Background: Quick procedures with proper psychometric properties that can capture the combined alignment of the foot-ankle complex in a position that may be more representative of the status of the lower limb during ground contact are essential for assessing a large group of athletes.
Methods: The assessed lower limb was positioned with the calcaneus surface facing upward in a way that all of the marks could be seen at the center of the camera display. After guaranteeing maintenance of the foot at 90° of dorsiflexion actively sustained by the athlete, the examiner took the picture of the foot-ankle alignment.
Results: Intraclass correlation coefficients ranging from 0.82 to 0.93 demonstrated excellent intratester and intertester reliability for the proposed measurements of forefoot, rearfoot, and shank-forefoot alignments. The intraclass correlation coefficient between the shank-forefoot measures and the sum of the rearfoot and forefoot measures was 0.98, suggesting that the shank-forefoot alignment measures can represent the combined rearfoot and forefoot alignments.
Conclusions: This study describes a reliable and practical measurement procedure for rearfoot, forefoot, and shank-forefoot alignments that can be applied to clinical and research situations as a screening procedure for risk factors for lower-limb injuries in athletes.