Ability of foot care professionals to cast feet using the nonweightbearing plaster and the gait-referenced foam casting techniques

Background: We examined the ability of foot care professionals to consistently capture the forefoot-to-rearfoot angular relationship of a single-cast foot. Methods: Eleven Canadian certified pedorthists each cast a single foot twice using the plaster of Paris and foam box techniques. Three independent raters subsequently measured the resultant casts. Statistical analysis of the data provided generalizability coefficient estimates (rho(2)) of the intracaster, intercaster, and rater reliabilities. Results: Intracaster reliabilities were excellent when the plaster and foam box techniques were used (rho(2) = 0.831 and 0.939, respectively). The casters were more intrareliable when foam was used (F = 2.755, P =.003). Intercaster reliabilities were poor for both techniques (rho(2) = 0.410 and 0.425). Although, intrarater reliability was excellent (rho(2) = 0.882), interrater reliability was poor (rho(2) = 0.418). Conclusion: Although plaster of Paris casting is widely perceived by the foot care community as the gold standard, other casting techniques may prove to be equally reliable.