Journal of the American Podiatric Medical Association最新文献

{"title":"Quantifying the Phoenix Sign: A Double-Blind Pilot Study on Lidocaine and Papaverine-Induced Vascular and Motor Changes After Common Peroneal Nerve Block in Diabetic Neuropathy.","authors":"Stephen L Barrett, Andrew Rader, Sequioa DuCasse, Artinder Nagra, Karen Anderson, Miquel Dalmau Pastor, Dwayne S Yamasaki, Scott Nickerson","doi":"10.3390/japma116030035","DOIUrl":"10.3390/japma116030035","url":null,"abstract":"<p><strong>Background: </strong>Focal entrapment of the Common Peroneal (Fibular) nerve (CPN) is the most frequent lower-extremity nerve entrapment yet it can be difficult to diagnose clinically. The Phoenix Sign-an increase in extensor hallucis longus (EHL) motor strength following lidocaine injection-may assist diagnosis. Additional observed effects include improved arterial perfusion and Doppler waveforms.</p><p><strong>Methods: </strong>In this double-blinded, randomized small pilot study, only four patients (N = 4) with diabetic peripheral neuropathy underwent bilateral peripheral nerve blocks with lidocaine or papaverine. The first leg to be tested was randomized; the contralateral leg received a different agent that was randomized initially. Pre- and post-block assessments included motor strength, Doppler velocity of dorsalis pedis and posterior tibial arteries, and near-infrared spectroscopy for microvascular perfusion.</p><p><strong>Results: </strong>All patients demonstrated increased EHL motor strength after injection with either agent. Doppler waveforms of the dorsalis pedis artery improved: lidocaine produced a 151.7% increase in blood flow velocity (<i>p</i> = 0.03), whereas papaverine produced a 16.8% increase (<i>p</i> = 0.19). Posterior tibial artery flow increased by 37.4% with lidocaine (<i>p</i> = 0.06) and 13.9% with papaverine (<i>p</i> = 0.33), but neither was statistically significant. No changes in oxygen saturation, oxyhemoglobin, deoxyhemoglobin, or total hemoglobin were observed using near-infrared spectroscopy. The consistency of motor responses across subjects supports the validity of the Phoenix Sign as a diagnostic tool.</p><p><strong>Conclusions: </strong>Peripheral nerve blocks with lidocaine or papaverine improved motor strength and macrovascular function in patients with diabetic peripheral neuropathy, though microvascular changes were not detected. These preliminary findings are consistent with the Phoenix Sign phenomenon and support further study as a potential clinical indicator. While these preliminary findings indicate support as a diagnostic tool, they are preliminary and hypothesis-generating for evaluating the Phoenix Sign as a potential clinical indicator of CPN entrapment and highlight the need for larger studies to evaluate vascular responses.</p><p><strong>Trial registration: </strong>NCT06919289 (retrospectively registered 8 April 2025).</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ChatGPT-5 and DeepSeek V3 for Artificial Intelligence-Assisted Patient Education in Foot and Ankle Disorders.","authors":"Bekir Karagoz, Hünkar Cagdas Bayrak, Tolga Keçeci","doi":"10.3390/japma116030033","DOIUrl":"10.3390/japma116030033","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the quality, reliability, and readability of information provided by artificial intelligence-based language models, ChatGPT-5 and DeepSeek V3, regarding foot and ankle disorders.</p><p><strong>Methods: </strong>The quality, reliability, and readability of the texts generated by both AI models were analyzed using DISCERN, the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P), the Global Quality Score (GQS), and the CLEAR scoring system. DISCERN was used to assess information reliability, PEMAT-P to evaluate understandability and actionability, GQS to assess overall quality, and CLEAR to evaluate content quality and accuracy. Standardized questions were asked to both models for 35 different foot and ankle disorders, and the generated texts were evaluated by two independent orthopedic specialists using a blinded method. Readability analysis was performed using word count, the Flesch-Kincaid Grade Level (FKGL; required reading level), and the Flesch Reading Ease (FRE; ease of readability) scoring systems.</p><p><strong>Results: </strong>ChatGPT-5 scored significantly higher than DeepSeek V3 in DISCERN, PEMAT-P, GQS, and CLEAR evaluations (<i>p</i> < 0.05), indicating that ChatGPT-5 provides more reliable, comprehensive, and higher-quality information. DeepSeek V3 demonstrated better readability, producing simpler and more understandable content, as reflected in its lower FKGL score and higher FRE score.</p><p><strong>Conclusions: </strong>While ChatGPT-5 delivers more detailed and reliable health information, DeepSeek V3 offers simpler and more readable texts. Both models have distinct advantages for patient education. Future research should assess the impact of AI-generated health information on patient decision-making and its clinical application potential.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Value of Technetium Tc 99m Monomer Methoxy Isobutyl Isonitrile Scintigraphy for the Level of Lower-Limb Amputation in Patients with Diabetic Foot Ulcers.","authors":"Mehmet Ekici, Ali Eray Günay, Seyhan Karaçavuş, Hümeyra Gençer, Fırat Ozan","doi":"10.3390/japma116030034","DOIUrl":"10.3390/japma116030034","url":null,"abstract":"<p><p><b>Background</b>: There is a positive relationship between mitochondrial damage in the cell and uptake in technetium Tc 99m monomer methoxy isobutyl isonitrile (^99mTc-MIBI) scintigraphy. Severe mitochondrial dysfunction with cell death occurs in patients with diabetic foot ulcers (DFUs). To decide on the level of amputation, ^99mTc-MIBI scintigraphy should be considered. <b>Methods</b>: Prospectively, 24 patients with DFUs were included in the study. Based on treatment that started with the hospitalization, patients were divided into two groups: those whose DFUs healed and did not need surgical intervention (healed group) and those whose DFUs did not regress despite surgical and medical treatment and who required further surgical intervention (reoperation group). Before surgery, ^99mTc-MIBI scintigraphy was performed. The ^99mTc-MIBI uptake rates of the injured foot relative to the healthy foot were recorded. Deep-tissue culture was taken at surgery. Erythrocyte sedimentation rate, white blood cell count, and C-reactive protein (CRP) and albumin levels were measured. <b>Results</b>: The ^99mTc-MIBI uptake rates of patients with poor prognosis were higher at all times than those of patients who did not require revision surgery. A significant difference was found between these values in the 10 and 30 s rates. The mean ± SD CRP level was 86.04 ± 21.87 mg/dL in the healed group and 144.43 ± 27.54 mg/dL in the reoperation group (<i>p</i> = 0.040). There was a positive correlation between ulcerated foot and healthy foot ^99mTc-MIBI involvement rates at 10 and 30 s and CRP values, and a negative correlation between albumin values. <b>Conclusions</b>: There was a significant relationship between ^99mTc-MIBI involvement rates and poor prognosis and reamputation. The correlation between CRP and albumin levels, which are among the predictive values, and ^99mTc-MIBI uptake confirmed this relationship in DFUs, which are difficult to manage and treat.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Provider Knowledge and Utilization of the Medicare Therapeutic Shoe Benefit.","authors":"Carol Szmuilowicz Kurth, Ryan Thomas Crews","doi":"10.3390/japma116030032","DOIUrl":"10.3390/japma116030032","url":null,"abstract":"<p><p>The Therapeutic Shoe Benefit (TSB) allows Medicare insurance beneficiaries to reduce their diabetic foot ulcer risk by providing offloading shoes. Anecdotal evidence suggests that the process is cumbersome and that not all providers are aware of this benefit. This study evaluated TSB awareness across multiple healthcare disciplines and documented barriers to utilization. An online study surveyed healthcare providers practicing in the United States to determine familiarity with TSB and barriers to prescribing therapeutic shoes. The project was IRB-reviewed and received exempt status. The survey was sent to a wide variety of healthcare practitioners including: podiatrists, primary care providers, physical therapists, orthotist/prosthetists, specialty providers, and diabetes educators. This was done through targeted emails from professional organizations, word-of-mouth messaging through private practice groups, and marketing on LinkedIn. The survey was administered via Qualtrics with embedded branching logic used to gather data from the TSB's three classifications of healthcare specialists: certifying physicians, prescribing practitioners, and suppliers. A total of 580 valid completions of the survey were analyzed. Irrespective of the TSB, podiatric physicians and medical professionals providing direct patient care recommend supportive shoes for patients with diabetes 98.2% (336/342) of the time. When asked about knowledge of the TSB, 522 or 90% of respondents indicated awareness of this Medicare benefit. Knowledge by specialty was hard to differentiate due to low responses by some specialties; however, prescribing podiatrists and prosthetic providers both responded with a familiarity rate above 92%. Common obstacles to providers prescribing shoes were: complexity of documentation (67.8%), challenges communicating with other providers (55.0%), and financial reasons/labor-to-reimbursement ratio (38.4%). TSB has the potential to reduce amputations and wound care costs. However, therapeutic shoes are underutilized with less than 20% of potential beneficiaries accessing this benefit. This research strengthens the argument that streamlining the process may increase access to therapeutic shoes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Isolation and Limb Preservation: The Case for the Podiatric Connection Model (PCM).","authors":"Arthur Charles Evensen, Jamie Leigh Moore","doi":"10.3390/japma116030031","DOIUrl":"10.3390/japma116030031","url":null,"abstract":"<p><p>Loneliness and social isolation are increasingly recognized as major determinants of health, with physiologic and behavioral effects that rival traditional biomedical risk factors. Populations commonly treated in podiatric practice, including older adults, patients with diabetes, rural residents, and veterans, are disproportionately affected by social isolation, yet its impact on foot and ankle outcomes remains underrecognized. Emerging evidence demonstrates that loneliness alters immune regulation, inflammatory signaling, pain perception, adherence behaviors, and healthcare utilization, all of which directly influence wound healing, postoperative recovery, and limb preservation. This paper introduces the Podiatric Connection Model (PCM), a clinically actionable framework designed to integrate social connection into podiatric care. The PCM provides a structured approach for identifying social risk factors, strengthening therapeutic relationships, engaging caregivers, tailoring follow-up intensity, and monitoring evolving psychosocial needs throughout the course of treatment. By reframing loneliness as a modifiable comorbidity rather than a background social issue, the PCM offers a practical strategy for improving adherence, reducing complications, and strengthening healing trajectories in high-risk foot and ankle populations.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Footwear Choices, Foot Problems, and Lower Extremity Pain Attributes in Individuals Engaged in Prolonged Standing.","authors":"Meltem Koç, Elif Kulet, Merve Samur, İkra Akyürek, Kılıçhan Bayar","doi":"10.3390/japma116030029","DOIUrl":"10.3390/japma116030029","url":null,"abstract":"<p><p><b>Background:</b> Prolonged standing can lead to musculoskeletal disorders, especially in the lower extremities, when appropriate footwear is not used. The aim of this study is to investigate the relationship between footwear styles, foot problems, and pain characteristics related to lower extremities in individuals with prolonged standing. <b>Methods:</b> A descriptive, cross-sectional study design was employed, using a random sample of individuals with prolonged standing (n = 159). Participants were asked questions about their footwear choices. They were asked to mark the lower extremity pain localization on the McGill Pain Map. In addition, foot deformities were evaluated by physical examination. <b>Results:</b> The findings revealed that most females (n = 88) and males (n = 71) preferred flat/sports footwear styles in both summer and winter. There was no significant difference between footwear styles and foot pain duration, intensity, and localization in both genders (<i>p</i> > 0.05). However, a statistically significant difference was observed among males between their summer footwear styles and pain related to lower extremities (low back pain and knee pain), and among females between their summer footwear styles and foot problems (bone deformities, skin pathologies and soft tissue issues) (<i>p</i> < 0.05). <b>Conclusions:</b> The results of this study show that the preferred footwear style was associated with lower extremity pain and foot problems, which emphasized the importance of footwear selection and footwear evaluation in the musculoskeletal evaluation of the lower extremities.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsible AI for Personalized Patient Education and Engagement Across Medical Conditions: Leveraging Multi-Agent LLMs, Ambient Technology, and NotebookLM-A Case Study in Diabetes Education and Limb Preservation.","authors":"Shayan Mashatian, Shu-Fen Wung, Aaron Ritter, Jessica Fishman, Jeffrey Robbins, Shereen Aziz, Michelle Huo, David G Armstrong","doi":"10.3390/japma116030030","DOIUrl":"10.3390/japma116030030","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;: Effective communication with patients is vital for improving health outcomes in chronic disease management. In this study, we investigated WoundScribeAI's Scribe AI, also known as Ambient Technology, and its patient education and engagement app, Pingoo.AI. It employed a multi-agent AI model that leveraged Large Language Models (LLMs) and NotebookLM to enhance patient communication in clinical settings. &lt;b&gt;Methods&lt;/b&gt;: The system comprised specialized agents that transcribed healthcare provider-patient conversations through ambient dictation. This transcription generated medical notes that followed the Subjective, Objective, Assessment, and Plan (SOAP) format-a structured document used by healthcare providers to record and communicate information about patient encounters. Simultaneously, comprehensive visit summaries were also created. In the next step, these visit summaries were used to produce conversational and educational content by leveraging NotebookLM, an AI model introduced by Google that can generate podcast-style conversations from provided information. Integrating these agents allows clinicians to deliver engaging, empathetic, and actionable information to patients. Medical experts conducted a two-phase evaluation of the system's performance based on multiple criteria, with a particular focus on diabetes education and diabetic foot care. The first phase used pre-recorded training videos, while the second phase involved simulated consultations by clinicians using the system. To validate the AI-generated educational content, we used several established frameworks in health communication that closely align with our enhancement goals. &lt;b&gt;Results&lt;/b&gt;: The results showed that the AI model generated accurate clinical documentation and met the criteria for accurate SOAP Notes, visit summaries, and engaging educational content for patients. Given that hallucination is a significant concern related to large language models, especially in critical fields like healthcare, we meticulously analyzed the generated outputs to identify any signs of hallucinated information. Three outcomes successfully passed the validation criteria, including accuracy, completeness, comprehensiveness, absence of potential harm, and no hallucination. Additionally, the Conversational Education content was confirmed against established patient education frameworks and met criteria such as the use of metaphors, empathetic tone, and appropriate language, providing additional detail to help manage the condition. &lt;b&gt;Conclusions&lt;/b&gt;: By providing specific instructions and prompts to NotebookLM to transform visit summaries into educational conversations, we significantly enhanced the comprehensiveness and engagement of the content for patients. In contrast to a traditional summary of the clinical visit, the podcast-style conversation enriched the content with background information, encouraging language, an empathetic tone, and helpful metaphors. Our anal","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the Forefoot-to-Rearfoot Relationship in the Sagittal Plane-A Novel Measurement for Evaluating Pseudoequinus in the Lower Extremity.","authors":"Joseph C D'Amico, Samantha Landau","doi":"10.3390/japma116030028","DOIUrl":"10.3390/japma116030028","url":null,"abstract":"<p><p>Evaluation of the static angle of the forefoot-to-rearfoot relationship in the sagittal plane is essential in determining the degree of pseudoequinus in the lower extremity. The concept of an increased sagittal plane forefoot-to-rearfoot relationship is generally referred to as anterior equinus, which may result in a pseudoequinus syndrome. As its name implies, pseudoequinus is not a true lack of ankle joint dorsiflexion but rather a condition wherein the ankle joint functions as if it were restricted. Currently, the literature lacks specifications on how to obtain this measurement. Qualitative methods exist to identify an increased sagittal plane forefoot-to-rearfoot relationship whereby the clinician observes whether the patient has an anterior equinus or pseudoequinus present. However, no method has been reported that is suitable for structured evaluation determining the degree of pseudoequinus present. Evaluation of this measurement is important in understanding the overall magnitude of equinus influence present and its concomitant effects on the superstructure. This article describes a new method for measuring the static angle for the sagittal plane forefoot-to-rearfoot relationship using an orthopedic evaluation device. The results of this study indicated that this measurement yielded high interrater and intrarater reliabilities. In effect, this is a simple-to-perform analytics assessment that, as part of comprehensive biomechanical examination, will provide the astute clinician with additional insights into the cause and effect of pathomechanical foot and limb function.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Pain to Search: Mapping USA and Global Interest in Plantar Fasciitis.","authors":"Bülent Alyanak, Fatih Bağcıer","doi":"10.3390/japma116030026","DOIUrl":"10.3390/japma116030026","url":null,"abstract":"<p><p><b>Background:</b> Plantar fasciitis is a leading cause of heel pain, affecting approximately 10% of the population. Despite its prevalence, treatments may result in symptom recurrence and chronicity, which can significantly increase patient dissatisfaction. Google Trends provides insights into public interest through search volume analysis. This study examines global and USA trends in plantar fasciitis, focusing on temporal, seasonal, and income-based variations. <b>Methods:</b> Google Trends data for \"Plantar Fasciitis\" (2004-2024) were analyzed for both global and USA search trends. Monthly and seasonal search volumes were grouped by time and location. Regression and post hoc tests were conducted to identify significant patterns. Comparisons were made between high- and low-income states in the USA. <b>Results:</b> Public interest in plantar fasciitis increased significantly over time, both globally (R² = 0.871, <i>p</i> < 0.001) and in the USA (R² = 0.854, <i>p</i> < 0.001). Interest peaked in summer and declined in winter, with seasonal differences significant worldwide (<i>p</i> < 0.05). Monthly variations were significant only in the USA. No significant difference was found between high- and low-income states (<i>p</i> > 0.05). <b>Conclusions:</b> Interest in plantar fasciitis has grown steadily, reflecting its prevalence and impact. The findings emphasize the need for accessible, high-quality information to address public demand. These insights can guide healthcare professionals and policymakers in developing targeted resources.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Chronic Ankle Instability Following Ankle Sprain on Ankle Dorsiflexion, Heel Lift Function, and Quality of Life.","authors":"Jia Wang, Haomin Li, Xiantie Zeng, Guijun Xu","doi":"10.3390/japma116030025","DOIUrl":"10.3390/japma116030025","url":null,"abstract":"<p><p><b>Background</b>: Chronic ankle instability (CAI) post-sprain leads to persistent functional deficits. This study evaluated CAI's specific impact on ankle dorsiflexion, heel lift function, stability, broader functional impairments, and quality of life. <b>Methods</b>: A case-control study enrolled 100 CAI patients (post-ankle sprain) and 100 healthy controls. Ankle strength (isokinetic dynamometer), stability (pressure plate), maximum dorsiflexion/plantar flexion ROM (mobility meter), functional limitations (0-10 activity scale), pain (VAS), coordination (Agility T-test, figure-of-eight test), and quality of life (FAOS) were compared. ANOVA and Mann-Whitney U tests were used. <b>Results</b>: Compared to controls, the CAI group showed significantly reduced ankle dorsiflexion strength (114.53 ± 10.47 N vs. 156.34 ± 13.26 N), heel lift strength (78.69 ± 5.44 N vs. 105.45 ± 8.28 N), stability scores (4.73 ± 0.52 vs. 8.65 ± 0.71 points), and ROM (dorsiflexion: 16.49° ± 1.23° vs. 22.35° ± 1.65°; plantar flexion: 27.58° ± 6.51° vs. 43.27° ± 5.45°). CAI patients reported higher activity limitation (6.34 ± 1.25 vs. 2.16 ± 0.55) and pain (5.37 ± 1.02 vs. 0.23 ± 0.01) and prolonged Agility T-test (11.24 ± 1.37 s vs. 7.51 ± 1.16 s) and figure-of-eight (16.35 ± 1.67 s vs. 12.43 ± 1.39 s) times. FAOS subscale scores (symptoms, daily activities, sports, pain) were significantly lower in the CAI group. All <i>p</i> < 0.05. <b>Conclusions</b>: CAI significantly compromises ankle dorsiflexion, heel lift strength, stability, and functional mobility, correlating with increased pain, activity restriction, and diminished quality of life. Rehabilitation should prioritize neuromuscular re-education, strength restoration, and dynamic stability training to improve outcomes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}