Journal Of Foot And Ankle Research[JOURNAL]
Sun
200 papers
Does Hallux Valgus Impair Medial Forefoot Loading? A Meta-Analysis of Plantar Pressure Distribution.
Wong DW, Chow EM, Liyeung LL … +5 more , Wang J, Mak TC, Cheung JC, Ni M, Leung AK
J Foot Ankle Res · 2025 Sep · PMID 40790291 · Full text
BACKGROUND: Hallux valgus is a common foot deformity that may alter plantar pressure distribution. This study aimed to determine whether hallux valgus consistently reduces medial forefoot (hallux and medial metatarsal) l...
BACKGROUND: Hallux valgus is a common foot deformity that may alter plantar pressure distribution. This study aimed to determine whether hallux valgus consistently reduces medial forefoot (hallux and medial metatarsal) load and impulse through a meta-analysis of plantar pressure data and increases central metatarsal loading. METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Web of Science, Scopus, CINAHL, and Embase were searched for studies comparing plantar pressure distribution between hallux valgus and non-hallux valgus feet. Random-effects meta-analyses were performed using standardized mean differences (SMD) for load (force and pressure) and impulse (force and pressure-time integrals) measures in hallux, medial metatarsal, and central metatarsal regions. Risk of bias was assessed using the JBI critical appraisal checklist for analytical cross-sectional studies. RESULTS: Twenty-one studies (3911 participants and 6407 feet) were included. In-shoe measurements showed significant reductions in hallux loading (force SMD: -0.78 [95% CI: -1.08, -0.49]; force-time integral SMD: -0.39 [-0.71, -0.07]). Platform-based measurements yielded inconsistent results. No conclusive evidence was found for reduced medial metatarsal loading or increased central metatarsal loading. Measurement modality significantly influenced results, with platform-based systems generally showing higher heterogeneity than in-shoe sensors. Nine (43%) and 12 studies (57%) had a high risk of bias on statistical analysis and confounder management, respectively. CONCLUSIONS: Hallux valgus is associated with reduced hallux loading in in-shoe measurements, but evidence for load redistribution to other forefoot regions is inconclusive. The choice of measurement modality significantly impacts results, highlighting the need for standardized assessment protocols in hallux valgus research. TRIAL REGISTRATION: This study was registered in PROSPERO with the reference number CRD42024574195.
Diabetes Foot Ulcer Prevention: A Review of Footwear Width Assessment for At-Risk Feet.
Jones PJ, Rowlands AV, Davies MJ … +1 more , Bus SA
J Foot Ankle Res · 2025 Sep · PMID 40754461 · Full text
BACKGROUND: Diabetes-related foot ulceration (DFU) is often related to footwear fit. People with diabetes often have wider feet than in those without diabetes. Standards for evaluating footwear width in those at risk are...
BACKGROUND: Diabetes-related foot ulceration (DFU) is often related to footwear fit. People with diabetes often have wider feet than in those without diabetes. Standards for evaluating footwear width in those at risk are therefore important. METHODS: We performed a systematic search with a narrative review to assess consensus in quantitative methods used to assess footwear width for people at risk of DFU within research studies, and how often footwear is considered too narrow or wide. Search terms included diabet*, footwear, fit, size and width. This returned 1397 results, with 16 studies included after full paper review. RESULTS: Three standards emerged, defining incorrectly fitting footwear as (1) one shoe size or (2) one width fitting larger or smaller than feet (4-7 mm) or (3) measured shoe width not equal to foot width. Footwear that was too narrow by one shoe size or width fitting was common (31.0%-78.0%) but too wide was rare (2 studies: 1.0% too wide where 100% had DM or 64.6% where 9% had DM). DFU was more likely in older people who wore either incorrect size or inappropriate footwear (n = 219, 100.0% DM, OR 1.7, p = 0.001) or incorrect length or width footwear (n = 440, 58.4% DM, OR 5.1, p = 0.02), but not in those with incorrect shoe width (n = 65, 9.0% DM, OR 0.75, p = 1.0). CONCLUSIONS: It is unclear how much space the at-risk forefoot requires. Standardised methods are needed to establish the accuracy and reliability of foot and footwear measuring tools, and to evaluate footwear fit, given their relationship with the clinical outcome.
Podiatrists' Reflections on Content and Delivery of Their Pre-Registration Podiatry Programme at a Regional University in New South Wales, Australia: A Survey of Graduates.
Chua WTH, Fellas A, Coda A … +1 more , Hawke F
J Foot Ankle Res · 2025 Sep · PMID 40751492 · Full text
INTRODUCTION: Understanding podiatrists' perceptions of their undergraduate education is important to ensure that educational content and delivery meets the needs of the current workforce to inform future planning. This...
INTRODUCTION: Understanding podiatrists' perceptions of their undergraduate education is important to ensure that educational content and delivery meets the needs of the current workforce to inform future planning. This study aims to explore podiatrists' perceptions of their undergraduate podiatry training at the University of Newcastle, Australia, and their preferences regarding educational content and delivery. METHODS: We conducted an online survey of podiatry graduates from the University of Newcastle, Australia. Data were analysed using descriptive statistics and Fisher's exact test to compare responses between groups. Qualitative responses were analysed using inductive content analysis. RESULTS: A total of 114 podiatrists responded. Nail avulsions, business management and modifying orthoses were perceived as being given insufficient time and focus in undergraduate training, with a higher proportion of private (71%) compared to public (33%) podiatrists reporting business management as lacking (p = 0.02). There was strong support for embedding endorsed scheduled medicines training within the programme (80%) and for delivering theoretical content face-to-face rather than online. Inductive content analysis revealed four areas to be emphasised in future curricula: modern technologies, biomechanics, wound care and routine podiatric care. Potential strategies to reduce examination stress included mock assessments, changed assessment weighting, reduced exam structure rigidity and reducing assessor bias. CONCLUSIONS: This study provides insights into Australian podiatrists' preferences for pre-registration curricula. Topics to emphasise in future curricula at the University of Newcastle, Australia, include greater manual skills and business training, modern technologies, biomechanics and routine podiatric care. Our results suggest exercising caution when substituting face-to-face with online learning. These findings provide valuable guidance for future curricula in a context of declining student numbers and increasing healthcare demands.
Identifying the Most Sensitive COP Variable in Static Balance: The Impact of Chronic Ankle Instability on Postural Stability.
Majlesi M
J Foot Ankle Res · 2025 Sep · PMID 40750356 · Full text
BACKGROUND: Chronic ankle instability (CAI) is associated with deficits in postural control, commonly evaluated using center of pressure (COP) variables. Identifying the most sensitive COP measures for detecting balance...
BACKGROUND: Chronic ankle instability (CAI) is associated with deficits in postural control, commonly evaluated using center of pressure (COP) variables. Identifying the most sensitive COP measures for detecting balance impairments in individuals with CAI is essential for enhancing assessment and rehabilitation strategies. This study aimed to determine the most sensitive COP variables for evaluating postural stability in individuals with CAI compared to healthy controls. METHODS: Forty participants (20 with CAI, 20 healthy controls) performed single-leg stance tasks on a force plate. COP variables-including average displacement, standard deviation, root mean square (RMS), range, slope, acceleration, velocity, and integral-were analyzed in anteroposterior (AP) and mediolateral (ML) directions. Repeated measures ANOVA was used for statistical comparisons. RESULTS: For the injured limb, ML RMS was significantly higher in the CAI group (p = 0.049), whereas AP variables showed no significant differences. In the noninjured limb, ML velocity was higher in controls (p = 0.049), whereas the integral value was greater in the CAI group (p = 0.042). Significant foot*direction interactions were observed for acceleration, velocity (p < 0.001), and integral (p = 0.045). CONCLUSIONS: ML RMS and integral were the most sensitive COP variables for detecting postural stability deficits in CAI individuals. These findings underscore the importance of ML-specific balance assessments and targeted rehabilitation strategies to enhance postural control in this population.
Anthropometric Foot Variations in Children: A Cross-Sectional Study Supporting Sex-Based Last Design.
Domínguez MP, Blanco SG, Paralera-Morales C … +3 more , Martínez AR, Quintana-Montesdeoca MP, Báez-Suárez A
J Foot Ankle Res · 2025 Sep · PMID 40746028 · Full text
INTRODUCTION: Proper shoe fit is essential for healthy foot development in children. Despite growing interest in the ergonomics of pediatric footwear, scientific evidence on sex-based foot morphology remains limited. Cur...
INTRODUCTION: Proper shoe fit is essential for healthy foot development in children. Despite growing interest in the ergonomics of pediatric footwear, scientific evidence on sex-based foot morphology remains limited. Current unisex shoe lasts may not adequately accommodate anatomical differences between boys and girls, particularly from mid-childhood onward. METHODS: A cross-sectional, observational study was conducted involving 1214 school-aged children (680 boys and 534 girls) between the ages of 1 and 16. Three-dimensional (3D) foot scans were used to obtain detailed anthropometric data, including toe length, ball area, ball perimeter, and metatarsal dimensions. Sex differences were assessed using independent-samples t-tests, and statistical significance was set at p < 0.05. RESULTS: Significant sex-based differences were found across several key foot dimensions. Boys exhibited larger ball area (mean right foot: 1021.35 vs. 865.85 mm in girls, p < 0.001), greater ball perimeter (207.54 vs. 192.39 mm, p < 0.001), and wider and higher metatarsal regions. These differences persisted even when toe length was held constant, suggesting divergent growth patterns in foot morphology. The findings indicate that a single unisex last may not be appropriate for children, especially from shoe size 32 onwards. CONCLUSIONS: This study provides robust anthropometric evidence supporting the need for sex-specific shoe last design in pediatric populations. Incorporating such data into footwear manufacturing could enhance ergonomic fit, improve comfort, and promote healthy motor development in children. Further longitudinal and multicenter research is needed to establish global standards for pediatric footwear. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05386992.
Foot Measurements From Three-Dimensional Scans: Elinvision 3DST Reliability.
Jones PJ, Rowlands AV, Davies MJ … +3 more , Webb D, Gillies CL, Shah A
J Foot Ankle Res · 2025 Sep · PMID 40737191 · Full text
BACKGROUND: 3D foot scanners such as the Elinvision 3DST foot scanner potentially offer a faster, alternative method to traditional plaster casting to produce orthotics or therapeutic footwear. OBJECTIVE(S): To assess th...
BACKGROUND: 3D foot scanners such as the Elinvision 3DST foot scanner potentially offer a faster, alternative method to traditional plaster casting to produce orthotics or therapeutic footwear. OBJECTIVE(S): To assess the reliability of 3DST-derived foot length, orthogonal ball width, heel width and ball girth. We also compared 3D scanner and manually derived measures. STUDY DESIGN: Repeated measures design. METHODS: Two independent raters carried out three scans each of the right foot of 20 healthy participants (10 female) aged 18 years or over (mean age 38 ± 11.4 years) using the 3DST scanner (software v1.6.21.833). Manual foot measurements were taken by an experienced rater using Ritz stick and tape measure. RESULTS: Intraclass correlation coefficients were excellent for both inter-rater reliability (0.99-1.00, 95% confidence interval (CI) 0.97-1.00) and intra-rater reliability (Rater 1: 0.98-1.00, 95% CI 0.96-1.00; Rater 2: 0.97-1.00, 95% CI 0.94-1.00). Standard error of the mean ranged from 0.1 to 0.4 cm both for scanner and manual measurements. The mean absolute differences between the scanner and manual measurements were ≤ 0.4 cm for foot length, orthogonal ball width (0.2-0.3 cm), ball girth and heel width (0.3-0.4 cm) but larger for foot waist, short heel, ankle circumference and anatomical ball width (0.5-1.1 cm). CONCLUSIONS: The 3DST scanner has potential application for capture of basic foot dimensions in footwear fit research. However, larger differences relative to manual measures for other dimensions limits its potential in orthotics or therapeutic footwear production.
Associations Between Diabetic Foot Deformity and the Intrinsic Foot Muscles: A Systematic Review.
Hanna T, Latey P, Ekanayake K … +3 more , Ribarovski L, McDonald R, Clarke J
J Foot Ankle Res · 2025 Sep · PMID 40726028 · Full text
BACKGROUND: Diabetic foot deformities such as claw toes are debilitating complications. It has been generally accepted that this results from atrophy of the intrinsic foot muscles (IFMs), despite this relationship being...
BACKGROUND: Diabetic foot deformities such as claw toes are debilitating complications. It has been generally accepted that this results from atrophy of the intrinsic foot muscles (IFMs), despite this relationship being underexplored. However, recent diagnostic imaging studies are finding some associations between diabetic intrinsic foot muscles and foot deformity. This new information requires a thorough review of the evidence. OBJECTIVES: Our aim is to systematically review the current literature to investigate any associations between diabetic foot deformity and intrinsic foot muscle changes and review their significance. METHODS: Electronic databases Medline, Embase, Scopus, CINAHL, and Web of Science were searched on 6 May 2020 for all years until 2020. The search was re-run on 26 June 2023 with dates ranging from 2020-2023. Human data studies on adults in English, investigating diabetes, foot deformities and intrinsic foot muscles were included for review. PROSPERO registration was approved on 24 July 2020. RESULTS: Eleven papers out of 1779 met the inclusion criteria. For the updated search, two papers out of the 226 met inclusion criteria. All were assessed for quality using the STROBE criteria and the Newcastle and Ottawa Scale. Six reported various correlations between intrinsic foot muscles and claw/hammer toe deformity measurements. Three papers reported limited or no associations. Three papers investigated medial column deformity (MCD); two found a significant correlation to intrinsic foot muscle atrophy. CONCLUSION: Overall, there is a weak association between diabetic foot deformity and intrinsic foot muscle atrophy and intermuscular adipose tissue infiltration.
Optimal Time Period to Achieve Temperature Stabilisation After Total Contact Cast (TCC) Removal for Assessing Dermal Temperatures in Active Charcot Neuro-Osteoarthropathy.
Bradley J, Rumble M, Wong J … +2 more , Yii M, Kaminski MR
J Foot Ankle Res · 2025 Sep · PMID 40714918 · Full text
BACKGROUND: Dermal temperature differentials between limbs are used to monitor disease progression and support safe withdrawal of immobilisation in Charcot neuro-osteoarthropathy (CNO). Despite the wide clinical use of d...
BACKGROUND: Dermal temperature differentials between limbs are used to monitor disease progression and support safe withdrawal of immobilisation in Charcot neuro-osteoarthropathy (CNO). Despite the wide clinical use of dermal thermometry, there is a lack of evidence on the optimal temperature stabilisation period after removal of immobilisation devices, such as total contact casts (TCCs). This study aimed to investigate the optimal time period to achieve temperature stabilisation post removal of TCC for assessing dermal temperatures in active CNO. METHODS: Over a 2-year period, this within-subjects repeated measures study recruited 12 adults with active CNO treated with TCC from a metropolitan high-risk foot service in Melbourne, Australia. Participants were excluded if they had bilateral CNO, an active foot ulcer, an inflammatory foot condition (e.g., gout), peripheral artery disease or major lower limb amputation. In a temperature-controlled room, dermal temperatures were recorded using an infrared thermometer after removal of TCC and contralateral footwear. Temperatures were recorded at 10-min intervals from baseline to 90 min at 10 anatomical locations on each foot. Paired samples t-tests or Wilcoxon signed-rank tests explored temperature stabilisation at each anatomical site across the 10 time points. RESULTS: Mean age was 55.1 (SD, 8.9) years, 75.0% were male and 83.3% had type 2 diabetes. All participants had peripheral neuropathy and a large proportion had history of foot ulceration (75.0%). The average duration of CNO was 2.9 (SD, 1.7) months, with most classified as stage 1 (91.7%), affecting the tarsometatarsal joints (58.3%) and midtarsal joints (83.3%). Overall, dermal temperatures had stabilised by 40 min for the Charcot (casted) foot and contralateral (non-casted) foot. CONCLUSIONS: This is the first study to explore the optimal time period to achieve temperature stabilisation when assessing dermal temperatures in active CNO. Forty minutes appears to be an appropriate resting time to reach thermal equilibrium. Although this approach may improve the accuracy of dermal thermometry, the time period may not always be feasible in clinical practice.
Bibliometric Analysis: Insights Into the Podiatric Medicine Landscape of Diabetic Sensory Peripheral Neuropathy and Genomics.
Jones BM, Pengelly RJ, Borthwick AM … +1 more , Bowen CJ
J Foot Ankle Res · 2025 Sep · PMID 40708097 · Full text
BACKGROUND AND AIMS: Research into diabetic foot complications is extensive; it remains challenging to identify critical literature. Evolving interprofessional boundaries, alongside advances in molecular medicine and pat...
BACKGROUND AND AIMS: Research into diabetic foot complications is extensive; it remains challenging to identify critical literature. Evolving interprofessional boundaries, alongside advances in molecular medicine and pathophysiological understanding, necessitates mapping of the scientific literature (corpus). Impact of these advances on podiatric medicine remains unclear. This study explores topics, research performance, and evolution across the literature and disciplines to understand the corpus in its current state. METHOD: A retrospective-observational bibliometric analysis examined Web of Science publications using PRISMA search strategy (August 2023) to understand interconnectedness, direction, and intersectionality of subject disciplines, growth areas, and output. Curated phrases and disease focussed classification anchored investigation to diabetic peripheral neuropathy. Qualitative and quantitative approaches analysed publication meta-data (authors, citations, keywords) to map key concepts and scientific developments. RESULTS: Analysis of 589 records (1991-2023) revealed observational studies as the dominant design. Prominent concepts included risk, polyneuropathy, and prevalence, with authors favouring accessible terms (peripheral neuropathy) across specialisms. Leading research hubs were in England, Demark, USA, Qatar, Germany, and Italy. Diabetic Medicine and Diabetes Care remained the highest-cited journals, whilst the International Journal of Molecular Science, Cell Stem Cell, and Nature Reviews Neurology provided contemporary insights. Post-2016, methodological rigour and objectivity increased. DISCUSSION: Recurring topics included enhancing pre-clinical screening, addressing earlier diagnosis, pain management stratification with medicines optimisation, and reproducibility challenges. Case-controls increasingly replaced larger prospective, longitudinal study designs to improve diagnostic test accuracy and detection of diabetic neuropathy, particularly for neuropathic pain affecting small nerve fibres. Molecular approaches gained prominence signalling a shift from purely clinically derived approaches. The corpus responded to subjectivity and variable diagnostic criteria by prioritising objectivity. Emerging insights into channelopathies and mitochondrial dysfunction may augment current assessment/screening approaches to refine risk stratification and management strategies.
Student Perspectives on Marketing the Podiatry Profession and Course Promotion: A Mixed Methods Study.
Kaminski MR, Robinson C, Whittaker GA … +12 more , Ho M, Bonanno DR, Munteanu SE, Dollinger M, Kazantzis S, Li X, Causby RS, Frecklington M, Walmsley S, Chuter V, Casey SL, Cotchett M
J Foot Ankle Res · 2025 Sep · PMID 40691626 · Full text
BACKGROUND: The decline in podiatry student enrolments at universities across Australia and New Zealand presents a workforce crisis that threatens the profession's sustainability and the delivery of essential healthcare...
BACKGROUND: The decline in podiatry student enrolments at universities across Australia and New Zealand presents a workforce crisis that threatens the profession's sustainability and the delivery of essential healthcare services to communities. Recent data highlight a limited understanding of the podiatry profession among allied health students. There is now a clear need for strategies to address negative stereotypes and to build knowledge of the profession's scope of practice, career opportunities, job prospects and earning potential. As part of a larger research initiative, this study explored student perspectives on marketing the podiatry profession to increase student enrolments. METHODS: A convergent mixed methods study design was employed. Participants included students enrolled in (i) podiatry and (ii) relevant 'non-podiatry' health, sport or science programs at nine Australian universities and one New Zealand university. Data were collected via an online survey (278 podiatry students and 553 non-podiatry students responding) and two online workshops with nine first-year podiatry students. Quantitative data were analysed using descriptive statistics and regression models, while qualitative data underwent inductive thematic analysis by three independent assessors. We integrated the data by exploring the connections between the quantitative and qualitative findings. RESULTS: Findings revealed that over 40% of podiatry students had initial concerns about their course and 34.2% had considered leaving. Instagram and Facebook were identified as the most influential social media platforms for sourcing information about courses and careers. Four over-arching themes emerged as important marketing strategies for increasing student enrolments: (i) enhance the visibility, perception and advocacy of podiatry; (ii) emphasise holistic and diverse practice in podiatry; (iii) enable early exposure and experience of podiatry practice and (iv) improve course entry pathways and flexibility. CONCLUSIONS: An evidence-based approach is required to enhance the visibility and appeal of podiatry as a career. Strategies should focus on addressing misconceptions about the discipline, expanding promotional efforts to broader audiences, leveraging relevant media platforms, reducing financial and academic barriers for prospective students, and improving study flexibility. Strengthening enrolments and reducing attrition are fundamental to ensuring the sustainability and growth of the podiatry profession in Australia and New Zealand.
One-Year Trajectory of Pain, Function, and Health-Related Quality of Life in Patients With Plantar Fasciopathy.
Røe C, Heide M, Søberg HL … +5 more , Brunborg C, Hoksrud AF, Myhre K, Brox JI, Mørk M
J Foot Ankle Res · 2025 Sep · PMID 40671207 · Full text
INTRODUCTION: Plantar fasciopathy is the most common painful condition in the foot and may imply long-term pain and functional limitations. The purpose of this study was to assess the time pattern of recovery in pain, fu...
INTRODUCTION: Plantar fasciopathy is the most common painful condition in the foot and may imply long-term pain and functional limitations. The purpose of this study was to assess the time pattern of recovery in pain, function, and health-related quality of life over 12 months in patients with plantar fasciopathy and assess whether demographic or clinical characteristics could influence these trajectories. METHODS: 200 participants referred to specialized care, diagnosed with plantar fasciopathy, and randomly assigned to advice plus customized orthosis or advice plus customized orthosis in combination with radial ESWT, sham-rESWT, or high-load exercises were included. Linear mixed model analysis based on demographic information, clinical characteristics, heel pain during activity and at rest the last week, and functioning and health-related quality at baseline and after 3, 6, and 12 months were conducted. RESULTS: Pain, function, and health-related quality of life improved gradually from baseline to 12 months follow-up with largest improvement within the first 3 months. Bilateral pain was associated with differential trajectories of pain at rest and foot function over time, and a lack of improvement from 6 to 12 months follow-up. CONCLUSIONS: Different recovery trajectories are important to consider when determining timepoints for follow-up in scientific studies as well as to individualize the clinical follow-up. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03472989.
Development of the CHILD-SHOE Reporting Checklist: A Scoping Review and Modified Delphi Study to Support Reporting in Children's Footwear Research.
Williams CM, Farlie M, Kolic J … +25 more , Morrison SC, Paterson K, Hill M, Bonacci J, Breet MC, Cranage S, Caswell SV, Hannigan JJ, Herbaut A, Hollander K, Ibikunle PO, Kennedy RA, Kong PW, Maharaj JN, Mazzella N, Munteanu SE, Okai-Nóbrega LA, Gijon-Nogueron G, Plesek J, Saeedi H, Tong JWK, Tora A, Venter R, Yurt Y, Banwell H
J Foot Ankle Res · 2025 Sep · PMID 40635302 · Full text
BACKGROUND: Inconsistent reporting of interventions and outcomes is a key barrier to research translation. Children's footwear research is often inconsistently reported as there are no standards or recommendations on wha...
BACKGROUND: Inconsistent reporting of interventions and outcomes is a key barrier to research translation. Children's footwear research is often inconsistently reported as there are no standards or recommendations on what to report or consensus on which outcomes are important. The primary aim of this research was to develop expert consensus in children's footwear features and descriptions for research reporting. The secondary aim focused on consensus building of outcome measures relating to footwear in research in children. The outcome of this study was to develop a reporting checklist and guidance for researchers who are conducting children's footwear studies. METHODS: This was a three-round modified Delphi survey informed by a scoping review. We searched four databases to enable data extraction from 109 records related to children's footwear research. These data established the basis for Round 1. Authors were identified through the scoping review and invited to participate. In Round 1, participants rated the appropriateness of domains relating to reporting footwear descriptions and features and outcomes. Outcome measures were organised against a childhood adaptation of the International Classification of Functioning, Disability and Health (ICF)-F-words in childhood disability domains. Consensus and agreement levels were set at 70%. Where 50%-69% of participants agreed, the item was returned for rating in Rounds 2 and 3. RESULTS: There were 33 participants who responded to Round 1 and 29 (88%) in both subsequent rounds. Participants agreed on 20 statements that researchers should use to describe children's footwear and their features. All ICF domains met consensus for outcome collection. There were 17 outcome measures that participants agreed should be used in the future when a researcher's aim aligns with specific domains. Where no specific outcome measures reached consensus or agreement within a domain, a statement was developed to guide researcher choice in the subsequently developed checklist. CONCLUSION: Participants reached consensus on the essential footwear characteristics and descriptions that should be consistently reported in children's footwear research. This enabled us to produce a list of preferred outcome measures. Using this checklist can support future research through collection and reporting of comparable data.
Static Plantar Pressure Distribution Measured Using PodoPrint Aluminum Platform in Multiple Sclerosis Patients: A Case-Control Study.
Ruiz-Sánchez FJ, Martins MDR, Losa-Iglesias ME … +5 more , Becerro-de-Bengoa-Vallejo R, Gómez-Salgado J, Saavedra-García MÁ, López-López D, Jiménez-Cebrián AM
J Foot Ankle Res · 2025 Sep · PMID 40598846 · Full text
INTRODUCTION: Multiple sclerosis (MS) is a complex early-onset neurological disorder with significant functional implications. Neuroinflammation and neurodegeneration are the primary pathological processes underlying MS,...
INTRODUCTION: Multiple sclerosis (MS) is a complex early-onset neurological disorder with significant functional implications. Neuroinflammation and neurodegeneration are the primary pathological processes underlying MS, both of which may alter lower limb loading patterns. These alterations can be evaluated through static plantar pressure distribution. This study hypothesized that patients with MS would exhibit higher static plantar pressures compared to healthy controls. METHODS: A multicenter case-control study was conducted with 88 participants, comprising 44 patients diagnosed with MS and 44 age- and sex-matched healthy controls. Static plantar pressures were assessed using the PodoPrint Aluminum pressure platform. RESULTS: The MS group demonstrated significantly lower maximum peak pressure values in both the right foot (p < 0.007) and the left foot (p < 0.001) compared to the control group. CONCLUSION: A marked reduction in maximum peak pressures and weight-bearing capacity was observed in patients with MS may have reduced plantar pressure, which could be indicative of altered gait patterns and balance issues.
Examining Foot Shape Variations in Individuals With and Without Diabetes.
Hemler SL, Schuster RW, Behling AV … +2 more , Pataky Z, Kelly LA
J Foot Ankle Res · 2025 Sep · PMID 40581874 · Full text
For people with diabetes, a good-fitting shoe is essential for reducing the risk of ulcers and eventual amputation. However, there is a lack of 3D data explaining differences in foot shape between people with and without...
For people with diabetes, a good-fitting shoe is essential for reducing the risk of ulcers and eventual amputation. However, there is a lack of 3D data explaining differences in foot shape between people with and without diabetes and how individual factors might influence these differences; these data are vital for adequate shoe design and prevention of diabetic foot ulcers. This study quantifies the differences in external foot shapes of people with and without diabetes and peripheral neuropathy and examines which factors might affect these variations. One-hundred thirty-six foot scans of older adults with and without diabetes and peripheral neuropathy were used to create and assess foot shape models against demographic and health factors. Principal component analysis (PCA) showed that the feet of people with diabetes and with neuropathy are not necessarily clustered into a particular foot shape but have more pronounced features in specific foot variations (e.g., ankle width, arch height, hallux abduction, and edema vs. atrophic feet) compared to people without diabetes and neuropathy. The mean pairwise distance (intrascore spread) in PC1 and PC2 for individuals with diabetes and neuropathy was 43% larger than for those without diabetes and neuropathy and 24% larger than for those with neuropathy but no diabetes. Partial least squares regression (PLSR) showed potential predicting the presence of diabetes and neuropathy; however, additional data are required to support the trend. Analyses, such as PCA and PLSR, could be useful for determining how to quantify these changes to design more appropriate footwear for these populations.
Follow-Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long-Term Outcomes: A Retrospective Cohort Study.
Schoug J, Katzman P, Uddman E … +1 more , Löndahl M
J Foot Ankle Res · 2025 Jun · PMID 40543056 · Full text
AIMS/HYPOTHESIS: Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow-up MRI examinations are often used to determine the optimal duration of tot...
AIMS/HYPOTHESIS: Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow-up MRI examinations are often used to determine the optimal duration of total contact cast (TCC) offloading treatment. This study investigated the use of follow-up MRI during CF treatment and its relationship to offloading duration and risk of future surgery. METHODS: People with diabetes mellitus and MRI-confirmed CF treated at Skåne University Hospital (Lund and Malmö, Sweden) between 2006 and 2022 were studied retrospectively. Individuals monitored with follow-up MRI examinations were compared with those who only underwent diagnostic MRI. A regression model was applied to evaluate factors predicting TCC and total CF treatment duration. RESULTS: One-hundred and twenty-two individuals (45 [37%] DM1; 47 [39%] women; median age 60 [IQR 53-68] years) with a total of 143 CF events were included. 76 (53%) of these CF events were monitored using a total of 141 follow-up MRI examinations. Individuals monitored with MRI had significantly longer TCC and total CF treatment durations (p < 0.001). Individual characteristics (with the exception of sex), rate of stage 1 CF, and risk of future surgery did not differ between the two groups and only use of follow-up MRI (p < 0.001) remained a significant predictor of both longer TCC and total CF treatment durations in a regression model. CONCLUSIONS/INTERPRETATION: In this retrospective cohort study, use of follow-up MRI was associated with longer TCC and total treatment times despite similar characteristics and outcomes. Prospective studies are needed to further elucidate the optimal use of MRI in monitoring CF.
Harnessing 3D Scanning and Printing Technology to Improve Students' Proficiency in Assessing Foot Posture.
Bonanno DR, Hurn SE, Banwell HA … +2 more , Alizzi D, Menz HB
J Foot Ankle Res · 2025 Jun · PMID 40538252 · Full text
INTRODUCTION: The Foot Posture Index (FPI-6), widely used to quantify foot posture, is a core component of musculoskeletal curricula in undergraduate podiatry programs. Teaching the FPI-6 can be challenging but 3D foot m...
INTRODUCTION: The Foot Posture Index (FPI-6), widely used to quantify foot posture, is a core component of musculoskeletal curricula in undergraduate podiatry programs. Teaching the FPI-6 can be challenging but 3D foot models provide a controlled risk-free way to practice, potentially reducing anxiety and increasing confidence. This study examined the effects of 3D foot models on podiatry students' confidence and anxiety when performing the FPI-6 and compared their scores to experts. METHODS: Fifty podiatry students from three Australian universities used the FPI-6 to score nine 3D printed foot models ranging from -11 (highly supinated) to +12 (highly pronated). Students' self-confidence and anxiety were measured before and after exposure to the 3D foot models using a 10-item self-confidence questionnaire and the 27-item Competitive State Anxiety Inventory-2 (CSAI-2). Changes in self-confidence were analysed with paired t-tests, whereas median differences in CSAI-2 scores pre- and post-intervention were assessed using the Wilcoxon signed-rank test. Students' foot posture scores were compared to consensus scores from an expert panel (n = 4) with variability in agreement explored using the Bland-Altman limits of agreement (LoA) analysis. RESULTS: Student confidence improved across all 10 questionnaire items after the FPI-6 simulation with 3D foot models (p ≤ 0.015) with a mean increase of 8.6% across all items (range, 1.9%-11.6%) and medium to large effect sizes (Cohen's d = 0.44-0.94). On the CSAI-2, 22 of 27 items showed improvements in cognitive and somatic state anxiety or self-confidence (p ≤ 0.038), whereas five items showed no significant change. The Bland-Altman analysis revealed a small mean difference of 0.389 between student and expert consensus scores with 95% LoA ranging from -3.3 to 4.1. CONCLUSION: The use of 3D foot models for FPI-6 simulation enhances podiatry students' confidence and reduces anxiety. Student's foot posture scores had good overall agreement with expert scores, though some discrepancies remained. This highlights the value of pre-scored models for targeted practice and emphasises the importance of validation and feedback to ensure confidence aligns with accuracy. The models demonstrated high utility, harnessing 3D scanning and printing technology to enhance students' proficiency in assessing foot posture.
A Systematic Review Examining the Association of Falls With Diabetes-Related Foot Ulcers.
Wu M, Sinha M, Alahakoon C … +3 more , Barratt KS, Thanigaimani S, Golledge J
J Foot Ankle Res · 2025 Jun · PMID 40524408 · Full text
BACKGROUND: The aim of this study was to systematically review the risk of falls in people with diabetes-related foot ulcers (DFU). METHODS: A systematic search of Medline, Pubmed, Embase, Cochrane and CINAHL was underta...
BACKGROUND: The aim of this study was to systematically review the risk of falls in people with diabetes-related foot ulcers (DFU). METHODS: A systematic search of Medline, Pubmed, Embase, Cochrane and CINAHL was undertaken to identify observational studies reporting falls and containing a group of people with a DFU and a control group with diabetes but no DFU. Risk of bias was assessed by a modified Newcastle-Ottawa Scale. Meta-analysis was performed using a random effects model. RESULTS: Four studies involving 3643 participants with a DFU and 42,436 participants with diabetes but no DFU were included. A meta-analysis showed high heterogeneity between studies (I = 95%) and an increased risk of falls in people with DFU (risk ratio 2.25 and 95% CI 1.05-4.84). One study had a low risk of bias and three studies had a high risk of bias. Leave-one-out analyses showed that exclusion of the study with the largest effect on heterogeneity resulted in a risk ratio of 1.80 (95% CI 1.33-2.43 and I = 0%). CONCLUSIONS: Currently available evidence suggests people with a DFU have a higher risk of falls but most past studies have a high risk of bias. Further well-designed cohort studies are required.
Immediate Effects of Footwear Design on In-Shoe Plantar Pressures, Impact Forces and Comfort in Women With Plantar Heel Pain.
Franettovich Smith MM, van den Hoorn W, van den Hoek A … +2 more , Kerr G, Hurn SE
J Foot Ankle Res · 2025 Jun · PMID 40509892 · Full text
BACKGROUND: Footwear is often recommended in the management of plantar heel pain (PHP), theoretically to reduce tissue stress during standing and walking; however, limited data exist to guide footwear design and recommen...
BACKGROUND: Footwear is often recommended in the management of plantar heel pain (PHP), theoretically to reduce tissue stress during standing and walking; however, limited data exist to guide footwear design and recommendations. METHODS: Plantar pressures, impact forces and comfort during walking were recorded in 29 women with PHP (mean age 47 ± 12 years) in six randomised shoe and insert conditions. A test shoe (polyurethane outsole, 14-mm heel-toe pitch) was compared to a control shoe (rubber outsole, 4-mm heel-toe pitch), and within the test shoe, five different insoles that varied by material, density and arch contouring were also compared. RESULTS: The test shoe reduced heel peak pressure (15%, p < 0.01) and reduced the loading rate but not the peak magnitude of the vertical ground reaction force (average loading rate reduction: 7%, p < 0.01; maximum loading rate: 29%, p < 0.01) and was more comfortable (47%-67%, p < 0.01) compared to the control shoe. Within the test shoe, dual-density inserts with arch contouring showed lower heel peak pressure compared to a lightweight flat insert (11%-12%, p < 0.03). The insert with the firmest material and higher arch contouring showed higher midfoot peak pressure (16%-21%, p < 0.01) compared to other inserts. Forefoot peak pressure did not differ between shoe or insert conditions (p > 0.05). There were no differences in impact forces or comfort between the different inserts within the test shoe (p > 0.05). CONCLUSION: Findings suggest that shoe and insert properties are both important and provide data to guide footwear design and management recommendations for PHP.
Lower Limb Kinematics of People With Midfoot Osteoarthritis During Level Walking and Stair Climbing.
Lithgow MJ, Maharaj JN, Buldt AK … +3 more , Munteanu SE, Mentiplay BF, Menz HB
J Foot Ankle Res · 2025 Jun · PMID 40485307 · Full text
BACKGROUND: Midfoot osteoarthritis (OA) affects one in eight people over 50, yet its impact on foot and lower limb kinematics remains poorly understood. This study compared foot and lower limb kinematics during level wal...
BACKGROUND: Midfoot osteoarthritis (OA) affects one in eight people over 50, yet its impact on foot and lower limb kinematics remains poorly understood. This study compared foot and lower limb kinematics during level walking and stair climbing between people with and without symptomatic radiographic midfoot OA. METHODS: Symptomatic radiographic midfoot OA was defined as midfoot pain in the last 4 weeks and radiographic OA in one or more midfoot joints. Cases aged ≥ 45 years were matched 1:1 for sex and age (± 5 years) to controls. A 10-camera motion analysis system was used to capture foot and lower limb kinematics during level walking and stair climbing, which were analysed with a validated multi-segmental lower limb model. Group differences were analysed using independent samples t-tests and effect sizes for discrete angles, whereas statistical parametric mapping compared kinematic patterns between groups. RESULTS: We included 24 midfoot OA cases (mean age 64.4, SD 9.5) matched to 24 controls (mean age 65.2, SD 10.1). During level walking, people with midfoot OA walked slower and displayed absolute joint angles that showed less hip extension throughout stance, less knee flexion in early and late stance, less ankle dorsiflexion throughout stance (medium to large effects), greater subtalar pronation in late stance, and greater tarsometatarsal supination during early stance (medium effects). There were few differences during stair ascent and descent. CONCLUSION: People with midfoot OA walk slower and demonstrate medium to large differences in sagittal plane hip, knee, and ankle kinematics, and medium differences in subtalar and tarsometatarsal kinematics. These findings offer insights into the walking patterns of people with midfoot OA and the mechanisms that may contribute to or result from the condition. Prospective studies are needed to clarify the temporal relationship between these factors and midfoot OA development.
Outcomes of Diabetic Toe Amputation With Versus Without Metatarsal Head Resection for Single Ray Wet Gangrene: A Preliminary Study.
Yammine K, Honeine M, Mouawad J … +3 more , Orm GA, Jamaleddine Y, Assi C
J Foot Ankle Res · 2025 Jun · PMID 40390232 · Full text
BACKGROUND: Diabetic wet gangrene of the toes is a serious condition that puts at risk the limb and life of patients. Two types of amputation are used when infection is around the metatarsophalangeal joint (MTPJ): comple...
BACKGROUND: Diabetic wet gangrene of the toes is a serious condition that puts at risk the limb and life of patients. Two types of amputation are used when infection is around the metatarsophalangeal joint (MTPJ): complete toe disarticulation and toe amputation including metatarsal head resection. Because very few published papers analyzed the results of toe amputation for wet gangrene, our study aimed to evaluate the outcomes of both techniques. METHODS: This is a retrospective comparative study of highly selective patients admitted for a single toe/ray diabetic wet gangrene that were treated with toe amputation through MTPJ (TA-MTPJ) versus toe amputation with resection of the metatarsal head (TA-MHR). Three primary outcomes were set for analysis: healing rate and the frequencies of infection recurrence and additional surgeries, including reamputations. RESULTS: The sample included 31 cases: 12 cases (39%) with TA-MTPJ and 19 cases (61%) with TA-MHR. Outcomes of TA-MTPJ versus TA-MHR were as follows: (a) healing frequency 66.7% versus 58% (p = 0.6), (b) infection recurrence 50% versus 52.6% (p = 0.8), (c) osteomyelitis 41.6% versus 42.1% (p = 0.8), and (d) reamputation 33.3% versus 47.3% (p = 0.4). CONCLUSIONS: This study showed high complications after toe amputation for diabetic digital wet gangrene, with a trend for higher frequency of complications after TA-MHR compared to TA-MTPJ. For any type of amputation required for toe wet gangrene, it is likely that a more proximal level of index amputation is required.
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