Evaluation of clinician-reported outcome measurement for foot posture in children and adolescents: a systematic review

Abstract

The human foot considered a complex structure, can be classified as neutral, cavus or flat, through clinical tests, imaging tests, plantar pressure, visual assessments, and others. A child with typical development may have a flat foot until the age of eight due to the structures that make up the medial, lateral, and transverse, longitudinal arches still being formed. Although this posture has a spontaneous resolution in some cases, some children and adolescents may present symptoms, reporting pain, and weakness in the lower limbs. The use of clinical tests to classify the foot posture and identify when an intervention is necessary is of great importance in the professional's decision-making process. For this, the best clinical test choice should be based on the properties of measures previously established in the literature and validated in children and adolescents. Objective: this systematic review has as the main objective, to evaluate and critically synthesize the clinical tests used in the literature to assess the posture of the feet of children and adolescents and investigate the property of a more reliable, valid, and better responsive measure.Method: Studies will be included that present in their methodology at least one measurement property of clinical tests that identify the foot posture (validity, reliability, responsiveness, sensitivity, or specificity) in children aged between four and 12 years and adolescents between 12 and 18 years old, female or male, with asymptomatic and/or symptomatic feet and no history of lower limb surgery. Two independent reviewers will carry out a computerized bibliographic search in the MEDLINE, CENTRAL, EMBASE, CINAHL, PEDro, and SciELO databases, and the search strategy will consist of indexed terms, keywords, or free search terms, using synonyms and combinations through Boolean operators to capture all related studies. Any disagreement between the two reviewers will be resolved through a third researcher. Kappa coefficients and 95% confidence intervals (CI) will be calculated to assess reliability among reviewers for item responses.