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Clinical Research
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How reliable, accurate and valid are current physical examination techniques of the foot and ankle? First Author: James Wrobel Authors: James S Wrobel, David G Armstrong The purpose of this structured literature review was to evaluate the validity, reliability, and accuracy of the orthopaedic, neurological and vascular examination of the foot and ankle. We searched EBSCO, MEDLINE, and the National Guideline Clearinghouse from 1980 to 2006 using database-specific keywords; and searched bibliographies of retrieved articles, the Cochrane Library, and websites. Of several hundred manuscripts identified, 17 fit the criteria offering reliability and/or intra class correlation information. We identified 32 manuscripts divided into the three aforementioned classes of examination. Intra class correlations based on the various examinations performed varied widely. The range was from 0.08 to 0.98, depending on the examination performed. In conclusion, while hundreds of manuscripts exist describing various methods of assessment, few have given attention to these prospective assessments' reliability, accuracy or validity. It is our hope that future works in this area will consider inclusion of these critical measures to better guide the clinician in selecting examinations that can accurately assess functional and physiological status of the lower extremity. This information can then be used by the discerning clinician to strike the delicate balance between the art of clinical examination and the science of reproducibility and validity. |
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