Reliability of a computer-aided color-coded video-based system for clinical assessment of the foot

There is a need for a user-friendly system that can provide quick and reliable assessment of foot disorders. The study described in this report was undertaken to determine the inter-rater and intra-rater reliability of a computer-aided, color-coded, video-based system developed for the assessment of foot alignment in patients with and without pes cavus deformity. Initially, 15 pedal angles were repetitively measured 7 times on 6 color-coded images of both feet, in 20 healthy adults. From the 7 repetitive measurements, the intra-class correlation was calculated and analysis of variance was used to estimate the minimum number of trials that would be necessary to identify a statistically significant difference in the measurements. To determine intra-rater reliability, 5 examiners evaluated a single set of data taken from 10 subjects. Additionally, data were obtained for 20 subjects with pes cavus deformity. The average intra-class correlation coefficient (ICC) for the anglular measurements for 2 to 7 trials was 0.98 +/- 0.06, while the intra-rater reliability was 0.90 +/- 0.14. No statistically significant differences were observed between right and left foot angles in able-bodied subjects; whereas, in the pes cavus group, 8 different angular measurements were observed to be statistically significantly different. The results of this investigation indicate that a computer-aided, color-coded, video-based system can be used to make reliable measurements of postural alignment in patients with and without pes cavus.

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