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Reliability of Clinical Tests of Foot and Ankle Characteristics in Older People

Hylton B. Menz Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

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Anne Tiedemann Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

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Marcella Mun-San Kwan Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

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Mark Dominic Latt Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

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Catherine Sherrington Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

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Stephen R. Lord Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia.

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Lower-extremity problems are common in older people; however, the reliability of clinical tools used to assess foot and ankle characteristics has not been rigorously evaluated. This study evaluated the test–retest reliability of a battery of simple clinical tests of foot and ankle characteristics (tactile sensitivity of the first metatarsophalangeal joint, navicular height, foot length and width, hallux valgus severity, an overall foot problem score, ankle flexibility, ankle dorsiflexion strength, and foot pain) in 31 individuals (13 men and 18 women) aged 76 to 87 years recruited from the community. Three examiners performed the tests on two occasions approximately 2 weeks apart. Intraclass correlation coefficients and coefficients of variation were calculated for continuously scored tests, and the kappa statistic (κ) was used to determine the reliability of hallux valgus severity grading. All of the continuously scored tests had acceptable reliability (intraclass correlation coefficients of 0.64 to 0.98; coefficients of variation of 0.6% to 15.0%), as did hallux valgus severity grading (κ = 0.77; absolute percentage agreement, 84%). These simple clinical tests can now be used with confidence in clinical and research settings to provide reliable and functionally important information regarding foot and ankle characteristics in older people. (J Am Podiatr Med Assoc 93(5): 380-387, 2003)

Corresponding author: Hylton B. Menz, PhD, Prince of Wales Medical Research Institute, University of New South Wales, High St, Randwick, New South Wales 2031, Australia.