The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot
Abstract Background The Ponseti method is the gold standard for clubfoot treatment. However, relapse and residual gait deviations are common, and follow-up until 7 years of age is recommended. We evaluated the reliability of the foot drawing method, a new instrument for the follow-up of clubfoot. Th...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05465-9 |
| _version_ | 1818207519647989760 |
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| author | Evgenia Manousaki Hanneke Andriesse Gunnar Hägglund Axel Ström Anna-Clara Esbjörnsson |
| author_facet | Evgenia Manousaki Hanneke Andriesse Gunnar Hägglund Axel Ström Anna-Clara Esbjörnsson |
| author_sort | Evgenia Manousaki |
| collection | DOAJ |
| description | Abstract Background The Ponseti method is the gold standard for clubfoot treatment. However, relapse and residual gait deviations are common, and follow-up until 7 years of age is recommended. We evaluated the reliability of the foot drawing method, a new instrument for the follow-up of clubfoot. The method uses drawings of the foot in the neutral position and external rotation to measure foot length and outward rotation. Methods Nineteen children aged 2.5–7 years who were treated with the Ponseti method for congenital clubfoot were included. Two raters made the drawings twice (D1 and D2). Each rater measured foot length, foot rotation, and foot–tibial rotation independently (D1). Later, the raters repeated the measurements (D2). Interrater reliability was assessed using the D1 from each rater. Intrarater reliability was assessed using the measurements from each rater’s D1 and D2. Bland–Altman plots were used to visualize the limits of agreement (LoA). The mean, 95% confidence interval, and one standard deviation of the differences in all measurements were calculated. Results The mean differences between and within raters were: foot length < 1 mm, foot rotation < 1°, and foot–tibia rotation < 2°, which indicated no systematic differences. The LoA for foot length were: 4.5 mm and 5.9 mm between raters for D1, − 4.8 mm and 5.9 mm for rater 1 (D1–D2), and − 5.1 mm and 5 mm for rater 2 (D1–D2). The LoA for foot rotation: were − 12° and 10.6° between raters (D1), − 8.4° and 6.6° for rater 1 (D1–D2), and − 14° and 14.1° for rater 2 (D1–D2). The LoA for foot–tibia rotation were: − 17.8° and 14.3° between raters (D1), − 12° and 12.2° for rater 1 (D1–D2), and − 12.7° and 13.6° for rater 2 (D1– D2). Conclusions The absence of systematic differences between and within raters, and LoA observed indicate that the foot drawing method is applicable in clinical practice and research. However, the results of the foot and foot–tibia rotation analyses imply that caution is needed when interpreting changes in foot rotation in feet with higher degrees of rotation. |
| first_indexed | 2024-12-12T04:30:13Z |
| format | Article |
| id | doaj.art-4cf1ee60835a4deca9f726e4eace07a4 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-12T04:30:13Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4cf1ee60835a4deca9f726e4eace07a42022-12-22T00:38:06ZengBMCBMC Musculoskeletal Disorders1471-24742022-05-012311810.1186/s12891-022-05465-9The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfootEvgenia Manousaki0Hanneke Andriesse1Gunnar Hägglund2Axel Ström3Anna-Clara Esbjörnsson4Department of Clinical Sciences Lund, Orthopedics, Lund University, Skane University HospitalDepartment of Clinical Sciences Lund, Orthopedics, Lund University, Skane University HospitalDepartment of Clinical Sciences Lund, Orthopedics, Lund University, Skane University HospitalClinical Studies Sweden Forum South, Skane University HospitalDepartment of Clinical Sciences Lund, Orthopedics, Lund University, Skane University HospitalAbstract Background The Ponseti method is the gold standard for clubfoot treatment. However, relapse and residual gait deviations are common, and follow-up until 7 years of age is recommended. We evaluated the reliability of the foot drawing method, a new instrument for the follow-up of clubfoot. The method uses drawings of the foot in the neutral position and external rotation to measure foot length and outward rotation. Methods Nineteen children aged 2.5–7 years who were treated with the Ponseti method for congenital clubfoot were included. Two raters made the drawings twice (D1 and D2). Each rater measured foot length, foot rotation, and foot–tibial rotation independently (D1). Later, the raters repeated the measurements (D2). Interrater reliability was assessed using the D1 from each rater. Intrarater reliability was assessed using the measurements from each rater’s D1 and D2. Bland–Altman plots were used to visualize the limits of agreement (LoA). The mean, 95% confidence interval, and one standard deviation of the differences in all measurements were calculated. Results The mean differences between and within raters were: foot length < 1 mm, foot rotation < 1°, and foot–tibia rotation < 2°, which indicated no systematic differences. The LoA for foot length were: 4.5 mm and 5.9 mm between raters for D1, − 4.8 mm and 5.9 mm for rater 1 (D1–D2), and − 5.1 mm and 5 mm for rater 2 (D1–D2). The LoA for foot rotation: were − 12° and 10.6° between raters (D1), − 8.4° and 6.6° for rater 1 (D1–D2), and − 14° and 14.1° for rater 2 (D1–D2). The LoA for foot–tibia rotation were: − 17.8° and 14.3° between raters (D1), − 12° and 12.2° for rater 1 (D1–D2), and − 12.7° and 13.6° for rater 2 (D1– D2). Conclusions The absence of systematic differences between and within raters, and LoA observed indicate that the foot drawing method is applicable in clinical practice and research. However, the results of the foot and foot–tibia rotation analyses imply that caution is needed when interpreting changes in foot rotation in feet with higher degrees of rotation.https://doi.org/10.1186/s12891-022-05465-9ClubfootFoot lengthFoot rotationReliability |
| spellingShingle | Evgenia Manousaki Hanneke Andriesse Gunnar Hägglund Axel Ström Anna-Clara Esbjörnsson The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot BMC Musculoskeletal Disorders Clubfoot Foot length Foot rotation Reliability |
| title | The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot |
| title_full | The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot |
| title_fullStr | The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot |
| title_full_unstemmed | The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot |
| title_short | The foot drawing method: reliability of measuring foot length and outward rotation in children with clubfoot |
| title_sort | foot drawing method reliability of measuring foot length and outward rotation in children with clubfoot |
| topic | Clubfoot Foot length Foot rotation Reliability |
| url | https://doi.org/10.1186/s12891-022-05465-9 |
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