Search

Abstract: Background: Radiographic charted values are widely applied in the assessment of paediatric flat foot and as quantitative markers of intervention success. Nearly all literature pertaining to the reliability of these measures relates to the adult foot. In view of the importance placed on these charted values we assessed the inter and intra-rater reliability of 10 key radiographic measures in children aged 7–14 years. Methods: We present the reliability of these measures in terms of intra class correlation and standard error based on repeated measures of 50 radiographs across five independent trained observers. Two new detailed methods are presented for the calculation of lateral and dorso-plantar talo-calcaneal overlap in an attempt to better define the talo-calcaneal inter-relationship. Results: The results demonstrate wide variation of measurement reliability, with some measures being highly reproducible and others showing poor reproducibility. A strong negative correlation between reliability and the number of steps required for the measurement was demonstrated. Consistent with other studies intra-rater reliability tended to be higher than that of inter-rater reliability. Conclusion: In conclusion, we have provided evidence as to which radiographic charted measures may be reliably used in evaluating the paediatric flat foot in children aged 7–14 years, and which measures are not reliable and we advise against their application. [Copyright &y& Elsevier]

Foot clearance is an important variable for understanding safe stair negotiation, but few studies have provided detailed measures of it. This paper presents a new method to calculate minimal shoe clearance during stair descent and compares it to previous literature. Seventeen healthy young subjects descended a five step staircase with step treads of 300 mm and step heights of 188 mm. Kinematic data were collected with an Optotrak system (model 3020) and three non-colinear infrared markers on the feet. Ninety points were digitized on the foot sole prior to data collection using a 6 marker probe and related to the triad of markers on the foot. The foot sole was reconstructed using the Matlab (version 7.0) "meshgrid" function and minimal distance to each step edge was calculated for the heel, toe and foot sole. Results showed significant differences in minimum clearance between sole, heel and toe, with the shoe sole being the closest and the toe the furthest. While the hind foot sole was closest for 69% of the time, the actual minimum clearance point on the sole did vary across subjects and staircase steps. This new method, and the findings on healthy young subjects, can be applied to future studies of other populations and staircase dimensions. [ABSTRACT FROM AUTHOR]