Foot pathology in patients with Paget's disease of bone

Thai version of the foot function index: a cross-cultural adaptation with reliability and validity evaluation

Background

The study aimed to translate the foot function index (FFI) questionnaire to Thai and to determine psychometric properties of the questionnaire among individuals with plantar foot complaints.

Methods

The Thai version of the FFI (FFI-Th) was adapted according to a forward and backward translation protocol by two independent translators and analyzed by a linguist and a committee. The FFI-Th was administered among 49 individuals with plantar foot complaints to determine internal consistency, reliability, and validity. Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC_3,1) were used to test the internal consistency and test-retest reliability. The Principal Component Analysis with varimax rotation method was used to test the factor structure and construct validity. Furthermore, the criterion validity was tested using Pearson’s correlation coefficient (r_p) between the FFI-Th and the visual analogue pain scale (pain-VAS) as well as the EuroQol five-dimensional questionnaire (EQ-5D-5L).

Results

The FFI-Th showed good to excellent internal consistency and test-retest reliability in the total score, pain, disability, and activity limitation subscales. The Principal Component Analysis produced 4 principal factors from the FFI-Th items. Criterion validity of the FFI-Th total score showed moderate to strong correlations with pain-VAS and EQ-5D-5L, and EQ-VAS scores.

Conclusion

The FFI-Th was a reliable and valid questionnaire to assess the foot function in a Thai population.

Trial registration

NCT03161314 (08/05/2017).

A review of the foot function index and the foot function index - revised

BACKGROUND

The Foot Function Index (FFI) is a self-report, foot-specific instrument measuring pain and disability and has been widely used to measure foot health for over twenty years. A revised FFI (FFI-R) was developed in response to criticism of the FFI. The purpose of this review was to assess the uses of FFI and FFI-R as were reported in medical and surgical literature and address the suggestions found in the literature to improve the metrics of FFI-R.

METHODS

A systematic literature search of PubMed/Medline and Embase databases from October 1991 through December 2010 comprised the main sources of literature. To enrich the bibliography, the search was extended to BioMedLib and Scopus search engines and manual search methods. Search terms included FFI, FFI scores, FFI-R. Requirements included abstracts/full length articles, English-language publications, and articles containing the term "foot complaints/problems." Articles selected were scrutinized; EBM abstracted data from literature and collected into tables designed for this review. EBM analyzed tables, KJC, JM, RMS reviewed and confirmed table contents. KJC and JM reanalyzed the original database of FFI-R to improve metrics.

RESULTS

Seventy-eight articles qualified for this review, abstracts were compiled into 12 tables. FFI and FFI-R were used in studies of foot and ankle disorders in 4700 people worldwide. FFI Full scale or the Subscales and FFI-R were used as outcome measures in various studies; new instruments were developed based on FFI subscales. FFI Full scale was adapted/translated into other cultures. FFI and FFI-R psychometric properties are reported in this review. Reanalysis of FFI-R subscales' confirmed unidimensionality, and the FFI-R questionnaires' response categories were edited into four responses for ease of use.

CONCLUSION

This review was limited to articles published in English in the past twenty years. FFI is used extensively worldwide; this instrument pioneered a quantifiable measure of foot health, and thus has shifted the paradigm of outcome measure to subjective, patient-centered, valid, reliable and responsive hard data endpoints. Edited FFI-R into four response categories will enhance its user friendliness for measuring foot health.