SciELO - Scientific Electronic Library Online

vol.48 issue1Metric properties of the "timed get up and go- modified version" test, in risk assessment of falls in active womenSevere microscopic polyangiitis with unilateral vocal cord paralysis as initial manifestation author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand



Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Colombia Médica

On-line version ISSN 1657-9534


GONZALEZ-MARTIN, Cristina et al. Variability between Clarke's angle and Chippaux-Smirak index for the diagnosis of flat feet. Colomb. Med. [online]. 2017, vol.48, n.1, pp.25-31. ISSN 1657-9534.


The measurements used in diagnosing biomechanical pathologies vary greatly. The aim of this study was to determine the concordance between Clarke's angle and Chippaux-Smirak index, and to determine the validity of Clarke's angle using the Chippaux-Smirak index as a reference.


Observational study in a random population sample (n= 1,002) in A Coruña (Spain). After informed patient consent and ethical review approval, a study was conducted of anthropometric variables, Charlson comorbidity score, and podiatric examination (Clarke's angle and Chippaux-Smirak index). Descriptive analysis and multivariate logistic regression were performed.


The prevalence of flat feet, using a podoscope, was 19.0% for the left foot and 18.9% for the right foot, increasing with age. The prevalence of flat feet according to the Chippaux-Smirak index or Clarke's angle increases significantly, reaching 62.0% and 29.7% respectively. The concordance (kappa I) between the indices according to age groups varied between 0.25-0.33 (left foot) and 0.21-0.30 (right foot). The intraclass correlation coefficient (ICC) between the Chippaux-Smirak index and Clarke's angle was -0.445 (left foot) and -0.424 (right foot). After adjusting for age, body mass index (BMI), comorbidity score and gender, the only variable with an independent effect to predict discordance was the BMI (OR= 0.969; 95% CI: 0.940-0.998).


There is little concordance between the indices studied for the purpose of diagnosing foot arch pathologies. In turn, Clarke's angle has a limited sensitivity in diagnosing flat feet, using the Chippaux-Smirak index as a reference. This discordance decreases with higher BMI values.

Keywords : Footprint; Pedigraph; Chippaux-Smirak index; Clarke's angle; Flatfoot; Foot; Sensitivity and Specificity; Anthropometry; Podiatry.

        · abstract in Spanish     · text in English | Spanish     · English ( pdf ) | Spanish ( pdf )