Terada Masafumi, Wittwer Ara M, Gribble Phillip A
University of Toledo, Toledo, OH, USA.
Int J Sports Phys Ther. 2014 Apr;9(2):187-94.
PURPOSE/BACKGROUND: The Foot Posture Index-6 (FPI-6) is considered a simple quantification tool to assess static foot alignment. Palpation of the foot is required for assessment of one of the six criteria that comprise the FPI-6; the remaining five criteria may be evaluated using still-frame photographs. Using only the image-based criteria may allow multiple clinicians to evaluate large groups of patients quickly. Reliability using only these five image-based criteria has not been established. The purposes of the current study were to establish the inter- and intra-rater reliability using five image-based criteria from the Foot Posture Index-6 (FPI-6) as well as to examine the agreement between the raters in identifying foot type using the composite five FPI scores.
Forty participants (23 females, 17 males; 23.67 ± 8.49 years; 64.59 ± 14.43 kg; 166.07 ± 11.79 cm) volunteered for this study. An investigator took three photos with a digital camera of the medial longitudinal arch, posterior ankle, and of the talonavicular joint approximately 45° from the posterior calcaneus for both right and left feet. Two investigators assessed the five image-based criteria of the FPI-6 for both feet of 40 participants on three occasions separated by a day. Inter-and intra-rater reliability were assessed with Intraclass Correlation Coefficients (ICC3,2). The amount of agreement for classification of foot posture type between the two raters was assessed with Cohen's kappa coefficient. Significance was set a priori at P < 0.05.
The inter-rater reliability was poor to moderate for all three sessions (ICC3,2 = 0.334-0.634). For the foot posture classification, the amount of agreement between two raters was poor for left (κ= 0.12) and right (κ= 0.19) feet. The intra-rater reliability was excellent for left (ICC3,2=0.956) and right feet (ICC3,2=0.959).
Excellent intra-rater and poor to moderate inter-rater reliability was found using only the five image-based criteria of the FPI-6. However, the classification of foot posture did not improve the amount of agreement between raters. Therefore, caution is needed when interpreting FPI scores from five image-based criteria.
3b.
目的/背景：足姿势指数-6（FPI-6）被认为是一种评估静态足部排列的简单量化工具。FPI-6包含的六项标准之一的评估需要触诊足部；其余五项标准可使用静态照片进行评估。仅使用基于图像的标准可能会使多名临床医生快速评估大量患者。仅使用这五项基于图像的标准的可靠性尚未确定。本研究的目的是使用足姿势指数-6（FPI-6）的五项基于图像的标准建立评分者间和评分者内的可靠性，并使用五项FPI综合评分来检验评分者在识别足型方面的一致性。
40名参与者（23名女性，17名男性；年龄23.67±8.49岁；体重64.59±14.43千克；身高166.07±11.79厘米）自愿参与本研究。一名研究者用数码相机为40名参与者的左右脚拍摄了三张照片，分别是内侧纵弓、后踝以及距舟关节，拍摄角度约为距跟骨后方45°。两名研究者在三个不同时间（间隔一天）对40名参与者双脚的FPI-6的五项基于图像的标准进行评估。使用组内相关系数（ICC3,2）评估评分者间和评分者内的可靠性。使用科恩kappa系数评估两名评分者在足姿势类型分类上的一致程度。预先设定显著性水平为P<0.05。
在所有三个时间段中，评分者间的可靠性为差到中等（ICC3,2 = 0.334 - 0.634）。对于足姿势分类，两名评分者在左脚（κ = 0.12）和右脚（κ = 0.19）上的一致程度较差。评分者内的可靠性在左脚（ICC3,2 = 0.956）和右脚（ICC3,2 = 0.959）上表现出色。
仅使用FPI-6的五项基于图像的标准时，发现评分者内可靠性出色，评分者间可靠性为差到中等。然而，足姿势分类并未提高评分者之间的一致程度。因此，在解释基于五项图像标准的FPI评分时需要谨慎。
3b。
