Email updates

Keep up to date with the latest news and content from Journal of Foot and Ankle Research and BioMed Central.

Open Access Open Badges Research

Reliability of capturing foot parameters using digital scanning and the neutral suspension casting technique

Matthew Carroll*, Mary-Ellen Annabell and Keith Rome

Author Affiliations

Department of Podiatry, School of Rehabilitation & Occupation Studies, Health & Rehabilitation Research Institute, AUT University, Private Bag 92006, Auckland, 1142, New Zealand

For all author emails, please log on.

Journal of Foot and Ankle Research 2011, 4:9  doi:10.1186/1757-1146-4-9

Published: 4 March 2011



A clinical study was conducted to determine the intra and inter-rater reliability of digital scanning and the neutral suspension casting technique to measure six foot parameters. The neutral suspension casting technique is a commonly utilised method for obtaining a negative impression of the foot prior to orthotic fabrication. Digital scanning offers an alternative to the traditional plaster of Paris techniques.


Twenty one healthy participants volunteered to take part in the study. Six casts and six digital scans were obtained from each participant by two raters of differing clinical experience. The foot parameters chosen for investigation were cast length (mm), forefoot width (mm), rearfoot width (mm), medial arch height (mm), lateral arch height (mm) and forefoot to rearfoot alignment (degrees). Intraclass correlation coefficients (ICC) with 95% confidence intervals (CI) were calculated to determine the intra and inter-rater reliability. Measurement error was assessed through the calculation of the standard error of the measurement (SEM) and smallest real difference (SRD).


ICC values for all foot parameters using digital scanning ranged between 0.81-0.99 for both intra and inter-rater reliability. For neutral suspension casting technique inter-rater reliability values ranged from 0.57-0.99 and intra-rater reliability values ranging from 0.36-0.99 for rater 1 and 0.49-0.99 for rater 2.


The findings of this study indicate that digital scanning is a reliable technique, irrespective of clinical experience, with reduced measurement variability in all foot parameters investigated when compared to neutral suspension casting.