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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.
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.
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).
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.
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