March 2018

Reliability of FPI-6 in older adults warrants caution

Because it uses 6 items to quantify and classify foot pressure, the Foot Pressure Index-6 (FPI-6) is considered a more complete measure than many others. The FPI-6 has been validated for use with adults aged 18 to 57, where it can play a role in identifying risk factors for sports and training injuries. However, it has not been validated in older adults, where edema, bunions, and bone callosity are more common and may affect the findings, and where this tool can play a role in assessing fall risk.

A recent study in the journal Musculoskeletal Science and Practice sought to confirm the validity of each measure in the FPI-6 in healthy older adults over age 65 by comparing 2 examiners’ ratings from 2 assessments over 2 weeks. While ratings for adults were substantially similar, ratings for older adults varied dramatically in this small, but healthy population. The examiners reported that age-related variations in foot structure made visualizing the underlying biomechanics difficult; as a result, the researchers urged caution when using the FBI-6 in older adults.


Aquino MRC, Avelar BS, Silva PL, et al. Reliability of foot posture index individual and total scores for adults and older adults. Musculoskelet Sci Pract. 2018 Feb 6. pii: S2468-7812(18)30042-0. doi: 10.1016/

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