title: Standardizing foot-type classification using arch index values.
abstract: OBJECTIVE
  The lack of a reliable classification standard for foot type makes drawing conclusions from existing research and clinical decisions difficult, since different foot types may move and respond to treatment differently. The purpose of this study was to determine interrater agreement for foot-type classification based on photo-box-derived arch index values.
  
  
  METHODS
  For this correlational study with two raters, a sample of 11 healthy volunteers with normal to obese body mass indices was recruited from both a community weight-loss programme and a programme in physical therapy. Arch index was calculated using AutoCAD software from footprint photographs obtained via mirrored photo-box. Classification as high-arched, normal, or low-arched foot type was based on arch index values. Reliability of the arch index was determined with intra-class correlations; agreement on foot-type classification was determined using quadratic weighted kappa (κw).
  
  
  RESULTS
  Average arch index was 0.215 for one tester and 0.219 for the second tester, with an overall range of 0.017 to 0.370. Both testers classified 6 feet as low-arched, 9 feet as normal, and 7 feet as high-arched. Interrater reliability for the arch index was ICC=0.90; interrater agreement for foot-type classification was κw=0.923.
  
  
  CONCLUSIONS
  Classification of foot type based on arch index values derived from plantar footprint photographs obtained via mirrored photo-box showed excellent reliability in people with varying BMI. Foot-type classification may help clinicians and researchers subdivide sample populations to better differentiate mobility, gait, or treatment effects among foot types.
authors.affiliation: Program in Physical Therapy, Neurological Institute, Columbia University, New York.
authors.forename: Christopher Kevin
authors.initials: CK
authors.lastname: Wong
authors.forename: Rich
authors.initials: R
authors.lastname: Weil
authors.forename: Emily
authors.initials: E
authors.lastname: de Boer
keywords: dermatoglyphics; foot deformities; photography; reliability of results