Journal of Foot and Ankle Research最新文献

{"title":"Lower Limb Kinematics of People With Midfoot Osteoarthritis During Level Walking and Stair Climbing.","authors":"Merridy J Lithgow, Jayishni N Maharaj, Andrew K Buldt, Shannon E Munteanu, Benjamin F Mentiplay, Hylton B Menz","doi":"10.1002/jfa2.70054","DOIUrl":"10.1002/jfa2.70054","url":null,"abstract":"<p><strong>Background: </strong>Midfoot osteoarthritis (OA) affects one in eight people over 50, yet its impact on foot and lower limb kinematics remains poorly understood. This study compared foot and lower limb kinematics during level walking and stair climbing between people with and without symptomatic radiographic midfoot OA.</p><p><strong>Methods: </strong>Symptomatic radiographic midfoot OA was defined as midfoot pain in the last 4 weeks and radiographic OA in one or more midfoot joints. Cases aged ≥ 45 years were matched 1:1 for sex and age (± 5 years) to controls. A 10-camera motion analysis system was used to capture foot and lower limb kinematics during level walking and stair climbing, which were analysed with a validated multi-segmental lower limb model. Group differences were analysed using independent samples t-tests and effect sizes for discrete angles, whereas statistical parametric mapping compared kinematic patterns between groups.</p><p><strong>Results: </strong>We included 24 midfoot OA cases (mean age 64.4, SD 9.5) matched to 24 controls (mean age 65.2, SD 10.1). During level walking, people with midfoot OA walked slower and displayed absolute joint angles that showed less hip extension throughout stance, less knee flexion in early and late stance, less ankle dorsiflexion throughout stance (medium to large effects), greater subtalar pronation in late stance, and greater tarsometatarsal supination during early stance (medium effects). There were few differences during stair ascent and descent.</p><p><strong>Conclusion: </strong>People with midfoot OA walk slower and demonstrate medium to large differences in sagittal plane hip, knee, and ankle kinematics, and medium differences in subtalar and tarsometatarsal kinematics. These findings offer insights into the walking patterns of people with midfoot OA and the mechanisms that may contribute to or result from the condition. Prospective studies are needed to clarify the temporal relationship between these factors and midfoot OA development.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 2","pages":"e70054"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effects of Footwear Design on In-Shoe Plantar Pressures, Impact Forces and Comfort in Women With Plantar Heel Pain.","authors":"Melinda M Franettovich Smith, Wolbert van den Hoorn, Adele van den Hoek, Graham Kerr, Sheree E Hurn","doi":"10.1002/jfa2.70055","DOIUrl":"10.1002/jfa2.70055","url":null,"abstract":"<p><strong>Background: </strong>Footwear is often recommended in the management of plantar heel pain (PHP), theoretically to reduce tissue stress during standing and walking; however, limited data exist to guide footwear design and recommendations.</p><p><strong>Methods: </strong>Plantar pressures, impact forces and comfort during walking were recorded in 29 women with PHP (mean age 47 ± 12 years) in six randomised shoe and insert conditions. A test shoe (polyurethane outsole, 14-mm heel-toe pitch) was compared to a control shoe (rubber outsole, 4-mm heel-toe pitch), and within the test shoe, five different insoles that varied by material, density and arch contouring were also compared.</p><p><strong>Results: </strong>The test shoe reduced heel peak pressure (15%, p < 0.01) and reduced the loading rate but not the peak magnitude of the vertical ground reaction force (average loading rate reduction: 7%, p < 0.01; maximum loading rate: 29%, p < 0.01) and was more comfortable (47%-67%, p < 0.01) compared to the control shoe. Within the test shoe, dual-density inserts with arch contouring showed lower heel peak pressure compared to a lightweight flat insert (11%-12%, p < 0.03). The insert with the firmest material and higher arch contouring showed higher midfoot peak pressure (16%-21%, p < 0.01) compared to other inserts. Forefoot peak pressure did not differ between shoe or insert conditions (p > 0.05). There were no differences in impact forces or comfort between the different inserts within the test shoe (p > 0.05).</p><p><strong>Conclusion: </strong>Findings suggest that shoe and insert properties are both important and provide data to guide footwear design and management recommendations for PHP.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 2","pages":"e70055"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long-Term Outcomes: A Retrospective Cohort Study.","authors":"Johan Schoug, Per Katzman, Erik Uddman, Magnus Löndahl","doi":"10.1002/jfa2.70058","DOIUrl":"10.1002/jfa2.70058","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow-up MRI examinations are often used to determine the optimal duration of total contact cast (TCC) offloading treatment. This study investigated the use of follow-up MRI during CF treatment and its relationship to offloading duration and risk of future surgery.</p><p><strong>Methods: </strong>People with diabetes mellitus and MRI-confirmed CF treated at Skåne University Hospital (Lund and Malmö, Sweden) between 2006 and 2022 were studied retrospectively. Individuals monitored with follow-up MRI examinations were compared with those who only underwent diagnostic MRI. A regression model was applied to evaluate factors predicting TCC and total CF treatment duration.</p><p><strong>Results: </strong>One-hundred and twenty-two individuals (45 [37%] DM1; 47 [39%] women; median age 60 [IQR 53-68] years) with a total of 143 CF events were included. 76 (53%) of these CF events were monitored using a total of 141 follow-up MRI examinations. Individuals monitored with MRI had significantly longer TCC and total CF treatment durations (p < 0.001). Individual characteristics (with the exception of sex), rate of stage 1 CF, and risk of future surgery did not differ between the two groups and only use of follow-up MRI (p < 0.001) remained a significant predictor of both longer TCC and total CF treatment durations in a regression model.</p><p><strong>Conclusions/interpretation: </strong>In this retrospective cohort study, use of follow-up MRI was associated with longer TCC and total treatment times despite similar characteristics and outcomes. Prospective studies are needed to further elucidate the optimal use of MRI in monitoring CF.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 2","pages":"e70058"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle Strengthening Exercises for the Foot and Ankle: A Scoping Review Exploring Adherence to Best Practice for Optimizing Musculoskeletal Health.","authors":"John W A Osborne, Hylton B Menz, Glen A Whittaker, Matthew Cotchett, Karl B Landorf","doi":"10.1002/jfa2.70040","DOIUrl":"10.1002/jfa2.70040","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Foot and ankle muscle strengthening exercises are common interventions for many musculoskeletal conditions that are associated with pain and limited function in the lower limb. The scientific literature has a multitude of strengthening exercises recommended, and they have been criticized for not adhering to best practice and for being poorly reported. The aims of this scoping review were to (i) describe what foot and ankle strengthening exercises have been recommended in the scientific literature, (ii) compare the prescription of these exercises to best practice recommendations, and (iii) assess the completeness of the reporting of these exercises and exercise programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. A systematic search of peer-review journal articles was conducted on 23 February 2023. Study designs that were included were experimental, quasi-experimental, feasibility, pilot studies, and observational. For each study included in the review, study design and participant details such as age, sex, and conditions treated were noted. To describe the foot and ankle strengthening exercises, each exercise was noted, which included its name, the number of sets and repetitions recommended, the load type and its magnitude, and whether there were any progression strategies. Exercises were grouped according to primary movement and a general exercise descriptor. To compare to best practice, each program's prescription parameters of frequency, intensity, and time were compared to the American College of Sports Medicine's (ACSM) guidelines. To assess completeness of reporting, each study was assessed with the Consensus on Exercise Reporting Template (CERT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The search yielded 1511 documents, and 87 were included after full-text screening. Of the included studies, most were randomized controlled trials, and the most common participants were healthy adults (mean age range: 18-83 years). Across all studies, a total of 300 foot and ankle exercises were prescribed. The most common strengthening exercise category involved ankle plantar flexion (25% of 300 exercises), followed by plantar foot intrinsics (16%). The most common prescription of strengthening exercises included 3 sets (37%) of 10 repetitions (38%) performed 3 times per week (34%), often without a prescribed load (66%). Prescribed sets per muscle group met ACSM recommendations for novice lifters in 93% of studies. In contrast, load intensity (for increasing muscle strength) was prescribed at the recommended dose of 60% of 1 repetition maximum or greater in only 2% of exercises. The median score for completeness of reporting according to the CERT checklist was 31% of all items.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This scoping review found that the studies predominantly included ankle plantar flexion and plantar foot intrinsic muscle","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 2","pages":"e70040"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing 3D Scanning and Printing Technology to Improve Students' Proficiency in Assessing Foot Posture.","authors":"Daniel R Bonanno, Sheree E Hurn, Helen A Banwell, Daniel Alizzi, Hylton B Menz","doi":"10.1002/jfa2.70056","DOIUrl":"10.1002/jfa2.70056","url":null,"abstract":"<p><strong>Introduction: </strong>The Foot Posture Index (FPI-6), widely used to quantify foot posture, is a core component of musculoskeletal curricula in undergraduate podiatry programs. Teaching the FPI-6 can be challenging but 3D foot models provide a controlled risk-free way to practice, potentially reducing anxiety and increasing confidence. This study examined the effects of 3D foot models on podiatry students' confidence and anxiety when performing the FPI-6 and compared their scores to experts.</p><p><strong>Methods: </strong>Fifty podiatry students from three Australian universities used the FPI-6 to score nine 3D printed foot models ranging from -11 (highly supinated) to +12 (highly pronated). Students' self-confidence and anxiety were measured before and after exposure to the 3D foot models using a 10-item self-confidence questionnaire and the 27-item Competitive State Anxiety Inventory-2 (CSAI-2). Changes in self-confidence were analysed with paired t-tests, whereas median differences in CSAI-2 scores pre- and post-intervention were assessed using the Wilcoxon signed-rank test. Students' foot posture scores were compared to consensus scores from an expert panel (n = 4) with variability in agreement explored using the Bland-Altman limits of agreement (LoA) analysis.</p><p><strong>Results: </strong>Student confidence improved across all 10 questionnaire items after the FPI-6 simulation with 3D foot models (p ≤ 0.015) with a mean increase of 8.6% across all items (range, 1.9%-11.6%) and medium to large effect sizes (Cohen's d = 0.44-0.94). On the CSAI-2, 22 of 27 items showed improvements in cognitive and somatic state anxiety or self-confidence (p ≤ 0.038), whereas five items showed no significant change. The Bland-Altman analysis revealed a small mean difference of 0.389 between student and expert consensus scores with 95% LoA ranging from -3.3 to 4.1.</p><p><strong>Conclusion: </strong>The use of 3D foot models for FPI-6 simulation enhances podiatry students' confidence and reduces anxiety. Student's foot posture scores had good overall agreement with expert scores, though some discrepancies remained. This highlights the value of pre-scored models for targeted practice and emphasises the importance of validation and feedback to ensure confidence aligns with accuracy. The models demonstrated high utility, harnessing 3D scanning and printing technology to enhance students' proficiency in assessing foot posture.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 2","pages":"e70056"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review Examining the Association of Falls With Diabetes-Related Foot Ulcers.","authors":"Mike Wu, Mallika Sinha, Chanika Alahakoon, Kristen S Barratt, Shivshankar Thanigaimani, Jonathan Golledge","doi":"10.1002/jfa2.70057","DOIUrl":"10.1002/jfa2.70057","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to systematically review the risk of falls in people with diabetes-related foot ulcers (DFU).</p><p><strong>Methods: </strong>A systematic search of Medline, Pubmed, Embase, Cochrane and CINAHL was undertaken to identify observational studies reporting falls and containing a group of people with a DFU and a control group with diabetes but no DFU. Risk of bias was assessed by a modified Newcastle-Ottawa Scale. Meta-analysis was performed using a random effects model.</p><p><strong>Results: </strong>Four studies involving 3643 participants with a DFU and 42,436 participants with diabetes but no DFU were included. A meta-analysis showed high heterogeneity between studies (I² = 95%) and an increased risk of falls in people with DFU (risk ratio 2.25 and 95% CI 1.05-4.84). One study had a low risk of bias and three studies had a high risk of bias. Leave-one-out analyses showed that exclusion of the study with the largest effect on heterogeneity resulted in a risk ratio of 1.80 (95% CI 1.33-2.43 and I² = 0%).</p><p><strong>Conclusions: </strong>Currently available evidence suggests people with a DFU have a higher risk of falls but most past studies have a high risk of bias. Further well-designed cohort studies are required.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 2","pages":"e70057"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing perioperative outcomes after transmetatarsal amputation in patients with or without peripheral vascular disease.","authors":"Mark A Plantz, Rachel Bergman, Erik Gerlach, Muhammad Mutawakkil, Milap Patel, Anish R Kadakia","doi":"10.1002/jfa2.70026","DOIUrl":"10.1002/jfa2.70026","url":null,"abstract":"<p><strong>Background: </strong>Transmetatarsal amputation (TMA) is a commonly performed procedure for gangrene in the setting of diabetes or peripheral vascular disease. The purpose of this study is to investigate the incidence of and risk factors for reoperation and perioperative complications after TMA in patients undergoing surgery for primarily infectious/diabetic wounds versus peripheral vascular disease.</p><p><strong>Methods: </strong>Patients undergoing TMA between January 1, 2015 and December 31, 2020 were identified using the American College of Surgeons National Surgical Quality Improvement Program database. The indication for surgery was reported using the International Classification of Disease 9/10 codes. Patients were categorized into two groups: patients undergoing surgery for primarily infectious/diabetic wounds versus peripheral vascular disease. The incidence of 30-day mortality, readmission, reoperation, nonhome discharge, and various medical and surgical complications was reported. Outcome measures were compared between the diabetic and peripheral vascular disease groups. Logistic regression was used to identify independent risk factors for each outcome measure of interest.</p><p><strong>Results: </strong>3392 patients were included in the final cohort. There was a 30-day mortality rate of 2.9%, reoperation rate of 13.8%, readmission rate of 16.8%, surgical complication rate of 22.2%, and medical complication rate of 15.8%. Patients undergoing surgery for a vascular indication had a higher rate of mortality, reoperation, hospital readmission, nonhome discharge, and various medical complications (p < 0.05). Patients undergoing surgery for infectious/diabetic wounds had a higher rate of deep surgical site infection and systemic sepsis (p < 0.05). A vascular surgical indication was independently associated with reoperation and overall medical complications (p < 0.05). Various factors, including age, body mass index, medical comorbidities, and the presence of preoperative sepsis were associated with poor outcomes.</p><p><strong>Conclusion: </strong>Significant rates of mortality, reoperation, and hospital readmission were reported after TMA. The presence of peripheral vascular disease was independently associated with reoperation and medical complications. Patients undergoing TMA, particularly for peripheral vascular disease, should be counseled about perioperative risks and indicated for surgery carefully.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 1","pages":"e70026"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key capabilities required for podiatry graduates: A Delphi consensus study.","authors":"Shannon E Munteanu, Matthew Cotchett, Matthew J Oates, Nicoletta Frescos, Vivienne Chuter, Mike Frecklington, Marie T Butler, Nick W Haley, Hylton B Menz","doi":"10.1002/jfa2.70036","DOIUrl":"10.1002/jfa2.70036","url":null,"abstract":"<p><strong>Introduction: </strong>Work-readiness is linked to health professional graduates' job performance, satisfaction, engagement and retention. However, there is currently no podiatry-specific graduate employer work-readiness survey tool that has been developed with employers of graduate podiatrists. The aim of this study was to conduct a modified Delphi survey to achieve consensus among employers of podiatry graduates on the key capabilities required for podiatry graduates.</p><p><strong>Methods: </strong>A Delphi method of consensus development was used, comprising three online survey rounds. Purposive sampling was used to recruit individuals with extensive experience and knowledge in mentoring and managing graduate podiatrists in Australia or New Zealand. In Round 1, participants were asked to rate agreement/disagreement with 71 items across seven domains relating to capabilities required of podiatry graduates that were extracted from a literature search and steering committee input. Participants were also asked to contribute further ideas in relation to these items, which were incorporated as new items (n = 7) in Round 2. In Rounds 2 and 3, participants re-appraised their ratings in view of the group consensus. Consensus was defined as ≥75% agreement. In Round 3, participants were also asked to rate the importance of each item as either 'essential' or 'optional'.</p><p><strong>Results: </strong>Twenty-five participants (mean [SD] of 14.9 [5.7] years of experience in managing podiatry graduates in clinical practice in Australia or New Zealand) completed Round 1, 24 in Round 2, and 23 in Round 3. Of the 78 items presented to our expert panel, 61 (78.2%) achieved consensus and were accepted, and 17 (21.8%) were excluded. Of the 61 items that achieved consensus, thirty-nine (63.9%) were rated as 'essential' by 75% of more respondents.</p><p><strong>Conclusion: </strong>Consensus among employers of podiatry graduates was established on the key capabilities required for podiatry graduates. Sixty-one items were identified across seven domains, and of these, 39 items were rated as 'essential'. The findings of this study have the potential to inform the creation of a podiatry-specific graduate employer work-readiness tool to provide feedback to podiatry education program providers and new graduates in the workplace.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 1","pages":"e70036"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating diagnostic uncertainty in children's chronic lower limb pain: A qualitative study of management strategies using vignette-based focus groups.","authors":"Jessica Coventry, James J Welch, Verity Pacey, Binh Ta, Elizabeth Sturgiss, Mitchell Smith, Cylie M Williams","doi":"10.1002/jfa2.70032","DOIUrl":"10.1002/jfa2.70032","url":null,"abstract":"<p><strong>Background: </strong>Chronic lower limb pain is common in children and adolescents and is frequently managed by podiatrists. Due to the complexities of understanding the cause of chronic pain, clinicians may experience uncertainty around the diagnosis, which in turn may impact their communication and management approaches. Limited research explores how podiatrists manage chronic lower limb pain in children, especially in the presence of diagnostic uncertainty. This study aimed to explore the management strategies including language that podiatrists report using to address the pain experience of children with chronic lower limb pain and to investigate if and how the reported management strategies used by podiatrists to address the pain experience of children with chronic lower limb pain vary based upon the level of diagnostic uncertainty.</p><p><strong>Methods: </strong>Eight focus groups were conducted with a total of 48 podiatrists. Participants were presented with three vignettes, each describing a child with chronic lower limb pain. They were then asked to discuss their certainty in the child's diagnosis presented and their approaches to explain and manage the child's pain. Audio data were recorded, transcribed and analysed using thematic analysis. Three key themes were generated: Language strategies, non-verbal communication strategies and treatment strategies.</p><p><strong>Results: </strong>Podiatrists were overall certain in the diagnosis presented in vignettes 1 (calcaneal apophysitis) and 2 (juvenile idiopathic arthritis); however, they expressed significant uncertainty in vignette 3, which was written to elicit uncertainty presenting a case with generalised lower limb pain. Many groups fixated on the Beighton score of 5/9 and interpreted this to mean hypermobility, which is inconsistent with the current clinical guidance. Podiatrists used similar language strategies across all 3 vignettes and supported their language strategies with non-verbal communication strategies. Podiatrists also discussed activity modification, passive and self-care strategies and building a team as the treatment strategies they would use.</p><p><strong>Conclusions: </strong>This study highlights the variety of clinical management strategies used by approaches and highlights how their approach may change depending on their certainty in the diagnosis.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 1","pages":"e70032"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Lateral Longitudinal Arch Evaluation Method for the Foot Using Ultrasonography: Validation With Radiography and Verification of Intrarater and Interrater Reliability.","authors":"Daichi Kawamura, Takashi Komatsu, Masanobu Suto, Hikaru Narita, Yasuyuki Umezaki, Saki Takahashi, Hiroshi Shinohara","doi":"10.1002/jfa2.70039","DOIUrl":"10.1002/jfa2.70039","url":null,"abstract":"<p><strong>Introduction: </strong>The lateral longitudinal arch (LLA) is an essential structure of the foot. However, LLA evaluation methods remain underexplored compared to those of the medial longitudinal arch (MLA). This study sought to develop a method for measuring the cuboid height, the keystone of the LLA, using ultrasonography and to verify its correlation with radiography, as well as intrarater and interrater reliability.</p><p><strong>Methods: </strong>This cross-sectional study included 21 university students (14 males and seven females). The cuboid height was measured using radiography and ultrasonography. The validity of ultrasonographic measurements was assessed through correlation with radiographic measurements and Bland-Altman analysis. Intrarater and interrater reliabilities were evaluated using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>A strong correlation was observed between cuboid heights measured using radiography and ultrasonography (r = 0.98, p < 0.01). The Bland-Altman analysis revealed a fixed bias of -0.71 mm (95% confidence interval [95% CI]: -0.96 to -0.46 mm). Intrarater and interrater reliability for ultrasonographic measurements were almost perfect, with ICCs of 0.98 and 0.99, respectively.</p><p><strong>Conclusions: </strong>Cuboid height measurements using ultrasonography demonstrated high validity and reliability. This method offers a noninvasive and cost-effective alternative to radiography, with potential clinical applications in the evaluation of LLA and related conditions such as cuboid syndrome and lateral foot injuries.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"18 1","pages":"e70039"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}