The reliability and reproducibility of foot type measurements using a mirrored foot photo box and digital photography compared to caliper measurements

The height of the medial longitudinal arch (MLA) is thought to be a predisposing factor to various lower extremity injuries. Discrepancy exists as to whether MLA height plays a role in injury prevention. The purpose of this study was to determine the intertester and intratester reliability, and the validity of the mirrored foot photo box (MFPB) and caliper measurements to radiographic measurements. METHODS: Thirty subjects with equal numbers of men and women were recruited. Both feet were tested (n=60) in a 90% weight bearing stance. A set of anatomic landmarks were palpated, marked, and measured using a caliper, MFPB, and radiographs. The protocol was completed by two testers on 2 days approximately 1 week apart. Intertester and intratester reliability were determined using the intraclass correlation coefficient (ICC)(2,k) and the ICC(2,1), respectively. Validity of both measurement techniques to radiographic measurements was determined using the ICC(2,k). RESULTS: The intertester reliability ranged from 0.991 to 0.577, while the intratester reliability ranged from 0.994 to 0.527, with first metatarsal angle being the only variable with poor reliability. Most variables demonstrated acceptable validity between the MFPB and the caliper measurements, and acceptable validity between the MFPB and calipers compared to radiographic measurements. The MFPB took 51.3+/-19.6s per foot while the caliper measurements averaged 227.4+/-68.9s to complete the measurements. DISCUSSION: The MFPB is as reliable as the caliper measurements, and offers better intertester reliability. Both the caliper and MFPB measurements demonstrated acceptable validity to radiographic measurements and testing time was reduced when using the MFPB compared to calipers.