CONSISTENCY OF VISUAL ASSESSMENTS OF ARCH HEIGHT AMONG CLINICIAN

Flat feet and high-arched feet have been cited as risk factors for mus culoskeletal injury and functional problems among runners and other ac tive individuals, although there are no established quantitative defin itions or measures for assessing either condition. As part of a larger study, four-plane photographs were made of the weight-bearing right f oot of 246 young male Army trainees. These photographs were independen tly evaluated by six clinicians and rated on a scale of clearly flat-f ooted (category 1) to clearly high arched (category 5). There was much interclinician variability in the assessments, even for extremes of f oot type. The probability of a clinician assessing a foot as clearly f lat, given that another clinician had rated the foot as clearly flat, ranged from 0.32 to 0.79, with a median probability of 0.57, while for clearly high-arched feet, probabilities ranged from 0.0 to 1.00, with a median of 0.17. These findings demonstrate the need for objective s tandards and quantitative methods of evaluating foot morphology.