Open AccessVariability between Clarke's angle and Chippaux-Smirak index for the diagnosis of flat feet
Author(s) -
Cristina González-Martín,
Salvador Pita-Fernández,
Teresa Seoane-Pillado,
Beatriz LópezCalviño,
Sonia PértegaDíaz,
Vicente Gil-Guillén
Publication year - 2017
Publication title -
colombia medica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.455
H-Index - 18
eISSN - 1657-9534
pISSN - 0120-8322
DOI - 10.25100/cm.v48i1.1947
Subject(s) - medicine , intraclass correlation , concordance , foot (prosody) , body mass index , logistic regression , anthropometry , population , comorbidity , demography , orthodontics , psychometrics , clinical psychology , linguistics , philosophy , environmental health , sociology
BackgroundThe 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.MethodsObservational 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.ResultsThe 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).ConclusionThere 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.