Non-radiographic validity and reliability measures for assessing foot types: A systematic review

Carrasco, Aline Cristina; Silva, Mariana F.; Guenka, Leandro Caetano; Silva, Carla T.; Moura, Felipe Arruda; Cardoso, Jefferson Rosa

doi:10.1016/j.fas.2020.11.011

Cited by 9 publications

(11 citation statements)

References 71 publications

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“… 1 There is a considerable debate as to which assessment measures are to be best included in flatfoot evaluation. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

“…Numerous measures are employed to diagnose flatfoot based on MLA height. 1 , 3 , 13 Clinical assessment tools (FPI-6, measurement of navicular height, anthropometric measurements, and visual observation), 1 , 14–17 radiological assessment, 18 ultrasonography, photographic techniques, and footprint analysis, 13 , 19 , 20 are all utilized to diagnose flatfoot based on MLA height.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, under certain conditions such as screening a huge population in epidemiological studies, radiographic assessment of flatfoot may be irrelevant. 3 , 21 In such cases, valid, safe, and noninvasive clinical assessment tools should be beneficial.…”

Section: Introductionmentioning

confidence: 99%

“…1 There is a considerable debate as to which assessment measures are to be best included in flatfoot evaluation. 2,3 It is commonly acknowledged that foot posture differs during the period of growth and musculoskeletal maturation, much like foot posture in children differs from the one in adolescence and in adulthood. 4,5 There is an appreciable scarcity of the available literature published studies about foot posture in adolescence; however, adolescence is an important phase of one's life, marked by a various diversity of developmental, physiological, and anatomical adaptations.…”

Section: Introductionmentioning

confidence: 99%

“…This was highlighted as a limiting factor in the previous systematic studies. 1,3,38,39 One way to settle this debate about diagnostic accuracy of FPI-6 and CA in adolescents, through investigating validity and diagnostic accuracy of FPI-6 and CA against one criterion standard measure under the same circumstances on the same sample of the population. Therefore, this study aimed to investigate and compare the validity and diagnostic accuracy of CA and FPI-6 against radiographic findings as a criterion standard measure to determine flexible flatfoot in adolescents aged 12-18 years.…”

Section: Introductionmentioning

confidence: 99%

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

Hegazy¹,

Aboelnasr²,

Abuzaid³

et al. 2021

JMDH

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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.

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“… 1 There is a considerable debate as to which assessment measures are to be best included in flatfoot evaluation. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%