Analysis of Footprints Obtained by Harris-Beath Method in Adult Women: Evaluation of Pes Planus on Plantar Indexes

Öz

Objective: Studies conducted to define the foot structure include the anatomical structures and anthropometric points within the foot. Harris Beath footprint stamp is a frequently used method for obtaining footprints. The data obtained from these marks can be used to identify foot problems such as pes planus. In this study, we aimed to determine the diagnostic sensitivity and cut-off points of different indices in flatfoot. Materials and Methods: 120 healthy adult women between the ages of 18-45 participated in our study. Static right footprints of the volunteers were obtained using the Harris Beath method and transferred to the computer with the help of a scanner. Images using ImageJ 1.51.8 program; arch index, Chippaux-Smiraks index, Stahel index and arch angle were calculated. In the distinction between normal foot and pes planus, arch index ≥0.26 was accepted as the reference. Sensitivity, specificity and cut-off values were calculated by performing nonparametric ROC curve analysis. The curves of the measurements were compared in pairs in terms of diagnostic value. Results: Sensitivity and specificity values for pes planus; It was found 0.86 and 0.68 (cut-off value: 0.374) for the Chippoux-Smiraks index, 0.87 and 0.65 (cut-off value: 0.632) for the Staheli index, and 0.65 and 0.78 (cut-off value: 35.923) for the arch angle. There was no significant difference in pairwise comparison of the ROC curves obtained for each method (P> 0.05). Conclusion: We believe that the Chippoux-Smiraks index, Staheli index and arch angle measurements can be used in pes planus screening in adult women in the population where the study sample was taken, due to their ease of application and harmlessness, as well as their high diagnostic sensitivity and specificity.

Anahtar Kelimeler

• Clinical Assessment
• Flatfoot
• Footprint Index
• Receiver Operating Characteristic Curve

Erişkin Kadınlarda Harris-Beath Yöntemi ile Elde Edilen Ayak İzlerinin Analizi: Plantar İndeksler Üzerinden Pes Planus Değerlendirmesi

Öz

Giriş ve Amaç: Ayak yapısını tanımlamak için yapılan çalışmalar, ayak içindeki anatomik yapıları ve antropometrik noktalarının ölçülmesini içerir. Harris Beath ayak izi ıstampası ayak izi elde edilmesinde sıklıkla kullanılan bir yöntemdir. Bu izlerden elde edilen veriler pes planus gibi ayak sorunlarının belirlenmesinde kullanılabilmektedir. Bu çalışmada farklı indekslerin pes planus konusunda tanı duyarlılığını ve kesme noktalarını belirlemeyi amaçladık. Gereç ve Yöntemler: Çalışmamıza 18-45 yaş aralığındaki 120 sağlıklı yetişkin kadın katıldı. Gönüllülerin statik sağ ayak izleri Harris Beath yöntemi kullanılarak elde edildi ve bir tarayıcı yardımıyla bilgisayar ortamına aktarıldı. Görüntüler ImageJ 1.51.8 programı kullanılarak; ark indeks, Chippaux-Smiraks indeksi, Staheli indeksi ve ark açısı hesaplandı. Normal ayak ve pes planus ayırımında ark indeks ≥0.26 referans kabul edildi. Nonparametrik ROC eğrisi analizi yapılarak duyarlılık, özgünlük ve kesme değerleri hesaplandı. Ölçümlere ait eğriler tanısal değeri bakımından ikili olarak karşılaştırıldı. Bulgular: Pes planus için duyarlılık ve özgünlük değerleri; Chippoux-Smiraks indeksi için 0.86 ve 0.68 (kesme değeri: 0.374), Staheli indeksi için 0.87 ve 0.65 (kesme değeri: 0.632) ve ark açısı için 0.65 ve 0.78 (kesme değeri: 35,923) olarak bulundu. Her bir yöntem için elde edilen ROC eğrilerinin ikili karşılaştırılmasında anlamlı fark saptanmadı(P>0.05). Sonuç: Ayak izinden hesaplanan Chippoux-Smiraks indeksi, Staheli indeksi ve ark açısı ölçümlerinin uygulama kolaylığı ve zararsız olması yanı sıra tanısal duyarlılık ve özgüllüklerinin yüksek olmasıyla, çalışma örnekleminin alındığı toplumda erişkin kadınlarda toplumsal pes planus taramalarında kullanılabileceği kanısındayız

Anahtar Kelimeler

• Ayak İzi İndeksleri
• Pes Planus
• Klinik Değerlendirme
• Alıcı İşletim Karakteristik Eğrisi

Kaynakça

1. Sammarco, G.J, Hockenbury R.T, Biomechanics of the foot and ankle. In: Nordin, M. and V.H. Frankel (ed), Basic Biomechanics of the Musculoskeletal System, 3rd edn, Lippincott Williams & Wilkins, New York, 2001, 222-253.
2. Drake, R, A.W, Vogl, and A.W. Mitchell, Gray's Anatomy for Students E-book, 2nd edn, Elsevier Health Sciences, Philadelphia, 2009, p.600-624.
3. Palastanga, N, Soames, R, Anatomy and Human Movement: Structure and Function, 6th edn, Churchill Livingstone, Elsevier, Edinburgh, 2011, p.201-383.
4. Dalley II, A.F, Agur, A.M, Moore, K.L, Essential Clinical Anatomy,5th edn, Lippincott Williams & Wilkins, Philadelphia, 2015, p.362-393.
5. Neumann, D.A, Kinesiology of the Musculoskeletal System; Foundation for Rehabilitation, Mosby & Elsevier, New York, 2010, 387-472.
6. Hunt, A.E, Smith, R.M, Mechanics and control of the flat versus normal foot during the stance phase of walking, Clinical Biomechanics, 2004, 19(4), 391-397.
7. Cavanagh, P.R, Rodgers, M.M, The arch index: a useful measure from footprints, Journal of Biomechanics, 1987, 20(5), p. 547-551.
8. Mathieson, I, Upton, D, Birchenough, A, Comparison of footprint parameters calculated from static and dynamic footprints, The Foot, 1999, 9(3), 145-149.

9. Urry, S.R, Wearing, S.C, A comparison of footprint indexes calculated from ink and electronic footprints, Journal of the American Podiatric Medical Association, 2001, 91(4), p. 203-209.
10. Echarri, J.J, Forriol, F, The development in footprint morphology in 1851 Congolese children from urban and rural areas, and the relationship between this and wearing shoes, Journal of Pediatric Orthopaedics B, 2003, 12(2), 141-146.
11. Goonetilleke, R.S, The Science of Footwear, CRC Press, New York, 2012, 3-112.
12. Razeghi, M, Batt, M.E, Foot type classification: a critical review of current methods, Gait & Posture, 2002, 15(3), 282-291.
13. Stavlas, P, et al., The evolution of foot morphology in children between 6 and 17 years of age: a cross-sectional study based on footprints in a Mediterranean population, The Journal of Foot and Ankle Surgery, 2005, 44(6), 424-428.
14. Gonzalez-Martin, C, et al., Variability between Clarke's angle and Chippaux-Smirak index for the diagnosis of flat feet, Colombia Médica, 2017, 48(1), 25.
15. Menz, H.B, Alternative techniques for the clinical assessment of foot pronation, Journal of the American Podiatric Medical Association, 1998, 88(3),119-129.
16. McCrory, J, et al., Arch index as a predictor of arch height, The Foot, 1997, 7(2), 79-81.
17. Menz, H.B, Munteanu, S.E, Validity of 3 clinical techniques for the measurement of static foot posture in older people, Journal of Orthopaedic & Sports Physical Therapy, 2005, 35(8), 479-486.
18. Staheli, L.T, Chew, Corbett, M, The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults, The Journal Of Bone and Joint Surgery, American volume, 1987, 69(3), 426-428.
19. Queen, R.M, et al., Describing the medial longitudinal arch using footprint indices and a clinical grading system, Foot & Ankle International, 2007, 28(4), 456-462.
20. Fascione, J.M, Crews, R.T, Wrobel, J.S, Dynamic footprint measurement collection technique and intrarater reliability: ink mat, paper pedography, and electronic pedography, Journal of the American Podiatric Medical Association, 2012, 102(2), 130-138.
21. Zuil-Escobar, J.C, et al., Reliability and accuracy of static parameters obtained from ink and pressure platform footprints, Journal of Manipulative and Physiological Therapeutics, 2016, 39(7), 510-517.
22. Igbigbi, P.S, Msamati, B.C, Shariff, M.B, Arch index as a predictor of pes planus: a comparative study of indigenous Kenyans and Tanzanians, Journal of the American Podiatric Medical Association, 2005, 95(3), 273-276.
23. Xiong, S, et al., Foot arch characterization: a review, a new metric, and a comparison, Journal of the American Podiatric Medical Association, 2010, 100(1), 14-24.
24. Pita-Fernández, S, et al., Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older. Journal of Epidemiology, 2015, 25(2), 148-154.
25. Linden, A, Measuring diagnostic and predictive accuracy in disease management: an introduction to receiver operating characteristic (ROC) analysis. Journal of Evaluation in Clinical Practice, 2006, 12(2), 132-139.