Journal Of Foot And Ankle Research[JOURNAL]
Sun
200 papers
The CUBED Versus ABCDE Recognition Tools in the Detection of Malignant Melanomas Arising in the Foot: An Analysis of Four Recent Case Studies in a Single NHS Community Trust.
Sherratt A, Vaughan E, Huckerby N … +2 more , Winn H, Swithenbank M
J Foot Ankle Res · 2026 Jun · PMID 42056756 · Full text
BACKGROUND: Melanoma of the foot and nail unit carries a worse prognosis than cutaneous melanoma elsewhere because lesions are frequently hidden, misdiagnosed, and therefore diagnosed at more advanced stages. Traditional...
BACKGROUND: Melanoma of the foot and nail unit carries a worse prognosis than cutaneous melanoma elsewhere because lesions are frequently hidden, misdiagnosed, and therefore diagnosed at more advanced stages. Traditional ABCDE criteria are often insufficient for foot and nail presentations; the CUBED recognition tool was developed to improve detection of atypical plantar and subungual lesions. AIM: To evaluate four consecutive cases of foot melanoma seen in a single NHS community podiatry department, compare case characteristics against ABCDE and CUBED recognition tools, and describe service responses that aimed to improve early detection. METHODS: A retrospective case series of four patients diagnosed with foot melanoma between 2019 and 2022 in one community podiatry service. Clinical features, referral timelines, diagnostic pathways, treatments, and outcomes were extracted and mapped against ABCDE and CUBED criteria. Shared-learning interventions developed by the department following these cases are described. RESULTS: All four cases were toe-based melanomas (one lentigo maligna, one nail-bed malignant melanoma, two acral melanomas). Presentations commonly included irregular colour, bleeding or ulceration, delayed healing, diagnostic uncertainty, and lesion enlargement. CUBED criteria more consistently identified concerning features across the series than ABCDE criteria, prompting urgent dermatology referral in each case. Outcomes varied: one patient remains disease-free after excision, one developed distant metastasis and died, two underwent toe amputation and received systemic treatment. Departmental responses included case-based teaching and a poster campaign promoting CUBED and ABCDE recognition across local clinical networks. CONCLUSION: Podiatrists are pivotal in early detection of foot melanoma. The CUBED tool demonstrated greater sensitivity for atypical foot and nail lesions in this series. Wider education and adoption of CUBED alongside ABCDE may reduce misdiagnosis, shorten diagnostic delay, and improve clinical outcomes.
Clinical Outcomes of Custom Foot Orthoses in Progressive Collapsing Foot Deformity: A Retrospective Cohort Analysis.
Robb K, Ryan M, Moisan G
J Foot Ankle Res · 2026 Jun · PMID 42036887 · Full text
BACKGROUND: Progressive collapsing foot deformity (PCFD) is a painful and function-limiting condition most commonly affecting middle-aged and older adults. Although custom foot orthoses (CFOs) are routinely prescribed as...
BACKGROUND: Progressive collapsing foot deformity (PCFD) is a painful and function-limiting condition most commonly affecting middle-aged and older adults. Although custom foot orthoses (CFOs) are routinely prescribed as a conservative intervention, evidence from large clinical cohorts remains limited. This study aimed to characterise patients with PCFD seeking orthotic care, examine demographic factors associated with pain improvement, evaluate clinical and self-reported outcomes following CFO use, and explore potential interaction effects of CFOs on clinical improvement across sex. METHODS: A retrospective analysis of clinical records between January 1, 2016 and May 31, 2025 extracted 130,365 appointments across 25 Canadian pedorthic clinics, further extrapolated into 669 PCFD encounters and 12,621 asymptomatic controls. Each assessment included pain ratings, Foot Posture Index (FPI), functional tests, gait analysis, and follow-up surveys on CFOs wear time, comfort, and recovery. RESULTS: Results identified that PCFD was more prevalent in females and older adults. Unilateral PCFD limbs demonstrated significantly higher FPI scores (flatter feet) than contralateral healthy limbs. Both sexes demonstrated significant pain reduction following CFOs use, with females reporting higher pain at baseline and follow-up. Mean pain decreased from 6.52 ± 2.56 at assessment to 3.69 ± 2.52 at follow-up (p < 0.0001). Eighty percent of patients reported symptoms improvement, and 56% wore orthoses for more than 6 hours per day. Comfort was positively associated with both wear time and magnitude of pain reduction. CONCLUSIONS: CFOs were associated with meaningful pain reduction, improved function, and high patient-reported benefit in individuals with PCFD. These findings support CFOs as a cost-effective conservative intervention and provide essential data to inform the design of a future randomised controlled trial evaluating their clinical efficacy.
Plantar Heel Pain Is Not Associated With Fatty Infiltration of the Abductor Digiti Minimi Muscle on Magnetic Resonance Imaging: A Cross-Sectional Observational Study.
Chen JSC, Osborne JWA, Menz HB … +5 more , Abbott M, Munteanu SE, Entwisle T, Connell DA, Landorf KB
J Foot Ankle Res · 2026 Jun · PMID 42033738 · Full text
BACKGROUND: Fatty infiltration, or fatty atrophy, of the abductor digiti minimi (ADM) muscle of the foot is proposed to be associated with entrapment of the first branch of the lateral plantar nerve (i.e., Baxter's neuro...
BACKGROUND: Fatty infiltration, or fatty atrophy, of the abductor digiti minimi (ADM) muscle of the foot is proposed to be associated with entrapment of the first branch of the lateral plantar nerve (i.e., Baxter's neuropathy) as part of plantar heel pain (PHP). However, this association has not been rigorously investigated. The aim of this study was to determine if there is an association between PHP and fatty infiltration of ADM. METHODS: This cross-sectional observational study compared 50 participants with PHP to a control group of 25 participants without PHP who were matched at recruitment for age (± 5 years), sex and body mass index (BMI) (± 10%). Fatty infiltration of ADM was assessed on all participants using magnetic resonance imaging (MRI). Prior to assessment, four grading scales of fatty infiltration were investigated for reliability by two independent assessors using Kappa or weighted Kappa and the most reliable scale was chosen for the primary data analysis. Following this, participant characteristics were compared between the PHP and the no-PHP groups using Chi-squared, Mann-Whitney U or independent samples t-tests to ensure there were no significant differences between the two groups in characteristics that could have confounded the findings. The association between PHP and fatty infiltration was analysed using the Chi-square test (χ). RESULTS: In the PHP and no-PHP groups, respectively, the mean age was 49.1 and 48.9 years, women comprised 58% and 56%, and the mean BMI was 30.6 and 30.2 kg/m. A four-point grading scale was found to be the most reliable scale (0.87 and 0.92 for inter- and intra-rater reliability, respectively). There were no significant differences (p > 0.05) for important participant characteristics (e.g., age, sex and BMI). There was some fatty infiltration (grades 1-3) in 78% and 96% of participants in the PHP and no-PHP groups respectively. No significant association was found (χ = 6.176, df = 3, p = 0.103) between PHP and fatty infiltration according to the four-point grading scale. CONCLUSIONS: After accounting for age, sex and BMI, there was no association between PHP and fatty infiltration of ADM. These findings suggest that adults with PHP do not have a greater predisposition for or amount of fatty infiltration of ADM compared to adults without PHP. Therefore, fatty infiltration of ADM is likely to be an incidental finding on MRI rather than a diagnostic sign of PHP, where Baxter's neuropathy may be present. Accordingly, clinicians should not focus on fatty infiltration of ADM on MRI to diagnose Baxter's neuropathy, or view it as a proxy marker, particularly when surgery for PHP is being considered.
Reliability and Validity of Ankle Muscle Strength Testing Using the ISOTIB Device.
Drew S, Horan SA, Duhig S
J Foot Ankle Res · 2026 Jun · PMID 41957913 · Full text
INTRODUCTION: One repetition maximum (1RM) testing is recognised as a reliable and valid method for determining maximum muscle strength. However, there are limited reports in the literature for measuring maximum ankle st...
INTRODUCTION: One repetition maximum (1RM) testing is recognised as a reliable and valid method for determining maximum muscle strength. However, there are limited reports in the literature for measuring maximum ankle strength using free-weight methods. The aim of this study was to determine the test-retest reliability and concurrent validity of a novel free-weight device (ISOTIB) used to measure ankle strength. METHODS: Fifteen healthy, recreationally active, adults (male = 10, female = 5, age = 29.7 ± 4.4 years) volunteered for the study, attending two sessions 1 week apart. Reliability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman method. Concurrent validity was examined by comparing 1RM ankle strength and normalised muscle activity using surface electromyography (sEMG) during dorsiflexion, inversion, and eversion movements performed with the ISOTIB device and an isokinetic dynamometer. RESULTS: The ISOTIB exhibited excellent test-retest reliability for maximal dorsiflexion (ICC = 0.99, 95% CI: 0.977-0.997), inversion (ICC = 0.99, 95% CI: 0.970-0.997), and eversion (ICC = 0.97, 95% CI: 0.920-0.991) strength. Concurrent validity was confirmed, with high positive correlations for maximal dorsiflexion (r = 0.90, 95% CI: 0.72-0.97) p < 0.001), inversion (r = 0.67, 95% CI: 0.24-0.88) p < 0.007), and eversion (r = 0.87, 95% CI: 0.64-0.96) p < 0.001) strength. sEMG results supported concurrent validity with comparable activity in the tibialis anterior, peroneus longus, and peroneus brevis muscles. CONCLUSION: The ISOTIB demonstrated excellent reliability and validity, suggesting it is a viable tool for assessing maximal ankle strength. The ISOTIB offers a practical alternative to current methods, which are typically expensive and utilise large immovable devices.
'I Didn't Know, I Definitely Guessed.' Exploring Pre-Registration Podiatry Students' Approach to Identifying Dermatological Conditions in Different Skin Tones, a Mixed Methods Study.
Otter S, Funnell F, Sykes A … +3 more , Ewins-Strowger K, Hemming N, Whitham D
J Foot Ankle Res · 2026 Jun · PMID 41928493 · Full text
BACKGROUND: Research suggests that healthcare professionals find it more difficult to correctly diagnose dermatological conditions in the nonwhite patient demographic. People of colour experience higher rates of delayed...
BACKGROUND: Research suggests that healthcare professionals find it more difficult to correctly diagnose dermatological conditions in the nonwhite patient demographic. People of colour experience higher rates of delayed and misdiagnosis, contributing to an increased mortality risk and increased health inequalities that remain widespread throughout the health care setting. This study aimed to investigate podiatry student's ability, confidence, approaches and perceptions in diagnosing dermatology pathologies in different skin tones. METHODS: A mixed methods explanatory sequential design was undertaken with pre-registration podiatry students from universities across South-central England. Participants completed a validated pictorial multiple-choice questionnaire comprising six images of either eczema or psoriasis in three different skin tone categories: light, medium or dark. Results were used to inform focus groups and a process of thematic analysis explored participants perceptions surrounding their diagnostic approaches and underpinning confidence. RESULTS: The medium skin tone (Fitzpatrick groups III/IV) was associated with the most correct responses for psoriasis (69%) followed by light skin tone (Fitzpatrick groups I/II) with 48%. Psoriasis in darker skin tones (Fitzpatrick groups V/VI) received the least correct responses (3%). In eczema, results were more evenly spread with darker skin tones (Fitzpatrick groups V/VI), receiving a slightly higher percentage of correct diagnoses (39%). Qualitative analysis revealed two emergent themes: (i) reports on confidence and apprehension and (ii) limitations in education provision: each with a series of sub-themes. Participants reported barriers to their diagnostic ability included an underrepresentation of dark skin tones in medical images and inadequate exposure to pathology on patients with dark skin tones. CONCLUSIONS: There was a notable lack of confidence in participants' ability to correctly diagnose dermatological pathology, particularly in dark skin tones. This study addresses the research gap in podiatric health inequalities and pinpoints the associated educational shortcomings from the podiatry education perspective.
From Pressure Patterns to Personalized Insoles: A Systematic Review of Demographic Influences on Plantar Pressure.
Ayati Najafabadi SM, Niroomand-Oscuii H, Hashemi Oskouei A
J Foot Ankle Res · 2026 Jun · PMID 41914079 · Full text
BACKGROUND: Plantar pressure distribution is a widely used biomechanical measure for characterizing foot-ground loading during gait in research and clinical assessment. Demographic variables, such as sex, age, and body w...
BACKGROUND: Plantar pressure distribution is a widely used biomechanical measure for characterizing foot-ground loading during gait in research and clinical assessment. Demographic variables, such as sex, age, and body weight, influence plantar loading patterns; however, findings across studies have been inconsistent, limiting direct clinical interpretation. METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Science Direct, and Scopus were searched for studies published between 2013 and 2025 that investigated the relationship between plantar pressure and sex, age, or body weight in healthy, asymptomatic individuals. Eligible studies were screened, data were extracted, and subgroup analyses were performed to assess pressure differences across specific foot regions. Protocol registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/view/CRD420251083389). RESULTS: Sex-specific differences revealed that women exhibited higher plantar pressure in the hallux, whereas men demonstrated greater loading in the heel and lateral heel regions. In older adults, a posterior-to-anterior shift in pressure was observed, with decreased heel loading and increased pressure in the forefoot, midfoot, and fifth metatarsal. Obesity was associated with significantly elevated plantar pressure in the first, fourth, and fifth metatarsals as well as in the heel, midfoot, and forefoot, whereas hallux pressure was relatively reduced compared to individuals of normal weight. Across all subgroup analyses, six foot regions, namely, the hallux, first, fourth, and fifth metatarsals, midfoot, and total heel consistently showed moderate to strong effect sizes. CONCLUSIONS: This study summarizes population-specific plantar pressure patterns associated with sex, age, and body weight. The hallux, selected metatarsals, midfoot, and heel consistently demonstrated pooled differences across studies and are highlighted as regions of interest for future research. These findings provide descriptive biomechanical reference patterns that may support hypothesis-driven investigations into plantar load redistribution and comfort-related outcomes. These findings should therefore be interpreted as providing comparative biomechanical context rather than direct clinical decision-making criteria.
Mental Health Predictors of Dynamic Balance in Individuals With Chronic Ankle Instability.
Jaffri A
J Foot Ankle Res · 2026 Jun · PMID 41913085 · Publisher ↗
BACKGROUND: Chronic ankle instability (CAI) is linked to impaired dynamic balance and psychological deficits, potentially hindering optimal rehabilitation outcomes. However, the impact of psychological deficits on dynami...
BACKGROUND: Chronic ankle instability (CAI) is linked to impaired dynamic balance and psychological deficits, potentially hindering optimal rehabilitation outcomes. However, the impact of psychological deficits on dynamic balance has not been explored before. Therefore, the aim of this study is to determine whether mental health factors predict dynamic balance performance in individuals with CAI using the Star Excursion Balance Test (SEBT). METHODS: This is a cross-sectional observational study performed in a university setting. Forty individuals with CAI (17 men, 23 women) participated in this study. Assessments included psychological profiles (kinesiophobia, self-reported mental health, self-efficacy, global mental health, and functional status via FAAM-Sport). Dynamic balance was evaluated using the SEBT composite and directional scores. RESULTS: Multiple linear regression analyses indicated that the SEBT composite score was significantly predicted by self-efficacy, global mental health and TSK-11, explaining 40% of the variance (F-value = 7.82, p < 0.01). Further directional analysis revealed that posterior-medial reach was best predicted by self-efficacy, global mental health and TSK-11 (F-value = 9.05, p < 0.01; 44% variance), while posterior-lateral reach was similarly predicted by self-efficacy, and global mental health (F-value = 6.92, P = 0.003; 28% variance). Anterior reach performance was most strongly associated with self-efficacy and TSK-11 (F-value = 10.26, p < 0.01; 36% variance). CONCLUSIONS: The findings underscore the importance of psychological factors as key predictors of dynamic balance in CAI. Incorporating mental health assessments into physical rehabilitation may enhance treatment outcomes for individuals with CAI.
Clinical Consensus Statement: Perioperative Management of Prothrombotics, Antiplatelets, Anticoagulants, DMARDs and Biologics in Elective Podiatric Surgery.
Tang J, Posmyk L, Cowden J … +3 more , Lang R, Milnes H, Donson L
J Foot Ankle Res · 2026 Mar · PMID 41872991 · Full text
INTRODUCTION: A substantial body of literature exists on the perioperative management of pharmacological agents specifically prothrombotic agents, antiplatelets, anticoagulants and disease-modifying antirheumatic drugs (...
INTRODUCTION: A substantial body of literature exists on the perioperative management of pharmacological agents specifically prothrombotic agents, antiplatelets, anticoagulants and disease-modifying antirheumatic drugs (DMARDs) aimed at mitigating risks associated with both the medications themselves and the comorbidities they treat. However, a clear and consistent consensus on best practice is either lacking or poorly defined especially in foot surgery. To address this gap, a working group of podiatric surgeons convened to develop a Clinical Consensus Statement (CCS) for the perioperative management of these drugs in foot and ankle surgery. METHOD: A five-member panel identified four key areas of interest: prothrombotic agents, antiplatelets, anticoagulants and disease-modifying antirheumatic drugs. They conducted a comprehensive literature review to assess the available data and identify evidence gaps, ultimately formulating nineteen questions grouped within these areas using a modified Delphi method. These questions were presented to delegates at the 2022 Faculty of Podiatric Surgery (FoPS) Conference. RESULTS: The recommendations from the clinical consensus statement are summarised in Appendix 1 highlighting the strength of each recommendation. Although more high-level evidence is needed to inform decision-making in this area, this consensus statement has utilised the available evidence base and reflects current practice. Rather than providing a definitive guideline, it provides valuable interim guidance for elective foot surgery, however, does not replace local trust policies and guidelines.
Enhancing Podiatry Students' Understanding of Foot Arch Through Footprint Activity.
Jacques A, Chehrehasa F
J Foot Ankle Res · 2026 Mar · PMID 41865365 · Full text
BACKGROUND: Understanding the structural anatomy and biomechanics of the foot arches is essential for podiatry students due to its clinical relevance in diagnosing conditions such as Pes Planus and Pes Cavus. The foot ar...
BACKGROUND: Understanding the structural anatomy and biomechanics of the foot arches is essential for podiatry students due to its clinical relevance in diagnosing conditions such as Pes Planus and Pes Cavus. The foot arches form a flexible base that supports body weight, absorbs shock and functions as a spring lever during activities such as walking and jumping. Therefore, understanding this anatomical knowledge is fundamental for podiatry students for maintaining foot health and supporting clinical assessment and treatment planning. Traditional pedagogical methods often face limitations due to cost, accessibility and emotional or cultural barriers. METHODS: To address these challenges, the footprint practical activity (FPA) was introduced as a hands-on, cost-effective and inclusive pedagogical strategy. Students collected their footprints and analysed two-dimensional footprints to interpret three-dimensional foot arch structures using Staheli's and Chippaux-Smirak indices. Educational impact was assessed by comparing overall grades between pre- (2020) and post-implementation (2023) cohorts. RESULTS: Implementation of the FPA resulted in a 12% improvement in academic outcomes. Student feedback highlighted enhanced anatomical comprehension and appreciation of clinical relevance, supporting the effectiveness of the intervention. The diagnostic tools used in the activity, Staheli's index and the Chippaux-Smirak index, showed consistent classification outcomes. CONCLUSION: The finding supports the integration of footprint-based analysis into lower limb anatomy education as a clinically relevant student-centred approach. The FPA enhances student engagement, supports anatomical learning and facilitates the teaching of foot arch variation, offering a valuable alternative to traditional pedagogical methods in podiatry anatomy education.
The Immediate Effects of Vibrotexture Shoe Insoles on Quiet Standing Balance and Lower Limb Muscle Activity in Healthy Young Adults.
Trotman M, Hurkat A, Tucker K … +2 more , Cattagni T, Hatton AL
J Foot Ankle Res · 2026 Mar · PMID 41858029 · Full text
INTRODUCTION: Shoe insoles that provide a single source of plantar sensory stimulus, such as texture or vibration, can improve measures of standing balance. Vibrotexture insoles, designed to provide multiple sources of s...
INTRODUCTION: Shoe insoles that provide a single source of plantar sensory stimulus, such as texture or vibration, can improve measures of standing balance. Vibrotexture insoles, designed to provide multiple sources of sensory stimuli, may provide greater benefits. This study aimed to investigate the immediate effects of wearing Vibrotexture insoles on quiet standing balance and lower limb muscle activity in healthy young adults. METHODS: Thirty healthy young adults (16 males, 23.6 ± 3.9 years) performed standing balance tests (eyes open/closed, firm/foam surface) wearing four different insoles (vibrotexture, textured, vibrating, and control) within standardized shoes. Balance outcomes included center of pressure (COP) velocity, COP anteroposterior and mediolateral (ML) path length and range. Lower limb muscle amplitude was examined using electromyography at the medial gastrocnemius, soleus, peroneus longus, rectus femoris, biceps femoris, and gluteus medius (dominant leg). Perceived insole comfort and user experience was reported. One-way Friedman tests were used to compare differences between insoles. RESULTS: For the primary aim of interest, there were no differences in balance measures or muscle activity between the vibrotexture insoles and other insole conditions. Exploratory secondary analyses revealed that COP ML path length was less while wearing the textured compared to vibrating insoles (eyes open, firm surface) (p = 0.022), and rectus femoris muscle amplitude was less while wearing the textured compared to control insoles (eyes open, foam surface) (p = 0.027). The vibrotexture insoles were perceived as less comfortable than the control insoles (p < 0.013). Participants commonly reported the sensory-stimulating insoles to feel "spiky", "tingly", or "rough". CONCLUSION: Wearing vibrotexture insoles for the first time does not appear to alter standing balance in young adults. However, textured insoles do alter COP ML path length and rectus femoris amplitude. These findings highlight the need to investigate vibrotexture insoles in more dynamic tasks and in populations with reduced foot sensation, where their effects may be more pronounced.
Effects of First Metatarsophalangeal Osteoarthritis on Plantar Pressures Across Multiple Activities.
Telfer S, Wukelic C, Entress N … +1 more , Ledoux WR
J Foot Ankle Res · 2026 Mar · PMID 41858013 · Full text
BACKGROUND: The first metatarsophalangeal joint (MTPJ1) is one of the sites most often affected by osteoarthritis (OA). The condition contributes to activity restrictions and reduced quality of life along with biomechani...
BACKGROUND: The first metatarsophalangeal joint (MTPJ1) is one of the sites most often affected by osteoarthritis (OA). The condition contributes to activity restrictions and reduced quality of life along with biomechanical changes that affect the joint and beyond. Despite this, previous studies have presented limited evidence of alterations in plantar pressures during level walking. In this case-control study, we hypothesized that activities that may stress the joint to a greater extent than standard gait may reveal greater differences in plantar pressures between those with MTPJ1 OA and healthy feet. METHODS: Participants with MTPJ1 OA (n = 22) and matched controls (n = 21) were recruited for this study. All were asked to perform four activities while plantar pressures were measured: standing, walking, stair ascent, and heel raise. Analysis of discrete pressure variables at anatomical regions and statistical parametric mapping was used to determine if there were significant differences in pressures between MTPJ1 OA and control groups. RESULTS: No differences were found for discrete variables across the activities, however, statistical parametric mapping revealed differences for the MTPJ1 OA group, including reduced loading under the distal first metatarsal head (60%-80% of stance), increased midfoot pressures at 70%-80% of stair ascent, and decreased lateral forefoot pressure during heel raise. CONCLUSION: MTPJ1 OA is associated with limited changes in plantar pressures across different activities. These regions of difference may be targeted by interventions such as foot orthotics as part of a personalized treatment program. LEVEL OF EVIDENCE: Level IV, case control study.
'No Foot, No Future': Lived Experiences of Foot Health and Care Access Among Rough-Sleeping Adults in a UK Coastal Community-A Qualitative Study.
Bower J, Paton J
J Foot Ankle Res · 2026 Mar · PMID 41851599 · Full text
INTRODUCTION: People experiencing homelessness face profound barriers in accessing healthcare, particularly preventive services such as foot care. Globally, rough sleepers are vulnerable to foot-related morbidity due to...
INTRODUCTION: People experiencing homelessness face profound barriers in accessing healthcare, particularly preventive services such as foot care. Globally, rough sleepers are vulnerable to foot-related morbidity due to prolonged exposure, inadequate footwear and poor hygiene access. Despite this, foot health remains an under-researched aspect of homelessness. OBJECTIVE: To explore the lived experiences of rough-sleeping adults in the United Kingdom in relation to foot health, self-care practices and access to podiatric services, and to understand how these experiences influence their overall health and well-being. METHODS: This qualitative study employed interpretative phenomenological analysis (IPA) to investigate the narratives of seven adults (five men and two women, aged between 30 and 62, all identifying as White British) who were sleeping rough in an urban UK setting. Semistructured interviews were conducted at a community drop-in centre. The consequent transcripts were analyzed thematically, focusing on participants' interpretations of foot health, access to care and coping within the context of homelessness. RESULTS: Four themes were identified: foot care as survival, normalisation of foot health problems, barriers to foot care access and the charity sector as a lifeline. Participants reported widespread foot problems, including chronic pain, infections and poor nail health. Barriers to care included stigma, distrust of medical professionals, inflexible services and competing survival priorities. Lack of access to basic hygiene and footwear exacerbated foot health issues. In contrast, charitable services offering podiatry were described as vital sources of support and dignity. CONCLUSION: Foot health is integral to the mobility, independence and psychosocial well-being of people experiencing homelessness. Findings highlight the need for flexible, outreach-oriented and stigma-informed approaches to podiatric care. Charitable models offer transferable insights for statutory and community services seeking to improve equitable access to foot care for socially marginalised populations.
Reporting and Utilization of Patient-Reported Outcomes Measures in the Evaluation of Foot Orthoses Treatment: A Systematic Review.
Jiménez-Guillén J, Tovaruela-Carrión N, Moreno-Fresco MM … +2 more , Martínez-Nova A, Munuera-Martínez PV
J Foot Ankle Res · 2026 Mar · PMID 41840464 · Full text
PURPOSE: 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...
PURPOSE: 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. METHODS: 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). RESULTS: 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. CONCLUSION: 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.
Prevalence and Incidence of Diabetes-Related Peripheral Neuropathy, Peripheral Artery Disease, Foot Ulcers and Lower Extremity Amputations in Ireland; A Systematic Review.
Kavanagh S, Pallin JA, Doherty AS … +4 more , M O'Keeffe L, Gilmore S, Lazzarini PA, Buckley CM
J Foot Ankle Res · 2026 Mar · PMID 41840435 · Full text
INTRODUCTION: 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...
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. TRIAL REGISTRATION: PROSPERO (CRD42023472904).
Australian Podiatry Research in Paediatrics: A Bibliometric Analysis.
Banwell HA, Tehan P, Carroll M … +1 more , Williams CM
J Foot Ankle Res · 2026 Mar · PMID 41820823 · Full text
BACKGROUND: The purpose of this study was to undertake a bibliographic analysis of foot and lower leg research relating to paediatric podiatry by Australian or affiliated Australian authors. METHODS: The Scopus database...
BACKGROUND: The purpose of this study was to undertake a bibliographic analysis of foot and lower leg research relating to paediatric podiatry by Australian or affiliated Australian authors. METHODS: The Scopus database search was conducted to identify all foot and lower limb research articles involving an Australian cohort of participants, published by Australian authors, or those affiliated with Australian institutions, pertaining to paediatric podiatry, in English from 1970 to 2024. We used bibliometric analysis through an open-source tool based on the R language. We described citations, journals, authors and institutions; countries and publications were manually categorised according to research type, level of evidence and funding source. RESULTS: The search strategy yielded 280 eligible articles, which received a total of 8331 citations and were published by 793 authors in 104 journals. The most frequent journal was Gait & Posture (35 articles; 12%), and the most published institution was the University of Sydney (170 affiliations). Most of the Australian paediatric articles published focused on detection, screening and diagnosis (n = 70, 25%) and only 33 articles (12%) provided Level I evidence. Seventy-three paediatric articles (25%) received Category 1 funding; 154 articles (55%) reported no research funding. CONCLUSION: Paediatric podiatry research represents 17% of Australian foot and lower limb research. Despite the smaller population base, paediatric research attracts a high level of engagement, moderate citation rates and low funding rates when compared to adult population studies. Paediatric podiatry research is primarily produced via Level 3 evidence. This highlights the need for an increase in the robustness of research methodologies in paediatric podiatry research to strengthen the quality and applicability of evidence informing clinical care for children and adolescent populations.
Establishing Normative Values for the Supination Resistance Test: An International Cross-Sectional Study.
Moisan G, Isabelle PL, Carrión ÁG … +6 more , Chicoine D, Farahpour N, Griffiths I, Dami A, Reguera Medina JM, McBride S
J Foot Ankle Res · 2026 Mar · PMID 41772844 · Full text
BACKGROUND: The supination resistance test quantifies the force required to supinate the foot and ankle. Although it demonstrates good to excellent intra- and inter-rater reliability and shows potential for predicting fo...
BACKGROUND: The supination resistance test quantifies the force required to supinate the foot and ankle. Although it demonstrates good to excellent intra- and inter-rater reliability and shows potential for predicting foot and ankle biomechanics during walking, assessing the biomechanical effects of foot orthoses, and distinguishing between healthy and pathological conditions, the supination resistance test remains underutilised in both clinical and research settings due to the lack of normative reference values. Thus, the primary objective of this study was to establish international normative values for the supination resistance test based on age and sex. A secondary objective was to compare supination resistance across age groups and between sexes. METHODS: In this international cross-sectional study, supination resistance was measured in 1198 healthy participants aged 18 years and older from North America, the Middle East, and Europe. Supination resistance was compared across age decades and between sexes using a two-way analysis of covariance, with body mass included as a covariate. Correlation coefficients and coefficients of determination were calculated to examine the relationships between supination resistance, body mass, and the Foot Posture Index. RESULTS: Supination resistance was greater in males than in females during the 3rd to 5th and 9th decades of life. In males, it increased from the 3rd to the 5th decade and then progressively declined. In females, it increased from the 3rd to the 6th decade, remained stable through the 7th decade, and then dropped sharply. Body mass accounted for 18.1% of the variance in supination resistance, whereas the Foot Posture Index accounted for only 0.3%. CONCLUSIONS: The international clinical reference values established for the supination resistance test, stratified by age and sex, carry important clinical implications and may support clinicians in screening, monitoring, and managing foot and ankle musculoskeletal conditions. Future research should investigate whether deviations from these normative values represent a risk factor for the development of musculoskeletal injuries and explore the relationship between restoring supination resistance to normative levels and the reduction of clinical symptoms.
Exercise Therapy for Chronic Ankle Instability: Which Modality for Which Deficit? A Systematic Review and Meta-Analysis.
Xu JS, Lin HJ, Li ZK … +4 more , Wang ZL, Fan C, Chen HF, Xie D
J Foot Ankle Res · 2026 Mar · PMID 41771785 · Full text
OBJECTIVE: Chronic ankle instability (CAI) involves heterogeneous sensorimotor deficits. Evidence comparing exercise modalities for specific deficits is limited, impeding personalised rehabilitation. To determine the rel...
OBJECTIVE: Chronic ankle instability (CAI) involves heterogeneous sensorimotor deficits. Evidence comparing exercise modalities for specific deficits is limited, impeding personalised rehabilitation. To determine the relative efficacy of exercise interventions and create an evidence-based framework for deficit-specific prescription in CAI. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Searches of 9 electronic databases from inception to 1 September 2025. STUDY SELECTION: Randomised controlled trials comparing exercise interventions against no intervention for sensorimotor outcomes in CAI individuals. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently conducted the screening, and will independently extract the data into an Excel spreadsheet. Methodological quality was assessed using PEDro criteria, and bias analysis was conducted using the Cochrane Risk of Bias tool 2. Sensitivity analysis and I statistics evaluated heterogeneity. Meta-analysis summarised standard mean difference for sensorimotor indicators. RESULTS: Fifty-eight studies (n = 2097) were included. Of the included studies, 28 were rated as low risk of bias, 19 as unclear risk and 11 as high risk. Balance training provided comprehensive benefits, improving patient-reported function, dynamic balance, joint position sense, concentric strength and functional performance. Strength training enhanced patient-reported function, dynamic balance and concentric strength. 3D, stroboscopic and neuromuscular training improved patient-reported function and dynamic balance; stroboscopic training also benefited joint position sense. Vibration training improved only dynamic balance. No interventions significantly improved force sense or eccentric strength. CONCLUSION: Exercise modalities have distinct efficacy profiles in CAI. Balance training is foundational, but therapy can be personalised by framework optimises management. TRIAL REGISTRATION: This systematic review was registered in the PROSPERO database (CRD42024606683).
Safeguarding Data Integrity in Online Podiatry Research: Understanding and Managing Non-Genuine Participation.
Gurr W, McDougall M, O'Brien A … +1 more , Carter K
J Foot Ankle Res · 2026 Mar · PMID 41762668 · Full text
Online research methods have become increasingly common in podiatry, offering efficient, low cost and convenient data collection. Emerging evidence from online studies suggests that the integrity of online research is be...
Online research methods have become increasingly common in podiatry, offering efficient, low cost and convenient data collection. Emerging evidence from online studies suggests that the integrity of online research is being compromised by participants who are not genuine: for example, they may not have the relevant health condition they are claiming to have or they may not be taking the trial medication as instructed. In health research, the consequences of non-genuine participants are significant, including unreliable data, wasted time and funding, researcher distress, loss of participant trust and, in some cases, cancelled projects. Growing awareness of fraudulent participation and reports of these challenges highlights the need for structured approaches designed to safeguard data integrity and the trustworthiness of results. In the United Kingdom, the University of Nottingham has recently published practical guidance for researchers and ethics committees on handling potential non-genuine participants. The aim of this commentary is to raise awareness of the risks posed by non-genuine participation in online research and to provide a summary of the recently published practical strategies for researchers to safeguard the integrity of their data.
Plantar Fasciitis Research: A Bibliometric Analysis From 2010-2024.
Xu B, Zhang G, Zhang Z … +1 more , Zhang L
J Foot Ankle Res · 2026 Mar · PMID 41758013 · Full text
OBJECTIVE: Plantar fasciitis is a common degenerative foot disease that significantly impairs quality of life. The disease is characterized by multifactorial pathogenesis, diverse intervention strategies, and heterogeneo...
OBJECTIVE: Plantar fasciitis is a common degenerative foot disease that significantly impairs quality of life. The disease is characterized by multifactorial pathogenesis, diverse intervention strategies, and heterogeneous therapeutic effects. Despite extensive research findings, the fragmented nature of these results hinders a comprehensive understanding of the field. METHODS: This study employed a bibliometric approach to analyze the literature data obtained from the Web of Science database over the past 15 years. The aim was to explore the knowledge structure, research trends, and collaborative features of this field from a quantitative perspective using bibliometric analysis. RESULTS: The study revealed a fluctuating trend in publications within the field, with the United States, Harvard Medical School, and Karl B. Landorf leading the research output and collaboration. Foot and Ankle International emerged as the most prolific and frequently cited journal in this domain. The research hotspots in this field primarily focus on "plantar fasciitis," "heel pain," and "extracorporeal shock wave therapy." Meanwhile, "shear wave elastography," "plantar fascia thickness," "systematic review," and "musculoskeletal disease" represent the research trends in this field. In addition, this study identifies the literature that has had a significant impact on the field. CONCLUSION: By organizing the entire research field of plantar fasciitis, this study provides decision support for future clinical practice and scientific research.
Exploring the Learning Experiences of Non-Medical Prescribing Among Podiatry Students on Clinical Placement.
Haines S, Khan HM, Pano ST … +3 more , Otter S, Holmes K, Carter K
J Foot Ankle Res · 2026 Mar · PMID 41741385 · Full text
BACKGROUND: Endorsement for scheduled medicines has been available to Australian podiatrists for over a decade. However, uptake and prescribing rates remain low. A key barrier is the limited number of endorsed prescriber...
BACKGROUND: Endorsement for scheduled medicines has been available to Australian podiatrists for over a decade. However, uptake and prescribing rates remain low. A key barrier is the limited number of endorsed prescribers, which restricts access to mentorship opportunities for podiatrists seeking endorsement. While existing literature explores practicing podiatrists' perspectives on endorsement, the views of students regarding prescribing remain underrepresented. This study aimed to explore final-year podiatry students' experiences with non-medical prescribing during clinical placements. METHODS: This qualitative study purposively recruited final-year podiatry students from the University of Western Australia. Semi-structured interviews were undertaken to explore participants' experiences of non-medical prescribing during clinical placements, which were audio-recorded, transcribed verbatim and analysed using constant comparative analysis until data saturation was reached. Data recorded prior to interview included demographic information, academic characteristics were determined using self-reported questionnaires to describe motivation, self-efficacy and mental wellbeing and clinical logbook records were retrospectively reviewed for data on prescribing encounters recorded by students during clinical placements. RESULTS: Fifteen participants aged between 23 and 46 years were recruited. Retrospective clinical logs showed that 631 of 7613 cases (8.3%) involved prescription of a scheduled medicine, with most prescribing opportunities occurring in public health settings. Six global themes relating to prescribing experiences emerged: limited exposure, confidence, learning experiences, proposed improvements, pursuit of endorsement and future career impacts. Relationships between themes were developed based on key concepts, particularly scarcity of endorsed prescribers, and limited amount and variety of prescribing encounters. CONCLUSION: This study demonstrated that although podiatry students experienced limited exposure to endorsed prescribing and low self-confidence in prescribing ability, they continued to see value in non-medical prescribing with a willingness to pursue endorsement in the future. Future implications to address limited student exposure to prescribing due to shortage of endorsed podiatrists may facilitate the uptake of endorsement for scheduled medicines.
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