Reliability and Validity of the INFOOT Three-dimensional Foot Digitizer for Patients with Rheumatoid Arthritis

Abstract

Abnormal foot posture and deformities are identified as important features in rheumatoid arthritis. There is still no consensus regarding the optimum technique(s) for quantifying these features; hence, a foot digitizer might be used as an objective measurement tool. We sought to assess the validity and reliability of the INFOOT digitizer. To investigate the validity of the INFOOT digitizer compared with clinical measurements, we calculated Pearson correlation coefficients. To investigate the reliability of the INFOOT digitizer, we calculated intraclass correlation coefficients, SEMs, smallest detectable differences, and smallest detectable difference percentages. Most of the 38 parameters showed good intraclass correlation coefficients, with values greater than 0.9 for 30 parameters and greater than 0.8 for seven parameters. The left heel bone angle expressed a moderate correlation, with a value of 0.609. The SEM values varied between 0.31 and 3.51 mm for the length and width measures, between 0.74 and 5.58 mm for the height data, between 0.75 and 5.9 mm for the circumferences, and between 0.78° and 2.98° for the angles. The smallest detectable difference values ranged from 0.86 to 16.36 mm for length, width, height, and circumference measures and from 2.17° to 8.26° for the angle measures. For the validity of the INFOOT three-dimensional foot digitizer, Pearson correlation coefficients varied between 0.750 and 0.997. In this rheumatoid arthritis population, good validity was demonstrated compared with clinical measurements, and most of the obtained parameters proved to be reliable.