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      Inter-rater reliability of the Foot Posture Index (FPI-6) in the assessment of the paediatric foot

      research-article
      Author(s): 1 , , 1
      Publication date (Electronic):
      Journal: Journal of Foot and Ankle Research
      Publisher: BioMed Central

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          Abstract

          Background

          Reliability is an integral component of clinical assessment and necessary for establishing baseline data, monitoring treatment outcomes and providing robust research findings. In the podiatric literature traditional measures of foot assessment have been shown to be largely unreliable. The Foot Posture Index (FPI-6) is a clinical tool used in the assessment of foot and to date, there is limited research published which evaluates the reliability of this tool in children and adolescents.

          Method

          Thirty participants aged 5 - 16 years were recruited for the research. Two raters independently recorded the FPI-6 score for each participant.

          Results

          Almost perfect agreement between the two raters was identified following weighted kappa analysis (Kw = 0.86).

          Conclusion

          The FPI-6 is a quick, simple and reliable clinical tool which has demonstrated excellent inter-rater reliability when used in the assessment of the paediatric foot.

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          Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index.

          Anthony C. Redmond, Jack Crosbie, Robert Ouvrier (2006)
          The limitations of clinical methods for appraising foot posture are well documented. A new measure, the Foot Posture Index is proposed, and its development and validation described. A four-phase development process was used: (i) to derive a series of candidate measures, (ii) to define an appropriate scoring system, (iii) to evaluate the validity of components and modify the instrument as appropriate, and (iv) to investigate the predictive validity of the finalised instrument relative to static and dynamic kinematic models. Methods included initial concurrent validation using Rose's Valgus Index, determination of inter-item reliability, factor analysis, and benchmarking against three dimensional kinematic models derived from electromagnetic motion tracking of the lower limb. Thirty-six candidate components were reduced to six in the final instrument. The draft version of the instrument predicted 59% of the variance in concurrent Valgus Index scores and demonstrated good inter item reliability (Cronbach's alpha = 0.83). The relevant variables from the motion tracking lower limb model predicted 58-80% of the variance in the six components retained in the final instrument. The finalised instrument predicted 64% of the variance in static standing posture, and 41% of the variance in midstance posture during normal walking. The Foot Posture Index has been subjected to thorough evaluation in the course of its development and a final version is proposed comprising six component measures that performed satisfactorily during the validation process. The Foot Posture Index assessment is quick and simple to perform and allows a multiple segment, multiple plane evaluation that offers some advantages over existing clinical measures of foot posture.
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            Normative values for the Foot Posture Index

            Anthony C. Redmond, Yvonne Z Crane, Hylton B. Menz (2008)
            Background The Foot Posture Index (FPI) is a validated method for quantifying standing foot posture, and is being used in a variety of clinical settings. There have however, been no normative data available to date for comparison and reference. This study aimed to establish normative FPI reference values. Methods Studies reporting FPI data were identified by searching online databases. Nine authors contributed anonymised versions of their original datasets comprising 1648 individual observations. The datasets included information relating to centre, age, gender, pathology (if relevant), FPI scores and body mass index (BMI) where available. FPI total scores were transformed to interval logit scores as per the Rasch model and normal ranges were defined. Comparisons between groups employed t-tests or ANOVA models as appropriate and data were explored descriptively and graphically. Results The main analysis based on a normal healthy population (n = 619) confirmed that a slightly pronated foot posture is the normal position at rest (mean back transformed FPI raw score = +4). A 'U' shaped relationship existed for age, with minors and older adults exhibiting significantly higher FPI scores than the general adult population (F = 51.07, p < 0.001). There was no difference between the FPI scores of males and females (2.3 versus 2.5; t = -1.44, p = 0.149). No relationship was found between the FPI and BMI. Systematic differences from the adult normals were confirmed in patients with neurogenic and idiopathic cavus (F = 216.981, p < 0.001), indicating some sensitivity of the instrument to detect a posturally pathological population. Conclusion A set of population norms for children, adults and older people have been derived from a large sample. Foot posture is related to age and the presence of pathology, but not influenced by gender or BMI. The normative values identified may assist in classifying foot type for the purpose of research and clinical decision making.
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              Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine

              Hylton B. Menz (2004)
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Foot Ankle Res
                Title: Journal of Foot and Ankle Research
                Publisher: BioMed Central
                ISSN (Electronic): 1757-1146
                Publication date Collection: 2009
                Publication date (Electronic): 21 October 2009
                Volume: 2
                Page: 26
                Affiliations
                [1 ]The University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK
                Article
                Publisher ID: 1757-1146-2-26
                DOI: 10.1186/1757-1146-2-26
                PMC ID: 2770503
                PubMed ID: 19845961
                SO-VID: 797ec0be-b35a-47dc-9dfd-cd26ea429c2c
                Copyright © Copyright © 2009 Morrison and Ferrari; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 15 June 2009
                Date accepted : 21 October 2009
                Categories
                Subject: Research

                ScienceOpen disciplines: Orthopedics
                Data availability:
                ScienceOpen disciplines: Orthopedics

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