Manchester Foot Pain And Disability Index Research Articles

Regenerative peripheral nerve interface reduces the incidence of neuroma in the lower limbs after amputation: a retrospective study based on ultrasound

BackgroundAmputees suffer from symptomatic neuroma and phantom limb pain. Regenerative peripheral nerve interface (RPNI) has recently been regarded as an effective method to prevent neuroma after amputation. However, the verifications of RPNI efficacy are mostly based on subjective evaluation, lacking objective approaches. This study aims to unveil the effect of RPNI on preventing neuroma formation and provide evidence supporting the efficacy of RPNI based on ultrasound.MethodsAmputees of lower limb at Peking University People’s Hospital from July 2020 to March 2022 were analyzed retrospectively. The clinical data collected consisted of general information, pathology of primary disease, history of limb-salvage treatment, amputation level of nerve, pain scales such as the Numerical Rating Scale (NRS) and the Manchester Foot Pain and Disability Index (MFPDI). Three months after amputation, the transverse diameter, anteroposterior diameter, and cross-sectional area of neuromas in stump nerves at the end of residual limbs were measured using ultrasound and compared to adjacent normal nerves.ResultsFourteen patients were enrolled in the study, including 7 in the traditional amputation group (TA group) and 7 in the RPNI group. There was no significant difference in basic information and amputation sites between the two groups. The NRS and MFPDI scores of patients in RPNI group were significantly lower than those in TA group, and decreased with the follow-up time increasing, indicating that RPNI could reduce symptomatic neuroma pain. The comparison of preoperative ultrasound and postoperative pathology showed ultrasound could reflect the size of neuroma in vivo. Independent-sample t tests indicated that the ratios of anteroposterior diameter, transverse diameter and area of the cross section of both the neuroma and adjacent normal nerve obtained via ultrasound were significantly reduced in the RPNI group.ConclusionThis study suggested that RPNI can effectively prevent the formation of symptomatic neuroma after amputation using ultrasound.

Plantar Pain, Balance and Foot Functions in Individuals with Diabetes Mellitus

Aim: The aim of this study was to investigate the relationship between plantar pain, balance and foot function in Diabetes Mellitus (DM) patients with obese and non-obese. Material and Methods: Fifty-four patients were diagnosed as DM were included. Participants were seperated as non-obese (n=27) and obese (n=27). The balance abilities (dynamic and static balance) of participants were examined with the Portable Computerized Kinesthetic Ability Trainer (SportKAT-550). Pain, disability and function status of foot were assessed according to Foot Function Index (FFI) and Manchester Foot Pain and Disability Index (MFPDI). Results: FFI-Disability and MFPDI scores of the Non-Obese.Group were significantly better than Obese Group. While there were no significant correlation between BMI and MFPDI, FFI-Activity.Limitation and FFI-Disability scores in both groups (p>0.05), there was medium and positive significant correlation just between BMI and FFI-Pain.in.Non-Obese Group (p

Is there an association between plantar fasciitis and knee osteoarthritis?

Knee osteoarthritis (OA) and plantar fasciitis share similar risk factors including ageing, occupation, obesity, and inappropriate shoe wear. However, the association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date. We aimed to assess the prevalence of plantar fasciitis using ultrasound in patients with knee OA and to identify factors associated with plantar fasciitis in these patients. We conducted a cross-sectional study including patients with Knee OA, fulfiling the European League Against Rheumatism criteria. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the Lequesne indexes were used to evaluate pain and function of the knees. The Manchester Foot Pain and Disability Index (MFPDI) was used to estimate foot pain and disability. Each patient underwent a physical examination, plain radiographs of the knees and the heels, and an ultrasound examination of both heels to find signs of plantar fasciitis. Statistical analysis was performed using SPSS. We included 40 knee OA patients, with a mean age of 59.85±9.65years [32-74] and a male-to-female ratio of 0.17. The mean WOMAC was 34.03±19.9 [4-75]. The mean Lequesne for knees was 9.62±4.57 [3-16.5]. Among our patients, 52% (n=21) experienced heel pain. The heel pain was severe in 19% (n=4). The mean MFPDI was 4.67±4.16 [0-8]. Limited ankle dorsiflexion and plantar flexion were noted in 47% of patients (n=17) each. High and low arch deformities were seen in 23% (n=9) and 40% (n=16) of patients. Ultrasound revealed a thickened plantar fascia in 62% (n=25). An abnormal hypoechoic plantar fascia was noted in 47% (n=19), with the loss of normal fibrillar architecture in 12 cases (30%). No Doppler signal was exhibited. Patients with plantar fasciitis had significantly limited dorsiflexion (n=2 (13%) versus n=15 (60%), p=0.004) and plantar flexion (n=3 (20%) versus n=14 (56%), p=0.026). The range of supination was also less important in the plantar fasciitis group (17.73±4.1 vs. 12.8±6.46, p=0.027). The low arch was statistically more present in patients with plantar fasciitis (G1: 36% [n=9] vs. G0: 0% [n=0], p=0.015). However, the high arch deformity was statistically more present in patients without plantar fasciitis (G1: 28% [n=7] vs. G0: 60% [n=9], p=0.046). Multivariate analysis showed that the risk factor for plantar fasciitis in knee OA patients was limited dorsiflexion (OR=3.889, 95% CI [0.017-0.987], p=0.049). In conclusion, our work showed that plantar fasciitis is frequent in knee OA patients, with reduced ankle dorsiflexion being the main risk factor for plantar fasciitis in these patients.

Translation, Cultural Adaptation, and Psychometric Evaluation of the Manchester Foot Pain and Disability Index in Persian-Speaking Iranians With Foot Disorders

Foot pain has a significantly detrimental effect on mobility, function, and health status. Researchers have developed a number of measurement tools to assess foot health and its impact on quality of life. This study was conducted to translate the original English Manchester Foot Pain and Disability Index (MFPDI) into Persian and to examine the psychometric properties of the Persian version. A total of 206 patients with a range of foot disorders filled out the Persian version of the MFPDI and the Short-Form 36 Health Survey. The Persian version of the MFPDI was re-completed by the participants at an interval of 5 to 7 days. The analyses performed included internal consistency, test-retest reliability, construct validity, and floor and ceiling effect analysis. The Persian MFPDI had a good internal consistency (Cronbach's α ≥ 0.70) and test-retest reliability (intraclass correlation coefficient=0.84). The construct validity of the Persian MFPDI was demonstrated to be acceptable as a result of its significantly strong negative correlations with the Short-Form 36 Health Survey. The results of this study showed that the Persian version of the MFPDI is a valid and reliable measure to assess foot-related disability.

Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis.

The present study was undertaken to determine whether vitamin D supplementation or maintaining sufficient vitamin D level reduces foot pain over 2 years in patients with symptomatic knee osteoarthritis (OA). A post hoc study was conducted from a randomized, double-blind, placebo-controlled trial named the Vitamin D Effect on Osteoarthritis (VIDEO) study. Symptomatic knee OA patients with serum 25-hydroxyvitamin D levels between 12.5 nmoles/liter and 60 nmoles/liter were included and randomly allocated to either monthly vitamin D3 or placebo treatment (1:1) for 2 years. Manchester Foot Pain and Disability Index (MFPDI) was used to evaluate foot pain and disabling foot pain was defined as at least 1 of the 10 functional limitation items (items 1-9 and 11) being documented as on "most/every day(s)" in the last month. A repeated-measures, mixed-effects model was used to analyze the change of MFPDI scores between groups adjusting for potential confounders. A total of 413 patients with a mean age of 63.2 years (49.7% males) were enrolled and 340 completed the study. The mean MFPDI score was 22.8 ± 7.3, with 23.7% of participants having disabling foot pain at baseline. There were significant differences in MFPDI scores change between groups over 2 years, with more improvements in the vitamin D group than in the placebo group (-0.03 versus 1.30; P = 0.013) and more improvement in those maintaining sufficient vitamin D levels (n = 226) than those who did not (n = 114) (-0.09 versus 2.19; P = 0.001). Vitamin D supplementation and maintenance of sufficient vitamin D levels may improve foot pain in those with knee OA.

The translation, cultural adaptation and psychometric evaluation of the Manchester Foot Pain and Disability Index in Persian-speaking Iranians with foot disorder

BackgroundFoot pain has a significantly detrimental effect on mobility, function and health status. Researchers have developed a number of measurement tools to assess foot health and its impact on the quality of life. This study was conducted to translate the original English Manchester Foot Pain and Disability Index (MFPDI) into Persian and to examine the psychometric properties of the Persian version. MethodsA total of 206 patients with a range of foot disorders filled out the Persian version of the MFPDI and the Short-Form 36 Health Survey (SF-36). The Persian version of the MFPDI was re-completed by the participants at an interval of five to seven days. The analyses performed included internal consistency, test-retest reliability, construct validity, and floor and ceiling effect analysis. ResultsThe Persian MFPDI had a good internal consistency (Cronbach’s α≥0.70) and test-retest reliability (ICC=0.84). The construct validity of the Persian MFPDI was demonstrated to be acceptable as a result of its significantly strong negative correlations with the SF-36. ConclusionThe results of this study showed that the Persian version of the MFPDI is a valid and reliable measure to assess foot-related disability.

Validation of the Chinese Manchester foot pain and disability index (C-MFPDI) among patients with inflammatory arthritis

BackgroundThe Manchester Foot Pain and Disability Index (MFPDI) is a patient-reported outcome tool used to measure foot pain and foot-related disability. The English version of the MFPDI has been successfully translated into other European languages, but there was no Chinese version to use in Chinese-speaking communities. The cross-sectional correlational study aimed to translate the MFPDI from English into simplified Chinese (C-MFPDI) and to test its psychometric properties among people with inflammatory arthritis in Singapore.MethodsThe MFPDI was translated from English into Chinese using a forward-backward translation framework and was administered to 100 Chinese-speaking people with inflammatory arthritis. From the original 100 participants, 30 participants re-evaluated the C-MFPDI after 2 weeks. A Visual Analogue Scale and the Taiwan Chinese Foot Function Index in simplified Chinese were used to evaluate concurrent validity with the C-MFPDI. Health-related quality of life was assessed using the Chinese version of the European Quality of Life-5 Dimension to test construct validity.ResultsThe C-MFPDI had a high translation equivalent rate (96.3%) and content validity index (0.92), good internal consistency (Cronbach’s α = 0.90) and test-retest reliability (ICC = 0.87). The concurrent validity of the C-MFPDI was demonstrated to be acceptable through its significantly moderate to strong positive correlations with the Taiwan Chinese Foot Function Index (r = 0.62–0.72, p < 0.01) and Visual Analogue Scale foot pain (r = 0.65, p < 0.01). The C-MFPDI total scores were moderately negatively associated with Chinese European Quality of Life-5 Dimension utility scores (r = − 0.40, p < 0.01).ConclusionThe C-MFPDI had good psychometric properties. The C-MFPDI can be used to assess disabling foot pain, impairment and disability in Chinese-speaking people with inflammatory arthritis.

Validation and cross-cultural adaptation of Greek version of Achilles tendon Total Rupture Score

BackgroundThe purpose of this study was the translation, cross-cultural adaptation and validation of the Achilles Tendon Total Rupture Score (ATRS) in Greek population. MethodsThe translation and cross-cultural adaptation of the original version of ATRS in Greek language was performed according to the methodology described by Beaton et al. Validation and test–retest reliability were evaluated in forty-six patients, treated surgically for acute Achilles tendon rupture. Validity was evaluated by correlation of total and all subscale scores of Greek version of Manchester Foot Pain and Disability Index (MFPDI). Test–retest reliability evaluated with interclass correlation coefficient and Crombach’s α coefficient was used for internal consistency. ResultsThe internal consistency (α=0.96) and test–retest reliability (ICC=0.97) were excellent. There were no ceiling and floor effects during test–retest assessment. The Greek version of ATRS showed strong correlation with all subscales and overall score of MFPDI (pain subscale: R=−0.954, p<0.01, function subscale: R=−0.811, p<0.01, appearance subscale: R=−0.763, p<0.01, overall: R=−0.914, p<0.01). ConclusionsGreek version of ATRS was successfully adapted in Greek population and it appears to be a valid and reliable instrument to evaluate outcomes in Greek speaking patients after Achilles tendon rupture. Level of evidenceLevel III.

Abstract: A Prospective Randomized Controlled Trial of Autologous Fat Grafting for Pedal Fat Pad Atrophy

INTRODUCTION: Pedal fat pad atrophy is associated with pain, decreased tissue thickness, and elevated foot pressures. To date, no objective studies have investigated the utility of injecting fat into the forefoot to treat this costly and debilitating form of lipoatrophy. We hypothesize that pedal fat grafting can reduce pain, improve function, increase tissue thickness, and decrease pedal pressures. MATERIALS AND METHODS: A randomized, controlled trial was performed, assessing tissue thickness, pain, and foot pressures after fat grafting to the forefoot. Patients were randomized to receive either fat grafting or conservative management. Ultrasound-assessed tissue thickness, pedobarograph-assessed foot pressures, and the Manchester Foot Pain and Disability Index (MFPDI)1 were obtained at baseline, 6mo, and 12mo visits. 18 patients (4 Male, 14 Female) comprised the treatment group, and 12 patients (4 Male, 8 Female) comprised the control group. RESULTS: Average age was 60 ± 8.7 years for the treatment group and 65.3 ± 8.5 for the control. Mean BMI was 26.8 ± 4.7 and 25.6 ± 6.1 in treatment and control groups respectively. 11 patients received bilateral injections with a mean volume of 4.8 ± 0.8mL and 4.7 ± 0.7mL in the right and left feet respectively. Mean follow-up time was 8.7 ± 6.2 months for the treatment group and 13.8 ± 4.2 months for controls (p=0.001). At 1 year, grafted subjects demonstrated improvements in foot function (p=0.022), pain (p=0.022), and work/leisure activities (p=0.021) with a significant increase in tissue thickness over the metatarsal heads (p<0.04) at 6mo but not at 12mo. However, controls experienced significant decreases in average metatarsal tissue thickness over the first 6mo (p<0.05), and in the thickness over the 3rd metatarsal at 12mo (p=0.036), with most of the worsening occurring between the 6mo and 12mo time point (p=0.023). Foot pressures did not decrease after grafting. However, controls experienced increasing left foot pressure (P=0.011). When comparing the groups at 1 year, controls had significantly greater foot pressures and forces than patients receiving fat grafting (p<0.05). CONCLUSION: Despite decreasing tissue thickness over time, fat grafting for forefoot fat pad atrophy significantly improves pain and disability outcomes and prevents worsening foot forces and pressures. Pedal fat grafting is a safe, minimally invasive approach to treat fat pad atrophy with minimal downtime. Future analysis will reveal whether fat grafting has lasting efficacy. DISCLOSURE/FINANCIAL SUPPORT:Supported by a PSF Pilot Research Grant (awarded to Dr. Jeffrey A Gusenoff). None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. REFERENCES: 1. Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ. Development and validation of a questionnaire to assess disabling foot pain. Pain. 2000;85(1–2):107–113. doi:10.1016/S0304-3959(99)00263-8.

Foot and ankle muscle strength in people with gout: A two-arm cross-sectional study

BackgroundFoot and ankle structures are the most commonly affected in people with gout. However, the effect of gout on foot and ankle muscle strength is not well understood. The primary aim of this study was to determine whether differences exist in foot and ankle muscle strength for plantarflexion, dorsiflexion, inversion and eversion between people with gout and age- and sex-matched controls. The secondary aim was to determine whether foot and ankle muscle strength was correlated with foot pain and disability. MethodsPeak isokinetic concentric muscle torque was measured for ankle plantarflexion, dorsiflexion, eversion and inversion in 20 participants with gout and 20 matched controls at two testing velocities (30°/s and 120°/s) using a Biodex dynamometer. Foot pain and disability was measured using the Manchester Foot Pain and Disability Index (MFPDI). FindingsParticipants with gout demonstrated reduced muscle strength at both the 30°/s and 120°/s testing velocities for plantarflexion, inversion and eversion (P<0.05). People with gout also displayed a reduced plantarflexion-to-dorsiflexion strength ratio at both 30°/s and 120°/s (P<0.05). Foot pain and disability was higher in people with gout (P<0.0001) and MFPDI scores were inversely correlated with plantarflexion and inversion muscle strength at the 30°/s testing velocity, and plantarflexion, inversion and eversion muscle strength at the 120°/s testing velocity (all P<0.05). InterpretationPeople with gout have reduced foot and ankle muscle strength and experience greater foot pain and disability compared to controls. Foot and ankle strength reductions are strongly associated with increased foot pain and disability in people with gout.

Foot-related pain and disability and spatiotemporal parameters of gait during self-selected and fast walking speeds in people with gout: A two-arm cross sectional study

ObjectivesTo examine gait parameters in people with gout during different walking speeds while adjusting for body mass index (BMI) and foot-pain, and to determine the relationship between gait parameters and foot-pain and disability. MethodGait parameters were measured using the GAITRite™ walkway in 20 gout participants and 20 age- and sex-matched controls during self-selected and fast walking speeds. Foot-pain and disability was measured using the Manchester Foot Pain and Disability Index (MFPDI) which contains four domains relating to function, physical appearance, pain and work/leisure. ResultsAt the self-selected speed, gout participants demonstrated increased step time (p=0.017), and stance time (p=0.012), and reduced velocity (p=0.031) and cadence (p=0.013). At the fast speed, gout participants demonstrated increased step time (p=0.007), swing time (p=0.005) and stance time (p=0.019) and reduced velocity (p=0.036) and cadence (p=0.009). For participants with gout, step length was correlated with total MFPDI (r=−0.62, p=0.008), function (r=−0.65, p=0.005) and physical appearance (r=−0.50, p=0.041); stride length was correlated with total MFPDI (r=−0.62, p=0.008), function (r=−0.65, p=0.005) and physical appearance (r=−0.50, p=0.041); and velocity was correlated with total MFPDI (r=−0.60, p=0.011), function (r=−0.63, p=0.007) and work/leisure (r=−0.53, p=0.030). ConclusionGait patterns exhibited by people with gout are different from controls during both self-selected and fast walking speeds, even after adjusting for BMI and foot-pain. Additionally, gait parameters were strongly correlated with patient-reported functional limitation, physical appearance and work/leisure difficulties, while pain did not significantly influence gait in people with gout.

Reflecting on the methodological challenge of recruiting older care home residents to podiatry research

Successful randomisd controlled trials (RCTs) require successful participant recruitment; poor recruitment leads to poor, under-powered studies, and may waste grant funds. Recruitment of older care home residents to RCTs is challenging. This is problematic for podiatry, because older people within care home settings are high users of podiatry services; therefore it is essential that strategies are employed to maximise recruitment to RCTs. We describe the experience of recruiting to a feasibility study of a podiatry intervention to reduce falls in care home residents in the East of Scotland. This was the first phase of a two phase project consisting of the feasibility study to acquire data (recruitment strategy, selection of suitable outcome measures) to inform the conduct of the second phase, an exploratory RCT. Recruitment difficulties became apparent early in the study. Difficulties arose when it came to assessing whether or not potential participants fulfilled certain inclusion criteria: (1) Presence of foot pain (defined as foot pain lasting for at least a day in the last month and a positive response of “some days” or “most/every days” to at least one item on the Manchester Foot Pain and Disability Index (MFPDI)) (2) Ability to provide informed consent. The reasons for these difficulties are that (1) we discovered that in the area in which our study was conducted, the majority of care home residents receive basic NHS podiatry care to treat any superficial lesions (i.e. pathological nails and skin callus) thus the prevalence of foot pain resulting from these lesions was lower than we had originally anticipated, and (2) the care homes that we engaged for this phase of the study had residents who were far more dependent and with much higher levels cognitive impairment than we anticipated, making obtaining informed consent difficult. Based on the existing inclusion criteria, it was deemed unlikely that we would meet our recruitment target for the subsequent exploratory randomised controlled trial (n=40).

Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish

The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment 19-item questionnaire developed in the UK to measure foot pain and disability. This study aimed at conducting cross-cultural adaptation and validation of the MFPDI for use in Spain. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures were followed in the MFPDI adaptation into Spanish. The cross-cultural validation involved Rasch analysis of pooled data sets from Spain and the UK. Spanish data set comprised 338 patients, five used in the adaptation phase and 333 in the cross-cultural validation phase, mean age (SD) = 55.2 (16.7) and 248 (74.5 %) were female. A UK data set (n = 682) added in the cross-cultural validation phase; mean age (SD) = 51.6 (15.2 %) and 416 (61.0 %) were female. A preliminary analysis of the 17-item MFPDI revealed significant local dependency of items causing significant deviation from the Rasch model. Grouping all items into testlets and re-analysing the MFPDI as a 3-testlet scale resulted in an adequate fit to the Rasch model, χ (2) (df) = 15.945 (12), p = 0.194, excellent reliability and unidimensionality. Lack of cross-cultural invariance was evident on the functional and personal appearance testlets. Splitting the affected testlets discounted the cross-cultural bias and satisfied requirements of the Rasch model. Subsequently, the MFPDI was calibrated into interval-level scales, fully adjusted to allow parametric analyses and cross-cultural data comparisons when required. Rasch analysis has confirmed that the MFPDI is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions.

OP0142-HPR Psychometric Characteristics of a Spanish Translation of the Manchester Foot Pain and Disability Index: Validation and Rasch Analysis

BackgroundThe Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment questionnaire developed in the UK to measure foot pain and disability in the general population1. It has been translated...

AB0852-HPR Pedobagraphic measurements of rheumatoid feet and comparison with clinical parameters

BackgroundFoot involvement in rheumatoid arthritis (RA) have been reported to be 56-100% in different studies. Pedobarography is used for dynamic plantar pressure measurement and to point out deformities of rheumatoid...

Development of a Danish Language Version of the Manchester Foot Pain and Disability Index: Reproducibility and Construct Validity Testing

Introduction. The Manchester Foot Pain and Disability Index (MFPDI) is a 19-item questionnaire for the assessment of disability caused by foot pain. The aim was to develop a Danish language version of the MFPDI (MFPDI-DK) and evaluate its reproducibility and construct validity. Methods. A Danish version was created, following a forward-backward translation procedure. A sample of 84 adult patients with foot pain was recruited. Participants completed two copies of the MFPDI-DK within a 24- to 48-hour interval, along with the Medical Outcomes Study Short Form 36 (SF-36), and a pain Visual Analog Scale (VAS). Reproducibility was assessed using the intraclass correlation coefficient (ICC) and 95% limits of agreement (Bland-Altman plot). Construct validity was evaluated with Pearson's Rho, using a priori hypothesized correlations with SF-36 subscales and VASmean. Results. The MFPDI-DK showed very good reliability with an ICC of 0.92 (0.88–0.95). The 95% limits of agreement ranged from −6.03 to 6.03 points. Construct validity was supported by moderate to very strong correlations with the SF-36 physical subscales and VASmean. Conclusion. The MFPDI-DK appears to be a valid and reproducible instrument in evaluating foot-pain-related disability in Danish adult patients in cross-sectional samples. Further research is needed to test the responsiveness of the MFPDI-DK.

Erratum to: A survey of foot problems in community‐dwelling older Greek Australians

Since the publication of our Research article [1], the copyright of the Manchester Foot Pain and Disability Index (MFPDI) now states a licence agreement is required for publication. As a result, Additional file 2 has been removed, the English language version of the MFPDI can be found through the ISIS Outcomes website [2].

The effect of foot orthoses on balance, foot pain and disability in elderly women with osteoporosis: a randomized clinical trial

To evaluate the effect of insoles with medial arch support and metatarsal pad on balance, foot pain and disability in elderly women with osteoporosis. This was a randomized controlled clinical trial. Ninety-four elderly women (>60 years) with osteoporosis in treatment in the outpatient clinic of the Rheumatology Division of UNICAMP were randomly assigned to an intervention group (IG) with foot orthoses or to a control group (CG) without orthoses. The Berg Balance Scale (BBS), the Timed Up and Go test (TUG), the Manchester Foot Pain and Disability Index (MFPDI) and a numeric pain scale (NPS) were assessed at baseline and after 4 weeks. The chi-squared test, Fisher's exact test and Mann-Whitney test were applied to compare baseline values between the two groups. Repeated measures of analysis of variance followed by Tukey's test for multiple comparisons and the contrast profile test were used to compare the longitudinal measures. For numeric variable relationship analysis, the Spearman correlation coefficient was used. The groups were similar at baseline. Only subjects from the IG displayed improvements in balance (both BBS and TUG), foot pain (NPS) and disability (MFPDI) (P < 0.001). Minor adverse effects were noted. Foot orthoses were effective for improving balance and for reducing pain and disability in elderly women. Orthoses can be used as an adjuvant strategy to improve balance and to prevent falls in the elderly.

The Swindon Foot and Ankle Questionnaire: Is a Picture Worth a Thousand Words?

Objectives. Despite increased awareness of the high prevalence and significance of foot and ankle problems in rheumatoid arthritis (RA), feet remain neglected. Reasons may include the perception that feet are difficult to assess, they are not included in the DAS28, and lack of freely available foot screening tools specific for RA. Methods. The Swindon Foot and Ankle Questionnaire (SFAQ) is a simply worded 10-point foot and ankle screening questionnaire with diagrams of feet and ankles for use in general rheumatology outpatients. All RA patients on our electronic database were invited to complete the questionnaire and attend clinic for assessment. Patients assessed clinically were scored out of 10 using the parameters from the questionnaire. The SFAQ was compared to the Manchester Foot Pain and Disability Index (MFPDI), DAS28, HAQ, HAD, and OSRA scores. Results. 597 questionnaires were sent, 301 (50%) returned, and 137 seen in clinic. There was good correlation between the postal SFAQ score, clinic score (r = 0.63), and the MFPDI (r = 0.65). Neither of the foot scores correlated with other RA disease outcome measures. 75% patients completed the picture. 73% corresponded to clinical findings. 45% of patients required an intervention following clinical review and trended towards higher scores. Conclusions. The SFAQ was quick to complete and correlated with the MFPDI. Lack of association with standard RA outcome measures suggests that relying on these scores alone may miss foot pathology. The diagrams were a useful complement. This simple screening tool could aid identification of RA foot and ankle problems.

Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass

To examine the relationship between obesity, body composition, and foot pain as assessed by the Manchester Foot Pain and Disability Index (MFPDI). Subjects 25-62 years of age (n = 136) were recruited as part of a study examining the relationship between obesity and musculoskeletal health. Foot pain was defined as current foot pain and pain in the last month, and an MFPDI score of ≥1. Body composition (tissue mass and fat distribution) was measured using dual x-ray absorptiometry. The body mass index (BMI) in this population was normally distributed around a mean of 32.1 kg/m(2). The prevalence of foot pain was 55.1%. There was a positive association between BMI and foot pain (odds ratio [OR] 1.11, 95% confidence interval [95% CI] 1.06-1.17). Foot pain was also positively associated with fat mass (OR 1.05, 95% CI 1.02-1.09) and fat mass index (FMI; OR 1.16, 95% CI 1.06-1.28) when adjusted for age, sex, and skeletal muscle mass and age, sex, and fat-free mass index (FFMI), respectively. When examining fat distribution, positive associations were observed for android/total body fat ratio (OR 1.42, 95% CI 1.11-1.83) and android/gynoid fat ratio (OR 35.15, 95% CI 2.60-475.47), although gynoid/total body fat ratio was inversely related to foot pain (OR 0.83, 95% CI 0.73-0.93). Skeletal muscle mass and FFMI were not associated with foot pain when adjusted for fat mass or FMI, respectively. Increasing BMI, specifically android fat mass, is strongly associated with foot pain and disability. This may imply both biomechanical and metabolic mechanisms.