Comparing Validity and Diagnostic Accuracy of Clarke’s Angle and Foot Posture Index-6 to Determine Flexible Flatfoot in Adolescents: A Cross-Sectional Investigation

Abstract

Objective Clinically, the foot posture index-6 (FPI-6) and Clarke’s angle (CA) are widely utilized to assess static foot posture; however, due to scarcity of scientific evidence, clinicians continue to debate the validity and diagnostic accuracy of these measures in children and adolescents. This study aimed to evaluate and compare the validity and diagnostic accuracy of the FPI-6 and CA in determining adolescents’ flexible flatfoot between ages of 12 and 18 years, considering radiographic investigation as a reference standard measure. Design Cross-sectional study. Setting Governmental hospitals. Participants and Methods A sample of 460 people (920 feet) with flexible flatfoot between the ages of 12 and 18 (15.23 ± 0.84 years) was enrolled in the study. The findings of the investigated measures were compared to the reference standard radiographic measure and plotted on the receiver operating characteristic (ROC) curve. The area under the ROC curve (AUC) was determined as a measure of FPI-6 and CA diagnostic accuracy. Intra-rater reliability, sensitivity, specificity, predictive values, and likelihood ratios of FPI-6 and CA were calculated and compared. The post-test probability of flatfoot was determined using the Fagan nomogram. Results CA had a substantially higher intra-rater reliability (ICC=0.99) than the FPI-6 (ICC=0.96), with p-value of 0.001. CA has greater sensitivity (98%) than FPI-6, as well as a superior specificity (99%), positive predictive value (98%), negative predictive value (98.9%), positive likelihood ratio (97), and a lower negative likelihood ratio (0.02). CA had such an area under ROC curve of 0.98 with a 95% confidence interval of 0.95–1.00, while FPI-6 had an area under ROC curve of 0.80 with a 95% confidence interval of (0.77–0.85). Conclusion FPI-6 and Clarke’s angle are both valid and diagnostically accurate clinical tests for flatfoot detection, with Clarke’s angle outperforming FPI-6 in adolescents aged 12 to 18 years with a normal BMI.

Selected hallmarks of hallux valgus in older women with symptomatic hallux valgus compared to middle-aged women with and without deformation of the forefoot

“…The plantar side of the feet was examined in both feet while standing barefoot using an electronic podoscope (CQ Elektronik System). The plantoconturograms obtained were used to analyse the foot length (measured from the longest toe to the back of the heel), foot width (measured at the widest point of the forefoot), alpha -hallux valgus angle (the angle between the tangent to the medial edge of the foot and the tangent to the medial edge of the big toe; the correct value of the alpha angle is from 0 o to 9 o ) [27], beta -the varus angle of the fth toe (the angle between the tangent to the lateral edge of the foot and the tangent to the lateral edge of the fth toe; the correct value of the beta angle is from 0 o to 5 o ), gamma -the heel angle (the angle between the tangent to the medial edge of the foot and the tangent to the lateral edge of the foot, the correct gamma angle is from 15° to 18° [27] Additionally, a baroresistive platform (P-walk, BTS Bioengineering) was used to examine the load of the body weight on the right and left lower limbs (the results were given in percentage points); the difference in the weight load on the feet and the arch index (AI) were estimated (the ratio of one-third of the area of the middle plantoconturogram to the area of the entire plantoconturogram without toes, the correct value of the index is 0.21-0.28, values above 0.28 indicate longitudinal at feet) [29]. Both the podoscope and the platform are reliable diagnostic tools that are repeatedly used in scienti c research, also on the group of elderly people [30][31][32][33][34][35][36].…”

Deteksi Dini Terkait Flat Foot Di Kb-Tk Al-Quran Terpadu Bintangku Surakarta

“…Clarke's angle test dapat dilakukan pada anak-anak prasekolah usia 3-6 tahun. Sedangkan pada dewasa dapat dilakukan pada usia ≥40 tahun [10].…”

“…Lalu tekan kaki kanannya yang sudah berada di atas kertas, kemudian secara bergantian tekan kaki kirinya juga yang sudah berada diatas kertas. Kemudian meminta peserta untuk berdiri dengan stabil dan melihat ke depan selama kurang lebih 2 detik, lalu kaki subjek dibersihkan dari cat [10]. Penghitungan clarke's angle test menggunakan spidol, penggaris, dan busur derajat [10].…”

“…Kemudian meminta peserta untuk berdiri dengan stabil dan melihat ke depan selama kurang lebih 2 detik, lalu kaki subjek dibersihkan dari cat [10]. Penghitungan clarke's angle test menggunakan spidol, penggaris, dan busur derajat [10]. Clarke's angle test di ukur menggunakan 2 sudut garis.…”

How Does Status of Longitudinal Arch of Feet Affect Sports Performances in Adolescent Basketball Players in Iceland?

“…Numerous different assessments are used to diagnose flatfoot based on MLA height, such as clinical assessment tools Foot Posture Index (FPI-6), measurement of navicular height, anthropometric measurements visual observation, radiological assessment, ultrasonography, photographic techniques, and footprint analysis [7], that during the last decade became incredibly popular due to their non-invasive nature and simple and reliable methodology.…”