THE INFLUENCE OF EXPERIENCE ON THE RELIABILITY OF GONIOMETRIC AND VISUAL MEASUREMENT OF FOREFOOT POSITION

Goniometric measurement of forefoot position relative to the rearfoot is a routine procedure used by rehabilitation specialists. This measur ement is also frequently made by visual estimation. The influence of t ester experience on the reliability of these two techniques at the for efoot is unknown. The purpose of this investigation was to directly ex amine the reliability of goniometric and visual estimation of forefoot position measurements when experienced and inexperienced testers perf orm the evaluation. Two clinicians (greater than or equal to 10 years experience) and two physical therapy students were recruited as tester s. Ten subjects (20-31 years old), free from pathology, were measured. Each foot was evaluated twice with the goniometer and twice with visu al estimation by each rester. Intraclass correlation coefficients (ICC ) and coefficients of variation method error were used as estimates of reliability. There was no dramatic difference in the intratester or i ntertester reliability between experienced and inexperienced testers, regardless of the evaluation used. Estimates of intratester reliabilit y (ICC 2,1), when using the goniometer, ranged from 0.08 to 0.78 for t he experienced examiners and from 0.16 to 0.65 for the inexperienced e xaminers. When using visual estimation, ICC (2,1) values ranged from 0 .51 to 0.76 for the experienced examiners and 0.53 to 0.57 for the ine xperienced examiners. The estimate of intertester reliability [ICC (2, 2)] for the goniometer was 0.38 for the experienced examiners and 0.42 for the inexperienced examiners. When using visual estimation, ICC (2 ,2) values were 0.81 for the experienced examiners and 0.72 for the in experienced examiners. Although experience does not appear to influenc e forefoot position measurements, of the two evaluation techniques, vi sual estimation may be the more reliable.