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01-12-2008 | Research | Uitgave 1/2008 Open Access

Journal of Foot and Ankle Research 1/2008

Normative values for the Foot Posture Index

Journal of Foot and Ankle Research > Uitgave 1/2008
Anthony C Redmond, Yvonne Z Crane, Hylton B Menz
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Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-1-6) contains supplementary material, which is available to authorized users.

Competing interests

HBM is Editor-in-Chief of the Journal of Foot and Ankle Research. It is journal policy that editors are removed from the peer review and editorial decision making processes for papers they have coauthored.

Authors' contributions

ACR developed the Foot Posture Index, and with HBM, designed the study. YZC coordinated the data capture and statistical analyses. All authors helped draft the manuscript and read and approved the final manuscript.



The Foot Posture Index (FPI) is a validated method for quantifying standing foot posture, and is being used in a variety of clinical settings. There have however, been no normative data available to date for comparison and reference. This study aimed to establish normative FPI reference values.


Studies reporting FPI data were identified by searching online databases. Nine authors contributed anonymised versions of their original datasets comprising 1648 individual observations. The datasets included information relating to centre, age, gender, pathology (if relevant), FPI scores and body mass index (BMI) where available. FPI total scores were transformed to interval logit scores as per the Rasch model and normal ranges were defined. Comparisons between groups employed t-tests or ANOVA models as appropriate and data were explored descriptively and graphically.


The main analysis based on a normal healthy population (n = 619) confirmed that a slightly pronated foot posture is the normal position at rest (mean back transformed FPI raw score = +4). A 'U' shaped relationship existed for age, with minors and older adults exhibiting significantly higher FPI scores than the general adult population (F = 51.07, p < 0.001). There was no difference between the FPI scores of males and females (2.3 versus 2.5; t = -1.44, p = 0.149). No relationship was found between the FPI and BMI. Systematic differences from the adult normals were confirmed in patients with neurogenic and idiopathic cavus (F = 216.981, p < 0.001), indicating some sensitivity of the instrument to detect a posturally pathological population.


A set of population norms for children, adults and older people have been derived from a large sample. Foot posture is related to age and the presence of pathology, but not influenced by gender or BMI. The normative values identified may assist in classifying foot type for the purpose of research and clinical decision making.

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