Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Musculoskelet Sci Pract. 2020 Apr;46:102107. doi: 10.1016/j.msksp.2020.102107. Epub 2020 Jan 13.
Diagnosis of flexible flatfoot is usually based upon radiographic or clinical measures. Radiographic measures pose a potential risk of radiation exposure especially in Paediatric population. Clinicians need a valid, accurate, easily used, noninvasive and cost effective measure to evaluate static foot posture clinically. Although, foot posture index-6 (FPI-6) are commonly used in clinical practice, its validity and diagnostic accuracy in evaluation of paediatric flexible flatfoot have not been fully proven yet.
To investigate validity and diagnostic accuracy of FPI-6 to determine Paediatric flexible flatfoot between ages of 6-18 years using radiographic findings as the gold standard measure.
Cross-sectional study.
A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6-18 years (mean age ± standard deviation of 12.36 ± 3.39 years). The results of FPI-6 were compared to the gold standard radiographic measures and displayed on the receiver operating characteristic curve. Intra-rater reliability, sensitivity, specificity, predictive values and likelihood ratios were calculated. Posttest probability was calculated from Fagan nomogram.
FPI-6 demonstrate high intra-rater reliability (ICC = 0.96) with p value < 0.001. FPI-6 showed a sensitivity of 83.7%, a specificity of 80.4, a positive predictive value of 64.7, a negative predictive value of 92, a positive likelihood ratio of 4.62 and a negative likelihood ratio of 0.20. FPI-6 shows moderate diagnostic accuracy [AUC = 0.82; 95%CI (0.78-0.85)].
FPI-6 is valid with moderate diagnostic accuracy to determine paediatric flexible flatfoot between ages of 6-18 years.
柔性平足的诊断通常基于影像学或临床测量。影像学测量存在潜在的辐射暴露风险，尤其是在儿科人群中。临床医生需要一种有效的、准确的、易于使用的、非侵入性的和具有成本效益的方法来进行临床静态足姿评估。虽然足部指数-6（FPI-6）在临床实践中经常使用，但它在评估儿科柔性平足方面的有效性和诊断准确性尚未得到充分证明。
研究 FPI-6 的有效性和诊断准确性，以确定 6-18 岁儿童的柔性平足，以放射学结果为金标准测量方法。
横断面研究。
对 612 名（1224 只脚）年龄在 6-18 岁（平均年龄±标准差为 12.36±3.39 岁）的柔性平足患者进行了横断面研究。将 FPI-6 的结果与金标准放射学测量结果进行比较，并显示在受试者工作特征曲线（ROC）上。计算了内部评估者可靠性、敏感性、特异性、预测值和似然比。从 Fagan 列线图计算了后验概率。
FPI-6 具有较高的内部评估者可靠性（ICC=0.96），p 值<0.001。FPI-6 的敏感性为 83.7%，特异性为 80.4%，阳性预测值为 64.7%，阴性预测值为 92%，阳性似然比为 4.62，阴性似然比为 0.20。FPI-6 显示出中等的诊断准确性[AUC=0.82；95%置信区间（0.78-0.85）]。
FPI-6 是一种有效的、具有中等诊断准确性的方法，可以确定 6-18 岁儿童的柔性平足。
