34: 798-803.PubMed
22.
go back to reference Juul-Kristensen B, Rogind H, Jensen DV, Remvig L: Inter-examiner reproducibility of tests and criteria for generalized joint hypermobility and benign joint hypermobility syndrome. Rheumatol. 2007, 46: 1835-1841. 10.1093/rheumatology/kem290.CrossRef Juul-Kristensen B, Rogind H, Jensen DV, Remvig L: Inter-examiner reproducibility of tests and criteria for generalized joint hypermobility and benign joint hypermobility syndrome. Rheumatol. 2007, 46: 1835-1841. 10.1093/rheumatology/kem290.CrossRef
23.
go back to reference van der Geissen LJ, Liekens D, Rutgers KJ, Hartman A, Mulder PG, Oranje AP: Validation of Beighton score and prevalence of connective tissue signs in 773 Dutch children. J Rheumatol. 2001, 28: 2726-2730. van der Geissen LJ, Liekens D, Rutgers KJ, Hartman A, Mulder PG, Oranje AP: Validation of Beighton score and prevalence of connective tissue signs in 773 Dutch children. J Rheumatol. 2001, 28: 2726-2730.
24.
go back to reference Redmond AC, Crosbie J, Ouvrier R: Development and validation of a novel rating system for scoring foot posture: the Foot Posture Index. Clin Biomech. 2006, 21: 89-98. 10.1016/j.clinbiomech.2005.08.002.CrossRef Redmond AC, Crosbie J, Ouvrier R: Development and validation of a novel rating system for scoring foot posture: the Foot Posture Index. Clin Biomech. 2006, 21: 89-98. 10.1016/j.clinbiomech.2005.08.002.CrossRef
25.
go back to reference Irving DB, Cook JL, Young M, Menz HB: Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study. BMC Musculoskelet Disord. 2007, 8: 41-10.1186/1471-2474-8-41.CrossRefPubMedPubMedCentral Irving DB, Cook JL, Young M, Menz HB: Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study. BMC Musculoskelet Disord. 2007, 8: 41-10.1186/1471-2474-8-41.CrossRefPubMedPubMedCentral
26.
go back to reference Portney LG, Watkins MP: Foundations of clinical research. Applications to practice. 2000, Upper Saddle River, NJ: Prentice Hall Health, 2 Portney LG, Watkins MP: Foundations of clinical research. Applications to practice. 2000, Upper Saddle River, NJ: Prentice Hall Health, 2
27.
go back to reference Weir JP: Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005, 19: 231-240.PubMed Weir JP: Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005, 19: 231-240.PubMed
28.
go back to reference Dennis RJ, Finch CF, Elliott BC, Farhart PJ: The reliability of musculoskeletal screening tests used in cricket. Phys Ther Sport. 2007, 9: 25-33.CrossRefPubMed Dennis RJ, Finch CF, Elliott BC, Farhart PJ: The reliability of musculoskeletal screening tests used in cricket. Phys Ther Sport. 2007, 9: 25-33.CrossRefPubMed
Metadata
Title
The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study
Authors
Angela M Evans
Keith Rome
Lauren Peet
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2012
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-5-1

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