The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지

Reliability of the Foot Posture Index (FPI-6) for Assessment of Stroke Patients

  • Lee, Jong Dae (Department of Physical Therapy, Pohang College) ;
  • Kim, Young Mi (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kim, Kyung (Department of Physical Therapy, College of Rehabilitation Science, Daegu University) ;
  • Koh, Da Hyun (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Choi, Myeong Su (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Lee, Ho Jung (Department of Rehabilitation Science, Graduate School, Daegu University)
  • Received : 2015.09.15
  • Accepted : 2015.10.14
  • Published : 2015.10.25
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study attempted to determine intra-rater reliability and inter-rater reliability for measurement of foot form using the FPI-6 (Foot Posture Index) in patients with hemiplegia caused by stroke. Methods: Twenty two stroke patients were recruited into the research and their foot posture was evaluated using the FPI. Two raters assessed 6 items sequentially in accordance with the FPI-6 manual. This procedure involved asking the subject to take several steps in-place, prior to settling into a comfortable stance position with double limb support. Subjects were instructed to stand still with their arms by their sides and look straight ahead. FPI-6 values ranged from -2 to +2 for each of the six criteria and from -12 to +12 for the total score, indicating a position for each foot either along the supinated (negative score) to pronated (more than +6) continuum of foot posture. Results: The results showed that intra-rater reliability and inter-rater reliability for a total FPI-6 score was high: 0.807-0.888. An almost perfect agreement between the two raters was identified in the foot's morphological classification (Somer's D=0.712; p<0.05). Intra-percentage agreement was high (88.6%). Conclusion: The FPI-6 is a quick, simple, and reliable clinical tool with demonstrated good to excellent intra-rater reliability and good inter-rater reliability when used in assessment of the stroke patient's foot.

Keywords

References

  1. Kelley RE, Borazanci AP. Stroke rehabilitation. Neurological research. 2009;31(8):832-40. https://doi.org/10.1179/016164109X12445505689689
  2. Bloomgren G, Richman S, Hotermans C et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. New England Journal of Medicine. 2012;366(20):1870-80. https://doi.org/10.1056/NEJMoa1107829
  3. Brown SH, Vera-Garcia FJ, McGill SM. Effects of abdominal muscle coactivation on the externally preloaded trunk: Variations in motor control and its effect on spine stability. Spine. 2006;31(13):E387-E93. https://doi.org/10.1097/01.brs.0000220221.57213.25
  4. Karatas M, Cetin N, Bayramoglu M et al. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. American journal of physical medicine & rehabilitation. 2004;83(2):81-7. https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  5. Ko YM, Jung MS, Park JW. The relationship between strength balance and joint position sense related to ankle joint in healthy women. J Kor Phys Ther. 2011;23:23-9.
  6. Neumann DA. Kinesiology of the musculoskeletal system: Foundations for physical rehabilitation. Mosby, 2002: Pages.
  7. Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Archives of physical medicine and rehabilitation. 2002;83(8):1138-44. https://doi.org/10.1053/apmr.2002.33644
  8. Yoon H, Lee S, Lee H. The comparison of plantar foot pressure in normal side of normal people, affected side and less affected side of hemiplegic patients during stance phase. The Journal of Korean Society of Physical Medicine. 2009;4:87-92.
  9. Jang GU, Kweon MG, Park S et al. A study of structural foot deformity in stroke patients. Journal of physical therapy science. 2015;27(1):191. https://doi.org/10.1589/jpts.27.191
  10. Keenan AM, Redmond AC, Horton M et al. The foot posture index: Rasch analysis of a novel, foot-specific outcome measure. Archives of physical medicine and rehabilitation. 2007;88(1):88-93. https://doi.org/10.1016/j.apmr.2006.10.005
  11. Reilly K, Barker K, Shamley D et al. The role of foot and ankle assessment of patients with lower limb osteoarthritis. Physiotherapy. 2009; 95(3):164-9. https://doi.org/10.1016/j.physio.2009.04.003
  12. Forghany S, Tyson S, Nester C et al. Foot posture after stroke: Frequency, nature and clinical significance. Clin Rehabil. 2011;25(11):1050-5. https://doi.org/10.1177/0269215511410581
  13. Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: The foot posture index. Clin Biomech (Bristol, Avon). 2006;21(1):89-98. https://doi.org/10.1016/j.clinbiomech.2005.08.002
  14. Redmond A. The foot posture index: User guide and manual. 2005.
  15. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the sem. J Strength Cond Res. 2005;19(1):231-40. https://doi.org/10.1519/15184.1
  16. Somers RH. A new asymmetric measure of association for ordinal variables. American Sociological Review. 1962;27(6):799-811. https://doi.org/10.2307/2090408
  17. Rome K, Ashford RL, Evans A. Non-surgical interventions for paediatric pes planus. Cochrane Database Syst Rev. 2010(7):CD006311.
  18. Sim J, Wright CC. The kappa statistic in reliability studies: Use, interpretation, and sample size requirements. Phys Ther. 2005;85(3):257-68.
  19. Macfarlane TS, Larson CA, Stiller C. Lower extremity muscle strength in 6- to 8-year-old children using hand-held dynamometry. Pediatr Phys Ther. 2008;20(2):128-36. https://doi.org/10.1097/PEP.0b013e318172432d
  20. Evans AM, Copper AW, Scharfbillig RW et al. Reliability of the foot posture index and traditional measures of foot position. J Am Podiatr Med Assoc. 2003;93(3):203-13. https://doi.org/10.7547/87507315-93-3-203
  21. Gilmour JC, Burns Y. The measurement of the medial longitudinal arch in children. Foot Ankle Int. 2001;22(6):493-8. https://doi.org/10.1177/107110070102200607
  22. Cornwall MW, McPoil TG, Lebec M et al. Reliability of the modified foot posture index. J Am Podiatr Med Assoc. 2008;98(1):7-13. https://doi.org/10.7547/0980007
  23. Morrison SC, Ferrari J. Inter-rater reliability of the foot posture index (fpi-6) in the assessment of the paediatric foot. J Foot Ankle Res. 2009;2:26. https://doi.org/10.1186/1757-1146-2-26
  24. Keenan AM, Redmond AC, Horton M et al. The foot posture index: Rasch analysis of a novel, foot-specific outcome measure. Arch Phys Med Rehabil. 2007;88(1):88-93. https://doi.org/10.1016/j.apmr.2006.10.005
  25. Park JW, Park S. Structural assessment of spastic hemiplegic foot using the foot posture index. J Kor Phys Ther 2011 Dec;23(6):55-9.
  26. Evans AM, Rome K, Peet L. The foot posture index, ankle lunge test, beighton scale and the lower limb assessment score in healthy children: A reliability study. J Foot Ankle Res. 2012;5(1):1. https://doi.org/10.1186/1757-1146-5-1