Email this article Flatfoot or not: subjective perception of the height of the feet arch among orthopedists
- Authors: Dimitrieva A.J.1, Kenis V.M.2, Sapogovskiy A.V.3
-
Affiliations:
- North-Western State Medical University named after I.I. Mechikov
- The Turner Scientific Research Institute for Children’s Orthopedics
- The Turner Scientific Research Institute for Children’s Orthopedics, Saint Petersburg, Russia
- Issue: Vol 8, No 2 (2020)
- Pages: 179-184
- Section: Original Study Article
- URL: https://bakhtiniada.ru/turner/article/view/21192
- DOI: https://doi.org/10.17816/PTORS21192
- ID: 21192
Cite item
Open Access
Access granted
Subscription Access
Abstract
Background. The visual assessment of flatfoot is the most commonly used method by pediatric orthopedists. It is necessary to confirm good consistency among specialists to justify its use as a standard.
Aim. The aim of this study was to determine the consistency of visual assessment of flatfoot among orthopedists.
Materials and methods. The first stage of this study included 187 primary school-aged children. The main methods used were clinical examination and computer plantography. Then, 130 images of the right foot were randomly selected in standard projections — medial and posterior, which were provided to 32 orthopedists (ten of whom were experts). Specialists needed to note whether the foot presented for analysis was flat. We used the w-Kendall concordance coefficient and τ-Kendall correlation coefficient to determine the inter-rater reliability. After five months, the intra-rater reliability was determined, and the Cohen coefficient was calculated.
Results. Our study demonstrated that the inter-rater reliability varied significantly depending on whether the orthopedist specialized in foot pathology. When calculating the concordance coefficient, an increase in the consistency among experts was noted after five months (0.58 and 0.76, respectively), compared with orthopedists who do not specialize in foot pathology. Although some heterogeneity was noted according to experts on the same foot, the overall correlation coefficient corresponded to a good and excellent level of consistency (0.65–0.84). Cohen’s coefficient among specialists corresponded to a good level of confidence (0.72), whereas among orthopedists who do not specialize in foot pathology, there was a low level of confidence (0.31). According to experts, the frequency of flatfoot was 24.6%, whereas according to orthopedists who do not specialize in foot pathology, it was 40.9% when they evaluated images of the same feet.
Conclusion. Experts’ answers regarding which foot should be considered flat demonstrated a good and excellent level of consistency. Therefore, they can be used to determine reference values of anthropometric parameters of the medial foot arch.
Full Text
##article.viewOnOriginalSite##About the authors
Alyona Ju. Dimitrieva
North-Western State Medical University named after I.I. Mechikov
Author for correspondence.
Email: aloyna17@mail.ru
ORCID iD: 0000-0002-3610-7788
SPIN-code: 7112-8638
Scopus Author ID: 1026726
PhD Student of Chair of Traumatology and Orthopedics for Children
Russian Federation, 195015, St. Petersburg, Kirochnaya St., 41Vladimir M. Kenis
The Turner Scientific Research Institute for Children’s Orthopedics
Email: kenis@mail.ru
ORCID iD: 0000-0002-7651-8485
SPIN-code: 5597-8832
Scopus Author ID: 36191914200
http://www.rosturner.ru/kl4.htm
MD, PhD, D.Sc., Professor, Deputy Director of Development and International Relations, Head of the Department of Foot Pathology, Neuroorthopedics and Systemic Diseases
Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Andrei V. Sapogovskiy
The Turner Scientific Research Institute for Children’s Orthopedics, Saint Petersburg, Russia
Email: sapogovskiy@gmail.com
ORCID iD: 0000-0002-5762-4477
SPIN-code: 2068-2102
Scopus Author ID: 808611
MD, PhD, Senior Research Associate of the Department of Foot Pathology, Neuroorthopedics and Systemic Diseases
Russian Federation, 196603, St. Petersburg, Pushkin, Parkovaya st. 64-68References
- Большая медицинская энциклопедия. Т. 19 / под ред. Б.В. Петровского. – 3-е изд. – М.: Советская энциклопедия, 1989. [Bol’shaya meditsinskaya entsiklopediya. Izdanie tret’e. Vol. 19. Ed. by B.V. Petrovskiy. Moscow: Sovetskaya entsiklopediya; 1989. (In Russ.)]
- Chuckpaiwong B, Nunley JA, 2nd, Queen RM. Correlation between static foot type measurements and clinical assessments. Foot Ankle Int. 2009;30(3):205-212. https://doi.org/10.3113/FAI.2009.0205.
- Hosl M, Bohm H, Multerer C, Doderlein L. Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model. Gait Posture. 2014;39(1):23-28. https://doi.org/10.1016/j.gaitpost.2013.05.017.
- Houck JR, Tome JM, Nawoczenski DA. Subtalar neutral position as an offset for a kinematic model of the foot during walking. Gait Posture. 2008;28(1):29-37. https://doi.org/10.1016/j.gaitpost.2007.09.008.
- Армасов А.Р., Киселев В.Я. Диагностическая ценность метода визуальной оценки стоп при диагностике плоскостопия у подростков // Гений ортопедии. – 2010. – № 3. – С. 101–104. [Armasov AR, Kiselev VY. Diagnostic value of the technique for feet visual estimation in adolescent platypodia determination. Genij ortopedii. 2010;(3):101-104. (In Russ.)]
- Dahle LK, Mueller MJ, Delitto A, Diamond JE. Visual assessment of foot type and relationship of foot type to lower extremity injury. J Orthop Sports Phys Ther. 1991;14(2): 70-74. https://doi.org/10.2519/jospt.1991.14.2.70.
- Cowan DN, Robinson JR, Jones BH, et al. Consistency of visual assessments of arch height among clinicians. Foot Ankle Int. 1994;15(4):213-217. https://doi.org/10.1177/107110079401500411.
- Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol, Avon). 2006;21(1):89-98. https://doi.org/10.1016/j.clinbiomech.2005.08.002.
- Keenan AM, Redmond AC, Horton M, et al. The Foot Posture Index: Rasch analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007;88(1):88-93. https://doi.org/10.1016/j.apmr.2006.10.005.
- Cain LE, Nicholson LL, Adams RD, Burns J. Foot morphology and foot/ankle injury in indoor football. J Sci Med Sport. 2007;10(5):311-319. https://doi.org/10.1016/j.jsams.2006.07.012.
- Evans AM, Rome K, Peet L. The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study. J Foot Ankle Res. 2012;5(1):1. https://doi.org/10.1186/1757-1146-5-1.
- Evans AM, Copper AW, Scharfbillig RW, et al. Reliability of the foot posture index and traditional measures of foot position. J Am Podiatr Med Assoc. 2003;93(3):203-213. https://doi.org/10.7547/87507315-93-3-203.
- Mentiplay BF, Clark RA, Mullins A, et al. Reliability and validity of the Microsoft Kinect for evaluating static foot posture. J Foot Ankle Res. 2013;6(1):14. https://doi.org/10.1186/1757-1146-6-14.
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-174. https://doi.org/10.2307/2529310.
Supplementary files
