Reliability and Validity of the Orthotic Deformation Test

The aim of this study was to evaluate the validity of an orthotic deformation test on insole arches and the impact of researcher expertise on the test's reproducibility. Three researchers with different levels of experience evaluated orthotic deformation by applying a vertical force with their thumb on the dorsal surface of 48 polypropylene orthoses. An electromechanical test machine was used to evaluate the stiffness of the orthoses, and the results were compared with those of the orthotic deformation tests. Fleiss' kappa and weighted kappa and Mann-Whitney U tests were used to evaluate the interobserver reliability and the validity, respectively. There was no consensus among the three researchers (Kappa = 0.080; p-value = 0.334), although the two researchers with higher levels of experience exhibited moderate consensus (Kappa = 0.52; p-value < 0.001). Orthoses characterised by a positive test suffered from more pronounced deformation when a constant vertical force was applied by the electromechanical test machine (5.62 [4.64-7.38] vs. 4.56 [3.59-5.28] mm; p-value = 0.003). The orthotic deformation test is valid for interpreting the degree of deformation of polypropylene custom orthoses when it is compared with an axial force from a compression-device test. However, considering the high dispersion of the results, it suggests that clinical experience is required to properly interpret the tests.