Clinical measures of static foot posture do not agree

Ben Langley, Mary Cramp, Stuart Morrison

Research output: Contribution to journalArticle (journal)peer-review

37 Citations (Scopus)
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Background: The aim of this study was to determine the level of agreement between common clinical foot classification measures. Methods: Static foot assessment was undertaken using the Foot Posture Index (FPI-6), rearfoot angle (RFA), medial longitudinal arch angle (MLAA) and navicular drop (ND) in 30 participants (29 ± 6 years, 1.72 ± 0.08 m, 75 ± 18 kg). The right foot was measured on two occasions by one rater within the same test environment. Agreement between the test sessions was initially determined for each measure using the Weighted Kappa. Agreement between the measures was determined using Fleiss Kappa. Results: Foot classification across the two test occasions was almost perfect for MLAA (Kw = .92) and FPI-6 (Kw = .92), moderate for RFA (Kw = .60) and fair for ND (Kw = .40) for comparison within the measures. Overall agreement between the measures for foot classification was moderate (Kf = .58). Conclusion: The findings reported in this study highlight discrepancies between the chosen foot classification measures. The FPI-6 was a reliable multiplanar measure whereas navicular drop emerged as an unreliable measure with only fair agreement across test sessions. The use of this measure for foot assessment is discouraged. The lack of strong consensus between measures for foot classification underpins the need for a consensus on appropriate clinical measures of foot structure.
Original languageEnglish
Article number45
Pages (from-to)45
JournalJournal of Foot and Ankle Research
Early online date1 Dec 2016
Publication statusE-pub ahead of print - 1 Dec 2016


  • Morphology
  • pes planus
  • pes cavus
  • Footclassification
  • Agreement
  • Pes cavus
  • Foot classification
  • Pes planus


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