Journal of Foot and Ankle Research最新文献

{"title":"Morphological Changes and MRI Characteristics of the Achilles Tendon in Amateur Marathon Runners With Different Running Experience.","authors":"Wanzhen Yao, Yong Chen, Siyu Dai, Jing Zhou, Xinmiao Mao, Yanjing Zhang, Jianping Ding, Jie Liu, Jie Huang","doi":"10.1002/jfa2.70125","DOIUrl":"10.1002/jfa2.70125","url":null,"abstract":"<p><strong>Background: </strong>With the escalating popularity of marathon running, Achilles tendon injuries, particularly gradual-onset Achilles tendon injury, have become common, often causing substantial training disruptions. However, the influence of running experience on the Achilles tendon structure in amateur runners remains largely unclear. This study aimed to investigate the association between running experience and asymptomatic Achilles tendon pathology as well as its structural changes.</p><p><strong>Methods: </strong>This was a cross-sectional observational study. Forty-eight amateur marathon runners were categorized into four groups based on running experience (1, 3, 5, and > 5 years), with 12 healthy nonrunners as controls. Inclusion and exclusion criteria were strictly applied. All participants underwent MRI scanning using a 3.0 T GE scanner. Two radiologists evaluated MRI scans for pathology and measured tendon length, thickness, volume, and cross-sectional area (CSA). Statistical analyses, including Shapiro-Wilk, ANOVA, Kruskal-Wallis H, and chi-squared tests, were conducted using SPSS 23.0.</p><p><strong>Results: </strong>Baseline characteristics showed no significant group differences. Qualitative analysis revealed that the prevalence of midportion tendinopathy, insertional tendinopathy, and retrocalcaneal bursitis increased significantly with longer running experience. Quantitative measurements indicated that tendon thickness, volume, and CSA were significantly greater in long-running groups compared to short-running and control groups, whereas tendon length remained unchanged. Interobserver reliability was excellent.</p><p><strong>Conclusion: </strong>In amateur marathon runners, running experience is associated with increased asymptomatic Achilles tendon pathology and morphological remodeling. Prolonged running may induce both adaptive and degenerative changes, highlighting the importance of MRI-based monitoring for early intervention in high-risk populations.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70125"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953618","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":"Prevalence, Severity and Impact of Foot Pain in 419 Pregnant Participants: The Queensland Family Cohort Study.","authors":"J Raquel Fontes, Melinda M Franettovich Smith, Felix Leung, Vicki L Clifton, Julie Hides, M Dilani Mendis","doi":"10.1002/jfa2.70132","DOIUrl":"10.1002/jfa2.70132","url":null,"abstract":"<p><strong>Background: </strong>Many hormonal, anatomical and biomechanical changes occur during pregnancy that may contribute to lower limb musculoskeletal dysfunction, including foot pain. Previous international studies have reported variable rates of foot pain in this population, but there is a lack of prospective longitudinal investigations. Improving the current understanding of foot pain is important to inform the development of management interventions during and after pregnancy. This study aimed to investigate the self-reported prevalence, severity, frequency and impact of foot pain on work, activities and quality of life during pregnancy.</p><p><strong>Methods: </strong>Pregnant participants were recruited through the Queensland Family Cohort study conducted at a tertiary maternity hospital. Questionnaires were administered at enrolment (12-24 weeks' gestation) to collect demographics and at 24 weeks' gestation, 36 weeks' gestation and at the end of pregnancy (6 weeks postpartum) to measure the presence, severity and frequency of foot pain and symptoms and the impact of foot pain on work, activities and quality of life.</p><p><strong>Results: </strong>Four hundred and nineteen pregnant participants with a mean age of 32.2 (range 16-45) years and body mass index of 27 (range 17-52) were included. A high prevalence of foot pain was reported during pregnancy (44% up to 24 weeks; 56% up to 36 weeks, 54% up to the end of pregnancy). The severity of foot pain was mild to moderate and occasional in frequency. Foot pain had a mild to moderate impact on work, activities and quality of life during pregnancy. Participants with foot pain reported a lower perceived level of health during and at the end of pregnancy.</p><p><strong>Conclusion: </strong>Foot pain is a highly prevalent musculoskeletal problem that impacts work and quality of life during pregnancy. Pre-natal and post-natal care may provide an opportunity to assess and provide advice, treatment or appropriate referral for the management of foot pain.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70132"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100869","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":"Australian Podiatry Research in Rheumatology: A Bibliometric Analysis.","authors":"Shan M Bergin, Polly Q X Lim, Hylton B Menz, Peta E Tehan, Matthew R Carroll","doi":"10.1002/jfa2.70128","DOIUrl":"10.1002/jfa2.70128","url":null,"abstract":"<p><strong>Background: </strong>To conduct a bibliographic analysis of English language foot and ankle research pertaining to rheumatology published by Australian authors.</p><p><strong>Methods: </strong>The Scopus database search was conducted to identify all Australian rheumatology articles published by podiatric authors in English from 1970 to 2024. Bibliometric analysis was performed using an open-source tool based on the R language. Citations, journals, authors, institutions and countries were described. Publications were manually categorised according to research type, level of evidence and funding source.</p><p><strong>Results: </strong>The search strategy yielded 89 eligible articles, which received a total of 2438 citations and were published by 200 authors. The most frequent journals were Arthritis Care & Research and Osteoarthritis and Cartilage each with 9 articles or 10% of total publications. The most published institution was La Trobe University (affiliation of 151 authors). Most of the Australian rheumatology articles focused on the evaluation of treatments and therapeutic interventions (n = 35; 39%) and 11 articles (12%) provided Level I evidence. Forty-two publications (47%) were supported by Category 1 funding, however, 29 (33%) reported no research funding.</p><p><strong>Conclusion: </strong>Rheumatology represents just 5% of Australian podiatry research. Despite this, it attracts high citation rates relative to number of publications and is well supported by Category 1 funding in comparison to other research fields. Funding sources outside of competitive Category 1 grants appear to be limited however, and research scope is narrow with a high number of evaluative studies conducted. Rheumatology research would benefit from an increase in available funding sources and a broader research scope that informs disease prevention and evidence-based clinical care.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70128"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108211","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":"Structure and Function of the Achilles Tendon and Plantarflexors 1 Year Following Achilles Tendon Rupture in the United Kingdom: A Cross-Sectional Study.","authors":"Samuel Briggs-Price, Jitendra Mangwani, Alexander Kilcran, Anchal Prasad, Reihaneh Salimian, Seth O'Neill","doi":"10.1002/jfa2.70134","DOIUrl":"10.1002/jfa2.70134","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon rupture (ATR) is the most common tendon rupture affecting the lower limb. This study investigates Achilles tendon structure, strength and function 1 year or more after ATR.</p><p><strong>Methods: </strong>This cross-sectional study recruited individuals ≥ 12 months post ATR. Structure was assessed using ultrasound tissue characterisation (UTC) including cross-sectional area (CSA), aligned fibrillar structure (AFS), disorganised fibrillar structure (DFS) and echo type percentage. Strength was measured using maximal voluntary isometric contraction (MVIC) plantarflexor testing and the calf raise test. Patient-reported outcomes included the Achilles tendon rupture score (ATRS), EQ-5D-5L and general practice physical activity questionnaire (GPPAQ). Achilles tendon resting angle (ATRA) was used as an indirect measure of tendon elongation. The relationship between outcomes and time since ATR was analysed using linear regression adjusting for age, sex, ethnicity and body mass index (BMI). Between limb comparisons were made using paired t-tests.</p><p><strong>Findings: </strong>Sixty participants (mean age 55.2 years and 78.5% male) were assessed at a mean of 6.8 years post ATR. The affected tendon showed a 62% larger cross-sectional area, with 28.7 mm² (16%) DFS compared to 7.3 mm² (7%) on the nonaffected side (p < 0.001). Linear regression showed decreasing AFS with time postinjury (p = 0.04); no significant associations were found for CSA or DFS. Significant deficits were observed in plantarflexor strength and function, with MVIC and calf raise work 18% and 40% lower in the affected limb (p < 0.001). ATRA indicated tendon elongation in the affected limb of 6.7° (p < 0.001). Median ATRS was 83, EQ-5D index was 0.95 and VAS was 85; 93% were physically active based on the GPPAQ.</p><p><strong>Conclusion: </strong>Significant structural and functional deficits persist years after ATR, including increased tendon size, fibre disorganisation, reduced strength and tendon elongation. ATRS scores were consistent with previous nonsurgical immobilisation protocol outcomes in the United Kingdom. Longitudinal studies are needed to understand the trajectory of recovery following ATR.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70134"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167486","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":"Reporting and Utilization of Patient-Reported Outcomes Measures in the Evaluation of Foot Orthoses Treatment: A Systematic Review.","authors":"Javier Jiménez-Guillén, Natalia Tovaruela-Carrión, Marta María Moreno-Fresco, Alfonso Martínez-Nova, Pedro V Munuera-Martínez","doi":"10.1002/jfa2.70148","DOIUrl":"10.1002/jfa2.70148","url":null,"abstract":"<p><strong>Purpose: </strong>Currently, there is no patient-reported outcome measure (PROM) specifically for evaluating foot orthoses treatments. This led us to ask the following question: What is the quality of the validated foot and ankle PROMs used to evaluate foot orthosis interventions? To do so, we analyzed the psychometric properties of these PROMs and identified the most widely used and those with the best measurement properties.</p><p><strong>Methods: </strong>Two literature searches were conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. The methodological quality of the articles was assessed using the updated COSMIN checklist. Psychometric evidence for the properties investigated in the articles was assessed using the updated COSMIN criteria for good psychometric properties. Ratings of methodological quality and psychometric evidence were synthesized using the method of Schellingerhout et al. (2012).</p><p><strong>Results: </strong>A total of 205 articles were included, identifying 11 validated PROMs for foot and ankle used in the evaluation of foot orthoses. The Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ) were the most commonly used, whereas the Victorian Institute of Sport Assessment-Achilles tendon (VISA-A) questionnaire demonstrated the best measurement properties.</p><p><strong>Conclusion: </strong>The VISA-A, the Foot and Ankle Outcome Score (FAOS), and the Revised Foot Function Index (FFI-R) appear to be useful PROMs for evaluating foot orthoses treatments; however, more evidence is needed to make more robust and reliable statements.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70148"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470064","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":"Exploring Experiences and Perspectives of Prescribed Foot Orthoses in People With Diabetes.","authors":"Niloofar Sedighi, Gordon Hendry, Jari Pallari, Ruth Barn","doi":"10.1002/jfa2.70130","DOIUrl":"10.1002/jfa2.70130","url":null,"abstract":"<p><strong>Background: </strong>Adherence to prescribed offloading among people with diabetes is often insufficient. Although factors influencing adherence with prescribed footwear have been well studied, uncertainties remain. Perceptions and views of people with diabetes on their prescribed foot orthoses, including areas for improvement, may offer important insights.</p><p><strong>Methods: </strong>Using a qualitative study design, a combination of online focus groups and individual interviews were employed to gain a deeper understanding of the experiences and perceptions of people at risk of diabetes-related foot ulcers regarding experiences of prescribed foot orthoses. All interviews and focus groups were recorded and transcribed verbatim. Transcribed data were coded, and thematic analysis was undertaken following a six-step thematic analysis framework.</p><p><strong>Findings: </strong>Eight people with diabetes at risk of developing foot ulcers who had been prescribed foot orthoses were included. Three major themes emerged from thematic analysis: (i) adherence and barriers to effective use of foot orthoses, which captured the role of health professionals as well as the interconnected relationship between footwear and foot orthoses, (ii) perceived benefits of foot orthoses and desired improvements, and (iii) anxiety and psychological impact, which highlighted how anxiety and fear can influence footcare behaviours, both as motivators and barriers.</p><p><strong>Conclusion: </strong>This study provides valuable insights into user experiences of prescribed foot orthoses and factors influencing foot orthoses-related behavioural choices; these findings may help researchers and healthcare professionals in designing and delivering foot orthoses that better meet the needs of users to enhance engagement with preventative strategies. Important considerations include the perception of balance and stability, the psychological impact of diabetes-related foot disease and the role of the healthcare professional in providing support both during and after foot orthoses provision.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70130"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108169","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":"Prevalence and Incidence of Diabetes-Related Peripheral Neuropathy, Peripheral Artery Disease, Foot Ulcers and Lower Extremity Amputations in Ireland; A Systematic Review.","authors":"Sinead Kavanagh, Jennifer A Pallin, Ann Sinéad Doherty, Linda M O'Keeffe, Steven Gilmore, Peter A Lazzarini, Claire M Buckley","doi":"10.1002/jfa2.70147","DOIUrl":"10.1002/jfa2.70147","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes-related foot disease is a leading cause of global disease burden, however the prevalence and incidence of diabetes-related foot disease in Ireland is poorly understood. Up-to-date population-level estimates of the incidence and prevalence are imperative to support appropriate health service planning. This study examined the prevalence and incidence of diabetes-related foot disease in the Irish population.</p><p><strong>Methods: </strong>We systematically searched Pubmed, EMBASE and Lenus the Irish Health Research repository, for peer-reviewed articles published until August 2025. Publications reporting on prevalence and incidence of peripheral neuropathy, peripheral artery disease, foot ulceration or amputation in people with diabetes in Ireland, were eligible for inclusion. The Joanna Briggs Institute Prevalence (JBI) Critical Appraisal Tool was used to assess included studies methodological quality and establish the degree to which bias was addressed in the study's design and analysis. Results were synthesised descriptively according to study characteristics and outcomes.</p><p><strong>Results: </strong>Three studies met the inclusion criteria (n = 145,945), with varying outcome measurement methods. In community-based diabetes populations, peripheral neuropathy prevalence ranged from 15% to 39% (n = 1055) and peripheral artery disease prevalence ranged from 18% to 34% (n = 383). For the history of foot ulcers, prevalence was 3.7% (n = 563) and annual incidence was 2.6% (n = 383). One national population-based study (n = 144,710) reported incidence of amputation increased from 144.2 to 175.7 per 100,000 people with diabetes between 2005 and 2009.</p><p><strong>Conclusion: </strong>This review found there is a paucity of information on prevalence and incidence of diabetes-related foot disease in Ireland. However, these findings suggest that prevalence is similar to, if not lower than, global rates of peripheral neuropathy, peripheral artery disease outcomes and amputation incidence outcomes. High heterogeneity in populations and outcomes highlights the need for robust studies and consensus on diabetes-related foot outcome assessment. Establishing a national diabetes register could strengthen surveillance, identify high-risk groups and inform cost-effective public health planning.</p><p><strong>Trial registration: </strong>PROSPERO (CRD42023472904).</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70147"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469995","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":"Postoperative Dressing Regimens in Nail Surgeries: A Scoping Review.","authors":"David Yousry Foad Isaac Wassef, Zainab Al-Modhefer, Kym Hennessy","doi":"10.1002/jfa2.70100","DOIUrl":"10.1002/jfa2.70100","url":null,"abstract":"<p><strong>Background: </strong>Toenail surgeries are one of the most common surgeries performed on the lower limb with many common postoperative complications, including prolonged healing time, infection and prolonged exudation. There is a wide variety of dressings designed to reduce the rate of postoperative complications and improve healing. The efficacy of dressings for improving postoperative healing in toenail surgeries is still unknown. There is no consensus on the correct dressing regimen and a low number of studies into the subject. This review aimed to assess the current literature to determine the most efficacious postoperative dressing regimens following toenail surgeries.</p><p><strong>Methods: </strong>Searches were conducted in MEDLINE, Embase, CINAHL, Cochrane library and SCOPUS from database creation to June 2025. Quantitative studies which applied any postoperative dressing regimen to any patient undergoing any form of toenail surgery and attributed the postoperative outcome to the dressing were deemed eligible for inclusion. Two independent reviewers performed the study selection, data extraction and risk of bias assessment. Risk of bias was assessed using the JBI critical appraisal tools.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria. The included studies had 27 dressing regimens across 15 outcome measures. Outcome measures investigated were as follows: pain, healing rate, time of exudate, inflammation, infection rate, bleeding, size of exudate, type of exudate, soothing effect, nail area preservation, time until normal shoe wear, satisfaction rate, time until full function, ease of removal by dressing type and ease of dressing removal by surgery type. Overall, no outcome measure had high quality evidence supporting use, suggesting no dressing was superior to others for any of the outcome measures.</p><p><strong>Conclusions: </strong>Collation of similar outcome measures was not possible due to the variability in outcome measures, and a lack of high-quality studies investigating the efficacy of specific dressing regimens for the reduction of postoperative complications or improving postoperative healing meant specific conclusions could not be formed. However, a consensus in the included articles was that primary dressings were more likely to impact postoperative outcomes when compared to secondary dressings. Further high-quality research investigating the efficacy of postoperative dressing regimens in nail surgery are needed.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70100"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019911","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":"Clinical and Structural Associations of Disability and Gait Performance in Patients With Rheumatoid Arthritis in Remission and Metatarsal Pain.","authors":"Rebeca Bueno Fermoso, Rosario Morales Lozano, Carmen Martínez Rincón, Pablo García Fernández, Juan Miguel López González, Maria Luz González Fernández","doi":"10.1002/jfa2.70133","DOIUrl":"10.1002/jfa2.70133","url":null,"abstract":"<p><strong>Background: </strong>Patients with rheumatoid arthritis (RA) may continue to experience foot-related disability despite clinical remission. Foot involvement is associated with self-reported disability and objective gait alterations. Foot involvement is heterogeneous; studying patients with localised forefoot pain may help clarify which structural and inflammatory factors are associated with functional impairment.</p><p><strong>Objectives: </strong>To identify clinical, structural and imaging factors associated with disability and gait performance in patients with RA in clinical remission with metatarsal-region forefoot pain.</p><p><strong>Methods: </strong>Cross-sectional study of 81 patients with RA in remission with metatarsal-region forefoot pain. Outcomes were Foot Function Index disability and activity limitation (FFI-D and FFI-AL), gait velocity (GV) and double-support time (DS). Associations were examined using Spearman correlations, age- and BMI-adjusted individual linear regression, parsimonious multivariable linear regression and exploratory cluster analysis.</p><p><strong>Results: </strong>Mean (SD) FFI-D and FFI-AL were 29.8 (29.4) and 29.1 (27.7); gait velocity (GV) was 0.90 (0.34) m/s and double-support time (DS) was 22.9 (8.2)% of the gait cycle. In bivariate and age/BMI-adjusted analyses, graded structural measures showed more consistent associations with disability and gait outcomes than dichotomous/count variables. In parsimonious models, disability (FFI-D/FFI-AL) was independently associated with pain intensity (VAS) and first metatarsophalangeal joint stiffness/limited dorsiflexion (1stMTP), whereas gait performance was mainly associated with age/BMI, greater graded forefoot structural severity and 1stMTP. Cluster analysis identified a higher grey-scale synovitis (GS)/lower structural-burden group and a lower GS/higher structural-burden group, with worse function and slower gait in the latter.</p><p><strong>Conclusions: </strong>In RA remission with metatarsal-region forefoot pain, perceived disability is mainly associated with pain and forefoot stiffness, whereas gait performance is more closely related to age/BMI and graded forefoot structural severity. These findings support severity-based region-specific structural assessment alongside pain evaluation in clinical follow-up, to avoid underestimating the independent contribution of structural damage to function and gait.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70133"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12901661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183019","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":"Working Right Ways in Foot Health With and for First Nations Peoples: Research Method Guided and Governed by First Nations Ways of Knowing, Being, and Doing in Cross-Sectional Qualitative Study Design.","authors":"James Gerrard, Shirley Godwin Badimaya Yamatji, Kim Whiteley Wiradjuri, James Charles Kaurna, Sean Sadler, Vivienne Chuter","doi":"10.1002/jfa2.70131","DOIUrl":"10.1002/jfa2.70131","url":null,"abstract":"<p><strong>Background: </strong>Underpinning ongoing colonisation of the lands now known as Australia, scientific racism in colonial research delivered flawed results by building Indigenous inferiority into methodology to produce dehumanising conclusions of First Nations Peoples. Scientific racism facilitated exclusion of First Nations Peoples from systems design and development; foregrounding ways exclusive and enforced colonial health systems cause First Nations health and wellbeing inequality. Inequities in foot health contribute to this inequality. This work describes and documents a process of First Nations-led authentic co-design for foot health research. This study represents ways and means to develop culturally responsive foot health research as judged by First Nations Peoples which will translate into improved and more responsive ways of delivering foot care.</p><p><strong>Methods: </strong>Non-Indigenous and First Nations Peoples sought authentic First Nations-led co-design process in foot health research methods, a governing First Nations Advisory Group, and broader First Nations governance and ethics approvals. Indigenous methodology, data sovereignty, and redistribution of power were imperative in ways of working. First Nations-led co-design developed culturally responsive semi-structured interviews to collect data. Talking with 10 registered health practitioners who work closely with lower limb and foot health represented the right mix of participants and enough data to convey a more complicated mosaic of multi-faceted stories. First Nations expertise informed analytic induction and the use of inductive reasoning and constant comparison to identify common and overarching themes, and to perform thematic analysis.</p><p><strong>Results: </strong>Authentic First Nations-led ways of working in cross-sectional qualitative study design are documented. Results of data analysis following these ways of working will be published subsequently.</p><p><strong>Conclusion: </strong>This work provides insights into working right ways in research which will underpin good foot health services with and for First Nations Peoples. The paper highlights ways of working that empowers First Nations Peoples in authentic co-design. First Nations-led foot health research changes ways of working to counter inequities in foot health caused and maintained by ongoing colonisation and systemic racism. This study provides qualified voiced lived experience which foot health researchers must listen to and receive learning and direction from.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 1","pages":"e70131"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277512","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}