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Authors

Background

The measurements used in diagnosing biomechanical pathologies vary greatly. The aim of this study was to determine the concordance between Clarke’s angle and Chippaux-Smirak index, and to determine the validity of Clarke’s angle using the Chippaux-Smirak index as a reference.

Methods

Observational study in a random population sample (n=1002) in A Coruña (Spain). After informed patient consent and ethical review approval, a study was conducted of anthropometric variables, Charlson comorbidity score, and podiatric examination. Descriptive analysis and multivariate logistic regression were performed.

Results

The prevalence of flat feet, using a podoscope, was 19.0% for the left foot and 18.9% for the right foot, increasing with age.

The prevalence of flat feet according to the Chippaux-Smirak index  or Clarke’s angle  increases significantly, reaching 62.0% and 29.7% respectively.

The concordance (kappa I) between the indices according to age groups varied between 0.25–0.33 (left foot) and 0.21–0.30 (right foot). The intraclass correlation coefficient (ICC) between the Chippaux-Smirak index and Clarke’s angle  was -0.445 (left foot) and -0.424 (right foot).

After adjusting for age, body mass index (BMI), comorbidity score and gender, the only variable with an independent effect to predict discordance was the BMI (OR=0.969; 95% CI:0.94-0.998).

Conclusion

There is little concordance between the indices studied for the purpose of diagnosing foot arch pathologies. In turn, Clarke’s angle has a limited sensitivity in diagnosing flat feet, using the Chippaux-Smirak index as a reference. This discordance decreases with higher BMI values.

 

 

Cristina González-Martín, Universidade da Coruña, Ferrol, Spain

Clinical Epidemiology Research Group, Health Sciences Department, Escuela Universitaria de Enfermería y Podología, Universidade da Coruña (UDC), Ferrol, Spain, Universidade da Coruña, Health Sciences Department, Escuela Universitaria de Enfermería y Podología,

Salvador Pita-Fernández, Universidade da Coruña, Coruña, Spain, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña

Universidade da Coruña, Coruña, Spain, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña

Teresa Seoane-Pillado, Universidade da Coruña, Coruña, Spain, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña


Biostatistician. Division of Clinical Epidemiology, Complexo Hospitalario Universitario A Coruña (CHUAC). SERGAS, A Coruña (Spain)

Beatriz López-Calviño, Universidade da Coruña, Coruña, Spain, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña

Biostatistician. Division of Clinical Epidemiology, Complexo Hospitalario Universitario A Coruña (CHUAC). SERGAS, A Coruña (Spain)

Sonia Pertega-Díaz, Universidade da Coruña, Coruña, Spain, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña

Biostatistician. Division of Clinical Epidemiology, Complexo Hospitalario Universitario A Coruña (CHUAC). SERGAS, A Coruña (Spain)

Vicente Gil-Guillen, Department of Clinical Medicine, Universidad Miguel Hernandez, Alicante, Spain , Department of Clinical Medicine, Universidad Miguel Hernandez, Alicante, Spain

Full profesor. Miguel  Hernandez UniversityDepartment of Clinical Medicine. Alicante (Spain)

 

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