The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study

A repeated measures, same-subject design assessed the intra- and inter-rater reliability of measures of foot posture, joint hypermobility and ankle range: the Foot Posture Index (FPI-6), the ankle lunge test, the Beighton scale and the lower limb assessment scale (LLAS), used by two examiners in 30 healthy children (aged 7 to 15 years). The Oxford Ankle Foot Questionnaire (OxAFQ-C) was completed by participants and a parent, to assess the extent of foot and ankle problems.The OxAFQ-C demonstrated a mean (SD) score of 6 (6) in adults and 7(5) for children, showing good agreement between parents and children, and which indicates mid-range (transient) disability. Intra-rater reliability was good for the FPI-6 (ICC = 0.93 - 0.94), ankle lunge test (ICC = 0.85-0.95), Beighton scale (ICC = 0.96-0.98) and LLAS (ICC = 0.90-0.98). Inter-rater reliability was largely good for each of the: FPI-6 (ICC = 0.79), ankle lunge test (ICC = 0.83), Beighton scale (ICC = 0.73) and LLAS (ICC = 0.78).The four measures investigated demonstrated adequate intra-rater and inter-rater reliability in this paediatric sample, which further justifies their use in clinical practice.Outcome measures are important when evaluating effectiveness of treatment and progress towards a final goal in paediatric populations. A Cochrane systematic review published by us recently highlighted the importance of the use of reliable and validated outcome measures [1]. However, the current evidence around the use of reliable outcome measures in paediatric populations is sparse.In the paediatric health care setting, measuring children's progress towards individual outcomes is increasingly important. Such measurements must be individual, in view of the diversity of developmental disabilities, goals, and interventions. The heterogeneity of the population often induces researchers to use generic standardised measurement tools or health-related quality of life measures; however, many are limited in terms of specificity a