Journal of Foot and Ankle Research最新文献

{"title":"Diabetes Distress in People at Risk for Diabetes-Related Foot Disease in Primary Health Care.","authors":"Thallita Cláudia Moraes Barbosa, Letícia Eugênio Mota, Maria Gabriela Campos Nunes, Laura Andrade Pinto, Letícia Alves Rocha, Patricia Peres de Oliveira, Vinicius Silva Belo, Daniel Nogueira Cortez","doi":"10.1002/jfa2.70194","DOIUrl":"10.1002/jfa2.70194","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes-related distress (DRD) is exacerbated in people at risk of Diabetes-related Foot Disease (DFD); however, knowledge on this topic is still limited, especially in Primary Health Care (PHC), which focuses on prevention and monitoring. This study evaluated DRD and its associated factors in PHC individuals at risk of developing DFD, aiming to support management strategies to reduce complications.</p><p><strong>Method: </strong>Cross-sectional study with 1563 individuals with diabetes mellitus (DM) registered in PHC services in Brazil. Participants were stratified according to their risk of DFD, based on the criteria from the International Working Group on the Diabetic Foot. The DRD was measured using the Problem Areas in Diabetes (B-PAID) scale, considering a score ≥ 40 as indicative of high distress. Sociodemographic, clinical, and behavioral variables were collected and analyzed using Gamma regression on the software Statistical Package for the Social Sciences (SPSS 26.0).</p><p><strong>Results: </strong>Among 1563 people with DM, 39.8% were at risk for DFD. In the multiple regression model, there is notable increase in DRD associated with greater difficulty in caring for the feet (β = 1.129; 1.014-1.257), loss of protective sensation (β = 1.311; 1.110-1.549), and poor glycemic control (β = 0.850; 0.761-0.951).</p><p><strong>Conclusion: </strong>Sociodemographic and clinical factors, particularly loss of protective sensation in the feet, difficulty in foot care, and inadequate control of glycated hemoglobin, are associated with greater DRD in people at risk for DFD. Primary health care stands out as a strategic space for integrating psychosocial support and clinical management, ensuring that preventive measures are implemented and resulting complications are avoided or detected early.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70194"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622241","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 Prospective Comparison of Ultrasound-Guided Ankle Versus Popliteal Nerve Blocks for Elective Forefoot Surgery in a UK Podiatric Surgery Unit.","authors":"Yang Sern Kang, Tommy Chan, Robert Morley","doi":"10.1002/jfa2.70219","DOIUrl":"10.1002/jfa2.70219","url":null,"abstract":"<p><strong>Background: </strong>Regional anaesthesia is central to perioperative care in foot surgery, yet comparative data within UK podiatric surgery services remain limited. Establishing local outcome baselines is essential for optimising care and supporting clinical scope.</p><p><strong>Aim: </strong>To compare pain intensity levels and functional recovery in patients undergoing elective forefoot surgery under ultrasound-guided ankle or popliteal nerve block.</p><p><strong>Methods: </strong>This prospective service evaluation involved 17 adults undergoing elective forefoot surgery. Participants were allocated via pragmatic, nonrandomised sequential scheduling based on surgeon preference to receive either an ultrasound-guided ankle block (n = 9) or popliteal nerve block (n = 8) using 0.5% levobupivacaine. Outcomes included sensory onset time, duration of analgesia, pain intensity (VAS), opioid consumption standardised to morphine milligram equivalents (MME), and functional recovery assessed using a modified Functional Recovery Index (FRI).</p><p><strong>Results: </strong>Sensory onset times showed no significant difference between groups (p = 0.491). Popliteal blocks provided significantly longer analgesia than ankle blocks (23.75 vs. 12.61 hours; p = 0.038), whereas procedural discomfort was comparable (p = 0.449). Postoperative pain trajectories differed significantly (p = 0.049), with pain decreasing from Day 1 to Day 3 following ankle block but increasing following popliteal block. Opioid consumption declined over time across the cohort (p = 0.015), with no significant between-group differences. Functional recovery demonstrated a trend towards greater early improvement in the ankle group.</p><p><strong>Conclusions: </strong>Both ankle and popliteal blocks provided effective perioperative anaesthesia for elective forefoot surgery. Popliteal blocks offered longer analgesia, whereas ankle blocks showed a trend towards earlier mobilisation. Although limited by sample size and Type II error risk, these findings provide baseline data to inform future adequately powered studies and contribute evidence from UK podiatric day-case practice that may have relevance to wider day-case foot surgery.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70219"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031896","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":"Clinician Perspectives on Prescribing Restrictions and Opioid Pain Management in Australian Podiatric Practice: A Qualitative Study.","authors":"Lachlan Aquilina, Mischa Kronenberg, Estie Kruger, Marc Tennant, Joon Soo Park","doi":"10.1002/jfa2.70202","DOIUrl":"10.1002/jfa2.70202","url":null,"abstract":"<p><strong>Background: </strong>Australian-endorsed general podiatrists and podiatric surgeons (EGPs and EPSs, respectively) operate under a fixed prescribing formulary, the National Podiatry Scheduled Medicines List (NPSML), that restricts access to opioid analgesics including tramadol and tapentadol, despite emerging evidence questioning the efficacy of available alternatives such as codeine. The impact of these restrictions on clinical practice has not been qualitatively examined.</p><p><strong>Methods: </strong>A qualitative descriptive study using semi-structured interviews was conducted with thirty-one clinicians: ten pharmacists, seven dentists, five EGPs and nine EPSs practising across metropolitan, regional and rural Australia. Profession-specific interview guides explored prescribing practices, analgesic strategies, experiences with formulary limitations and perceived impacts on patients and care systems. Interviews were audio-recorded, transcribed verbatim and analysed using comparative thematic analysis with inductive coding. This study was reported in accordance with the COREQ checklist.</p><p><strong>Results: </strong>Three themes were identified: (1) Inadequacy of fixed prescribing formularies: All professional groups, including pharmacists and dentists not directly constrained by the NPSML, critiqued the static, list-based prescribing model as structurally misaligned with contemporary evidence and practice. (2) Codeine as an unreliable ceiling for moderate to severe pain: Codeine was widely regarded as an unreliable analgesic because of variable metabolism, with clinicians describing cases of treatment failure necessitating emergency department referral. (3) Fragmented care pathways and cascading patient impact: Prescribing restrictions were perceived to generate disjointed care pathways, delayed pain relief, increased healthcare utilisation and disproportionately affected patients in rural settings.</p><p><strong>Conclusion: </strong>Australia's NPSML is perceived by clinicians to be structurally misaligned with current pharmacological evidence, professional competencies and equitable care principles. These findings support the transition to a dynamic, scope-of-practice-based prescribing model that can respond to emerging evidence and meet the analgesic needs of diverse patient populations.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70202"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800427","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":"Screening for Depression and Anxiety in People With Diabetes and a Foot Ulcer in the Podiatry Clinic.","authors":"Emma Fletcher, Matthew Allen, Andrew Sharpe, Muneeb Ibad, Mathilde Mordaunt, Rosie Callen, Andy Gorman, Heather Schofield, Edward Jude, Adam Robinson, Reena Patel, Sheena Thayyil, Hermione Price, Edward Gee, Boris Mankovsky, George Dunn, Michael Edmonds, Neil Reeves, Adrian Heald","doi":"10.1002/jfa2.70208","DOIUrl":"10.1002/jfa2.70208","url":null,"abstract":"<p><strong>Introduction: </strong>There is close association between experience of diabetes-tissue complications and depression/psychological distress. Our aim was to describe the results of prospective screening for anxiety/depression in a high-risk multidisciplinary foot hospital clinic where people present with diabetes foot ulceration.</p><p><strong>Methods: </strong>Fifty patients attending our podiatry clinic participated in this study. All had active foot ulceration. The scales completed were GAD-7 for anxiety/PHQ-9 for depression plus 2-specific diabetes distress scale items (16 + 2 questions). Spearman's rho(ρ) was utilised for correlational analysis due to the skewed distributions of variables. Medical history was obtained from primary and secondary care electronic health records. Inclusion criteria were type 1 or 2 diabetes and active foot ulceration.</p><p><strong>Results: </strong>Eight patients were diagnosed with type 1 diabetes and 42 with type 2 diabetes. Mean (standard deviation) (sd) age of the study population was 65.4 (12.9) years (n = 50) of which 86.7% were men. Median time since diagnosis was 14.5 (3.1) years. 42% of the patients had CKD (estimated GFR < 60 mL/min/1.73 m²). Median (IQR) for PHQ-9 was 9 (3-16) and GAD-7 was 4 (0.5-9.0) (mild-moderate median scores for both). The median (IQR) of number of comorbidities was 8.3 (3.9); number of separate drugs was 10.5 (4.1). Depression/anxiety scores correlated highly positively with each other (Spearman's rho 0.791, p < 0.001) and with the diabetes distress score. Age was significantly and inversely correlated with anxiety (rho -0.472, p = 0.017) and depression (rho -0.250, p = 0.040). The PHQ-9 questionnaire score for depression was higher in people taking more individual pharmacological agents (0.490, p = 0.001) and in people with a higher HbA1c (rho 0.421, p = 0.007) and correlated with the total of the 2 diabetes distress score items (rho 0.456, p = 0.006). Ulcer healed status at 12 weeks was not associated with any questionnaire score. Insulin treatment was associated with higher PHQ-9 score.</p><p><strong>Conclusion: </strong>In this prospective study, we found a high correlation between depression/anxiety symptoms and diabetes foot ulceration, both recognised and unrecognised (until assessment). Both depression and anxiety symptoms declined with age. Higher depression scores associated with a higher current HbA1c and with greater number of prescribed medications.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70208"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992130","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":"Efficacy of Vitamin C Treatment to Aid the Healing of Foot Ulcers in People With Diabetes: A Randomised, Placebo-Controlled Double-Blind Trial: The FOOT-C Study Protocol.","authors":"Michelle R Kaminski, Eleanor Thong, Shaun Mason, Gavin Abbott, Chris Lemoh, Jennifer Wong, Paige van der Pligt, Zhong Lu, Janet Golder, Jeong Hyun Kwon, Glenn D Wadley","doi":"10.1002/jfa2.70193","DOIUrl":"10.1002/jfa2.70193","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes-related foot ulceration (DFU) is a serious complication, serving as a leading cause of amputation, disability, hospitalisation and a significant contributor to healthcare costs. Deficiencies in vitamin C and other micronutrients are common in DFU. Emerging evidence suggests vitamin C supplementation may enhance wound healing; however, high-quality randomised controlled trials are lacking. Therefore, the aim of this study is to investigate the efficacy of oral vitamin C supplementation (1 g/day) for 8 weeks on wound healing in people with DFU.</p><p><strong>Methods: </strong>This is a multi-site, parallel group, randomised, placebo-controlled, double-blind trial. Eighty adults with DFU will be recruited and randomly assigned to either placebo or vitamin C supplementation (500 mg twice daily). Ulcer measurements will be obtained at baseline, 2, 4, 6 and 8 weeks with all other measures collected at baseline and 8 weeks. The primary outcome measure is the percentage reduction in ulcer size (ulcer volume in mm³) at 8 weeks, compared to baseline. Secondary outcomes are changes in plasma vitamin C, time to 50% ulcer healing, time to complete ulcer healing, rate of healing of ulcers and adverse events. Exploratory outcomes include changes to glycaemic status, blood lipids, blood pressure, peripheral arterial perfusion, mental health and well-being, scurvy signs and symptoms and oxidative stress.</p><p><strong>Discussion: </strong>The findings from this research will provide high-quality evidence on the efficacy of vitamin C for wound healing in people with DFU and help to inform clinical practice regarding vitamin C supplementation alongside current standard care to aid in the healing of DFUs.</p><p><strong>Trial registration: </strong>Australian and New Zealand Clinical Trials Registry (ACTRN12624000675527). Universal Trial Number (UTN) U1111-1308-1050.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70193"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698174","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 Research Related to Sporting and Musculoskeletal Injuries of the Foot and Ankle: A Bibliometric Analysis.","authors":"Benjamin Peterson, John Osborne, Ameer Nor Azhar, Matthew Carroll, Peta Tehan","doi":"10.1002/jfa2.70184","DOIUrl":"10.1002/jfa2.70184","url":null,"abstract":"<p><strong>Background: </strong>There is growing research evidence related to musculoskeletal and sports podiatry published by Australian researchers. This short report presents data from the musculoskeletal and sports podiatry stream of a national bibliometric review which aimed to map all Australian podiatry-related research from 1970 to 2024.</p><p><strong>Methods: </strong>A systematic search of the literature was conducted via Scopus until December 2024. Studies were screened for eligibility using Covidence. Study meta-data was analysed using Biblioshiny to describe publications volume, authors, institutions, journals, and research collaborations. Via manual processes, each publication was categorised for: level of evidence using National Health and Medical Research Council criteria; research type using the United Kingdom Clinical Research Collaboration Health Research Classification System; and funding source, using Higher Education Research Data Collection specifications.</p><p><strong>Results: </strong>The search strategy yielded 288 records published by 774 authors (19% international), with a total 12,593 citations, with 44.1 mean citations per article from 1991 to 2024 were included. A total of 65 articles (23%) were categorised as level I evidence. The British Journal of Sports Medicine and the Journal of Science and Medicine in Sport were equally the most frequent publication sources, publishing 23 (8%) articles respectively. Podiatry-related musculoskeletal and sports research is usually undertaken without dedicated funding (67%). The majority of published articles focussed on the evaluation of treatments and therapeutic interventions (36%) and on the aetiology of conditions (34%).</p><p><strong>Conclusion: </strong>The musculoskeletal and sports podiatry stream was the most widely researched, with the highest proportion of level I evidence among all streams of the national bibliometric review. Given the high burden of disease and adverse impacts on activities of daily living associated with musculoskeletal conditions, further attention in preventative care and the promotion of wellbeing in sports and musculoskeletal research would be beneficial.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70184"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413223","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":"Science or Tradition? Strength of Evidence for Footwear Fit Guidelines From Peer-Reviewed Studies of People With Diabetes-A Foot in Diabetes UK Systematic Review.","authors":"Petra J Jones, Christoforos Vlachopoulos, Helen Branthwaite, Krishna Gohil, Ryan Cassidy, Chris Morriss-Roberts, Christian Pankhurst, Andrew Hill","doi":"10.1002/jfa2.70189","DOIUrl":"10.1002/jfa2.70189","url":null,"abstract":"<p><strong>Background: </strong>Footwear fit advice for patients and people with diabetes varies significantly. A review of the strength of evidence for footwear fit standards developed in peer-reviewed studies is urgently needed both to inform future research and guidelines.</p><p><strong>Methods: </strong>We performed a systematic review to summarise and evaluate strength of evidence (GRADE) and risk of bias (Newcastle-Ottawa Scale) of footwear fit standards in peer-reviewed research studies involving people with diabetes through a search of Medline, Scopus, Embase and Web of Science databases.</p><p><strong>Results: </strong>Wearing incorrect shoe size increased DFU risk by up to 10 times (OR 1.7, p = 0.001 to OR 10.4, p < 0.001) based on 4 studies (risk of bias: poor (n = 3) to good (n = 1), but GRADE strength of evidence was Low to Moderate). GRADE strength of evidence for recommended footwear length, width and depth were very low to low. No studies were found examining DFU risk or in-shoe pressure in shoelace alternatives, varying toe box shapes, heel width or height.</p><p><strong>Conclusion: </strong>Strength of evidence for current footwear fit guidelines is limited. Footwear fit guidance should currently be based on assessing adequate shoe size, with further research required to determine quantitative ranges for toe gaps, etc.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70189"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537534","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":"Intrinsic Foot Muscle Cross-Sectional Area on MRI in People With and Without Plantar Heel Pain: A Cross-Sectional Observational Study.","authors":"John W A Osborne, Ana M Azevedo, Hylton B Menz, Glen A Whittaker, Matthew Cotchett, Tom Entwisle, David A Connell, Shannon E Munteanu, Karl B Landorf","doi":"10.1002/jfa2.70183","DOIUrl":"10.1002/jfa2.70183","url":null,"abstract":"<p><strong>Introduction: </strong>This study compared the cross-sectional areas (CSA) of key intrinsic foot muscles in people with and without plantar heel pain (PHP).</p><p><strong>Methods: </strong>Seventy-five adults participated in the study: 50 participants with PHP and 25 age-, sex-, and body mass index (BMI)-matched participants without PHP (control group). Cross-sectional images were generated using 3.0T magnetic resonance imaging (MRI). CSAs of four intrinsic foot muscles-abductor hallucis, quadratus plantae, flexor digitorum brevis and abductor digiti minimi-were measured. The difference in CSA of each muscle was compared between the groups using independent samples t-tests and Cohen's d effect sizes were calculated.</p><p><strong>Results: </strong>Participants were well matched: mean age 49.1 and 48.9 years, women accounted for 58% and 56%, and BMI 30.6 kg/m² and 30.2 kg/m² in the PHP and control groups, respectively. There were no significant differences in mean CSAs for all four muscles (p > 0.05) between the PHP and control groups, and effect sizes were tiny or very small.</p><p><strong>Conclusion: </strong>This study found no differences in muscle CSAs of key intrinsic muscles of the foot in people with and without PHP, indicating that people with PHP do not have key intrinsic foot muscle size deficits. As such, intrinsic muscle size does not appear to be a logical therapeutic target for PHP. Clinicians translating our findings into practice should, therefore, consider whether strengthening interventions targeting intrinsic muscles in PHP are warranted.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70183"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654736","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":"Validity and Reliability of the Turkish Version of the Idiopathic Toe Walking Outcome (iTWO) Proforma.","authors":"Esra Giray, Munteha Ilkyaz Karadag, Sude Gozukucuk Turkyilmaz, Kubra Yildiz Celik, Pinar Akpinar, Ozge Gulsum Illeez, Feyza Unlu Ozkan, Ilknur Aktas, Evrim Karadag-Saygi, Cylie M Williams","doi":"10.1002/jfa2.70188","DOIUrl":"10.1002/jfa2.70188","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate the validity and reliability of the Turkish version of the Idiopathic Toe Walking Outcome proforma (iTWO proforma-T), a clinician- and parent-reported tool designed to assess symptoms, functional performance, and treatment outcomes in children with idiopathic toe walking (ITW).</p><p><strong>Methods: </strong>Thirty-five children aged 4-14 years with ITW were included. The translation procedure followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Construct validity was examined through correlations between individual iTWO proforma-T items and the Toe Walking Severity Scale, the Oxford Ankle Foot Questionnaire (OxAFQ), and the Pediatric Outcomes Data Collection Instrument (PODCI). Test-retest reliability was assessed in 10 of the 35 participants using intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>Most items demonstrated excellent test-retest reliability (ICC > 0.90), including parent-reported toe-walking percentage, satisfaction, treatment adherence, pain-on-activity, and clinician-reported gait scale. Validity analyses showed significant and meaningful correlations between iTWO proforma-T items and established measures. The estimated toe-walking percentage correlated strongly with the Toe Walking Severity Scale (ρ = -0.549) and the OxAFQ emotional domain (ρ = -0.493). Functional performance items (gait scale, 2- and 6-minute walk tests) showed moderate positive correlations with toe-walking severity, whereas pain-related items correlated negatively with relevant PODCI and OxAFQ domains.</p><p><strong>Conclusion: </strong>The iTWO proforma-T is a valid and reliable instrument for evaluating symptoms, functional status, and treatment-related outcomes in children with idiopathic toe walking. The tool preserves the structure and measurement characteristics of the original proforma and can be confidently used by clinicians and researchers for evidence-based assessment and follow-up in Turkish-speaking pediatric populations.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70188"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609632","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 the Role of Footwear in Trail Running and Hiking: A Scoping Review.","authors":"Aaron Jackson, Kiseon Hong, Mike Frecklington, Kelly Sheerin, Matthew Carroll","doi":"10.1002/jfa2.70197","DOIUrl":"10.1002/jfa2.70197","url":null,"abstract":"<p><strong>Introduction: </strong>Off-road activities such as trail running and hiking have undergone a significant surge in global popularity over the last 2 decades, but this engagement also raises the potential for musculoskeletal injuries, which are prevalent and comparable to rates reported in road running. Footwear is critical in these dynamic environments, incorporating features such as aggressive outsole patterns and structural stability elements to accommodate varied and rugged terrain.</p><p><strong>Methods: </strong>Given the limited synthesis and fragmented nature of the literature, this scoping review systematically mapped and summarised existing research on the influence of footwear in hiking and trail running. The review was guided by three research questions that examined key outcome domains and methodological approaches, using the Arksey and O'Malley framework, and was reported in accordance with PRISMA-ScR guidelines.</p><p><strong>Results: </strong>A search across four databases identified 16 eligible studies. Thirteen studies (81%) focused on trail running, exploring various footwear types, including advanced footwear technology, minimalist designs, and specific midsole characteristics. Biomechanical outcomes were the most frequently investigated (62% of studies), while physiological outcomes, performance, injury, and comfort were addressed in 25%-31% of studies each.</p><p><strong>Conclusion: </strong>Although methodological strengths include an increasing commitment to ecological validity by leveraging wearable sensors in combined lab and field protocols, persistent limitations include frequent use of small sample sizes and the underrepresentation of female participants in many controlled trials. A significant evidence gap remains regarding the chronic effects of prolonged footwear use and the interaction of footwear with fatigue. Future research requires methodological standardisation and longitudinal studies to advance toward individualised, evidence-based footwear solutions.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"19 3","pages":"e70197"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698184","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}