Table 7.
Studies using foot function measures in surgical interventions
| Instrument | 1st Author | Objective | Population (N, Sex, Age, Dx, location) | Analysis | Items/Domains/Subscales | Response type | Summary evaluation |
|---|---|---|---|---|---|---|---|
| Foot Function Index (FFI), 2000 |
Lin, S
[39] |
Validation of AOFAS forefoot outcomes of arthrodesis surgery |
N: 16 Mean age: 44 (SD=13.96) 8 male |
Pre-post surgery |
FFI |
VAS |
Both FFI and AOFAS scores were improved at post surgery. |
| |
|
|
Dx: Tarsometatarso injury/degenerative arthritis |
Follow-up 36 months (24–65 months) |
23 items |
|
Conclusion: useful |
| |
|
|
Location: USA |
FFI and AOFAS were applied at pre-surgery and at follow up |
3 domains |
|
|
| FFI, 2002 |
Watson, TS
[61] |
Validation with VAS pain scale with SF-36 short form in plantar fasciotomy |
Group I N (control): 75 Mean age: 46 (range: 20–78) 14 male |
Retrospective observational Follow up duration 26.4 months |
FFI |
VAS |
FFI scores were improved. |
| |
|
|
Group II N (surgery): 46 Mean age: 46 (Range: 25–78) 9 male |
Group II filled out FFI and SF-26 at post-surgery only |
23 items |
|
FFI scores reflected activities of daily living. SF-36 s cores reflection satisfaction of physical and role model. |
| |
|
|
Dx: Sub-Calcaneal pain syndrome |
Validation with VAS pain scale SF-36 short form |
3 domains |
|
Conclusion: useful. |
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2003 |
Mulcahy, D
[56] |
Surgery-Reconstruction of the forefoot; FFI scores were used to test if there was correlation with WOMAC, AOFAS HMIP, and AOFAS LMIP. |
N: 79 14 male Mean age: 59 (Range: 24–80) |
Retrospective observational; Follow up 6yrs.+3 mo (6mo-19 years) |
FFI; 23 items; 3 domains |
VAS |
FFI pain subscale was used to monitor pain in both groups. |
| |
|
|
Dx: RA forefoot deformity |
|
|
|
Conclusion: useful |
| |
|
|
Mean age of surgery: 52 years (range: 23–79) |
|
|
|
|
| |
|
|
Group 1 stable 1st ray. (no surgery) |
|
|
|
|
| |
|
|
Group 2: 1st ray surgery |
|
|
|
|
| |
|
|
Location: Canada |
|
|
|
|
| FFI, 2004 |
Ibrahim T
[48] |
Surgery- MTP joint replacement; Validation of AOFAS Hallux scale scores with FFI scores from those who did not have surgery and those who had surgery |
N: 8, 1 male |
Retrospective observational; Follow up for 17 months |
FFI |
VAS |
Correlation observed between the scores of AOFAS and FFI |
| |
|
|
Mean age: 58 (Range: 51–80) |
|
23 items |
|
Note: AOFAS Hallux scale had not been validated. |
| |
|
|
Dx. Hallux rigidus |
|
3 domains |
|
Conclusion: useful |
| |
|
|
Location: UK |
|
|
|
|
| FFI, 2004 |
Vallier, HA
[52] |
Surgery-Open reduction internal fixation; Correlation of FFI and musculoskeletal function assessment (MFA) |
N: 100 60 male |
Retrospective observational |
FFI |
VAS |
Scores of FFI and MFA were correlated |
| |
|
|
Mean age: 32.6 (Range: 13–77) |
Follow up 36 months (12–74 months) |
23 items |
|
Conclusion: useful |
| |
|
|
Dx: Talar neck fracture |
FFI was applied to N=59 at follow-up |
3 domains |
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2005 |
Taranow, WS
[49] |
Surgery- metalic hemiarthroplasty: Do FFI scores improve at post-operation |
N: 28 17 male |
Retrospective observational case review |
FFI |
VAS |
FFI scores from pre to post operation showed significant improvement. |
| |
|
|
Mean age: 52.9 (Range: 38–71) |
Follow 33.4 months |
23 items |
|
Conclusion: useful |
| (3–mo-111mo) | |||||||
| |
|
|
Dx: Hallux rigidus |
|
3 domains |
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2005 |
Grondal, L
[40] |
Surgery-Athrodesis vs. Mayo resection of MTP; FFI scores as outcomes |
N: 31; 26 male |
RCT not-blinded, ANOVA and multiple comparisons |
FFI |
VAS |
FFI scores at post-surgery within groups were improved and there no significant differences between the groups. |
| |
|
|
Mean age: 54 yrs |
|
23 items |
|
Conclusion: useful |
| (Range: 33–77) | |||||||
| |
|
|
Resection N=: 16 |
|
3 domains |
|
|
| |
|
|
Fusion N=: 15 |
|
|
|
|
| |
|
|
Dx: RA painful forefoot deformity |
|
|
|
|
| |
|
|
Location: Sweden |
|
|
|
|
| FFI, 2005 |
Daniels, TR
[62] |
Surgery -Free tibular graft; FFI scores were validated with MODEMS and SF-36 short form |
N: 28, 13 male |
Observational |
FFI 21 items (2 items about orthoses were not applicable) 3 domains |
Likert |
The scores of FFI, SF-36 and MODEMS were demonstrating similar improved outcomes at post-surgery |
| |
|
|
Mean age: 52 (Range: 22–76) |
Follow-up: 36 months (26–52 months) |
|
|
Conclusion: useful |
| |
|
|
Dx: Vascularized fibular bone graft |
FFI was applied at pre-surgery and at 6 and between 26–54 month post surgery |
|
|
|
| |
|
|
Location: Canada |
|
|
|
|
| FFI, 2005 |
Lee, S
[63] |
Surgery -Isolated sesamoidectomy; FFI disability sub-scale validated with VAS pain scale and SF-36 short form |
N; 32; 8 male |
Retrospective observational |
FFI 9 items |
VAS |
The scores of FFI disability and VAS pain sub-scales were correlated.Conclusion: useful |
| |
|
|
Mean age: 37.2 (Range: 18–65) |
62 month |
1 domain: disability scale |
|
|
| Post-op N=: 20 | |||||||
| |
|
|
Dx: Hallux alignment |
|
|
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2006 |
SooHoo, NF
[64] |
Surgery- Any type of foot and ankle surgery; Validating AOFAS, SF-36 and measuring Standard Response Mean (SRM) and effect size (ES) |
N: 25; 6 Male |
Pre-post surgery FFI was applied at pre-surgery and 6 months post-surgery |
FFI |
VAS |
Of the instruments used, scores of the pain subscale was the only measure reflecting high SRM (−0.83) and ES (−0.86). Therefore, pain is the most important outcome in studies regarding chronic foot and ankle pain. |
| |
|
|
Mean age: 40 (Range: 21–69) |
|
23 items |
|
Conclusion: useful |
| |
|
|
Dx: Chronic foot and ankle conditions requiring surgery |
|
3 domains |
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2006 |
Van der Krans, A
[41] |
Surgery- Calcaneal Cuboid arthrodesis; Correlation with AOFAS clinical rating index (CRI) of the hind foot |
N: 20; 4 Male |
Pre-post surgery |
FFI-Dutch 15 items |
5-point verbal scale |
FFI and CRI scores showed significant improvements |
| |
|
|
Mean age: 55 (Range: 30–66) |
Follow-up 25 months (13–39 months) |
Pain and function subscales |
|
Conclusion: useful |
| |
|
|
Dx: Flat foot |
FFI was applied at pre-surgery and ad follow-up |
|
|
|
| |
|
|
Location: Netherlands |
|
|
|
|
| FFI, 2006 |
Harris, M
[53] |
Surgery- High impact fracture repair; Correlation with Musculoskeletal function assessment (MFA) |
N: 76; 45 Male |
Pre-post surgery follow up 26 months (24–38 months). FFI was applied at pre-surgery, 6 and 12 weeks and at 6 months by mail, telephone, and was self-administered. |
FFI |
VAS |
High FFI score occurred in those with the worse fractures and external fixation. This is also reflected in MFA scores. |
| |
|
|
Mean age: 45 (Range: 17–81) |
|
23 items |
|
Conclusion: useful |
| |
|
|
Dx: distal tibial plafond fracture |
|
3 domains |
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2006 |
Stegman M
[42] |
Surgery-Triple arthrodesis; Correlation with AOFAS hind foot scores |
N: 81; 38 Male |
Pre-post surgery |
FFI Dutch |
Likert |
FFI-5pt and AOFAS hind foot scores improved 89%. However, patient did not perceive the benefit of the procedure. |
| |
|
|
Mean age: 40.5 (Range: 14–79) |
FFI applied at pre-surgery and 1 yr (1–4) post surgery |
15 items |
|
Conclusion: useful |
| |
|
|
Dx: Hind foot disorders |
|
2 domains |
|
|
| |
|
|
Location: Netherlands |
|
|
|
|
| FFI, 2007 |
Jung, HG
[45] |
Surgery-Fusion of tarso metatarso-joint; Correlation with SF-36, AOFAS |
N: 67; 12 Male |
Retrospective observational |
FFI |
VAS |
Scores of the FFI, SF-36 AOFAS and VAS pain scale were markedly improved at post-surgery |
| |
|
|
Mean age: 60.2 (Range: 35–84) |
Follow for 40.6 months |
23 items |
|
Conclusion: useful |
| |
|
|
Dx: Non-traumatic osteoarthritis of the tarso-meta-tarso joints |
FFI applied at post-surgery |
3 domains |
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2008 |
Vesely, R
[43] |
Surgery – Tibio Calcaneal arthrodesis; Correlation with ankle-hind foot score |
N: 20; 16 Male |
Retrospective observational |
FFI |
VAS |
The scores of FFI and ankle hind foot were improved. |
| |
|
|
Mean age: 58.7 (Range: 23–72) |
FFI applied at post-surgery, time unknown |
23 items |
|
Conclusion: useful |
| |
|
|
Dx: Traumatic arthritis of the ankles |
Article in Czech with English abstract. |
3 domains |
|
|
| |
|
|
Location: Czech Republic |
|
|
|
|
| FFI, 2008 |
Stropek, S
[37] |
Surgery- arthroscopy |
N: 26; 6 Male |
Pre-post surgery observational |
FFI |
VAS |
FFI pain scale scores were markedly improved at post surgery in 79% of the patients |
| |
|
|
Age: male: 45; female: 49 |
FFI applied at pre-surgery and at 3 month follow-up |
Pain scale |
|
Conclusion: useful |
| |
|
|
Dx: Calcaneal spur |
|
9 items |
|
|
| |
|
|
Location: Czech Republic |
|
|
|
|
| FFI, 2008 |
Schutte, BG
[50] |
Surgery-Total ankle replacement; pain and function outcome measure |
N: 47; 16 Males |
Pre-post surgery |
FFI-Dutch |
Likert |
Total scores improved at post–surgery |
| |
|
|
Mean age: 57.1 (range 37–81) |
FFI applied at pre-surgery and at follow up |
18 items |
|
Conclusion: useful |
| |
|
|
Dx: Ankle joint deformity |
Duration of follow up 28 months (range 12–67) |
Pain and difficulty subscales |
|
|
| |
|
|
Location: Netherlands |
|
|
|
|
| FFI, 2008 |
Ward, CM
[57] |
Surgery-Reconstruction; Validation of SF 26 with FFI |
N: 25; 14 Male |
Pre-post surgery |
FFI |
VAS |
At follow up the FFI scores were in the mid-range. The scores for smokers were worse than non-smokers, females were worse than males. FFI activity limitation and disability scores were correlated with SF-36 physical component scores. |
| |
|
|
|
|
|
|
|
| |
|
|
Mean age: 15 (Range: 8.7-25) |
FFI applied at mean age of 41.5 years after 26.1 yrs follow-up |
23 items |
|
Conclusion: useful |
| |
|
|
Dx: Flexible Cavovarus Charcot Marie-Tooth |
|
3 domains |
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2009 |
Castellani, C
[65] |
Surgery-Fixation with cannulation osteosynthesis; Outcomes of an intervention |
N: 21; 11 Male |
Retrospective observational |
FFI |
VAS |
At follow-up 3 of the 21 (14%) had poor FFI disability scores |
| |
|
|
Dx: Transitional fracture of distal tibia |
FFI was applied at 3.8 yrs after implants removal |
23 items |
|
Conclusion: useful |
| |
|
|
Age 13.7 (1.4) |
|
3 domains |
|
|
| |
|
|
Location: Austria |
|
|
|
|
| FFI, 2009 |
Bonnin, MP
[51] |
Surgery – Total ankle arthoplasty; Correlations of FAAM (foot and ankle ability measure) |
N: 140; 50 Male |
Pre-post surgery pre at pre-surgery FAAM and FFI was applied, and also at 53.8 ±29 months (12–125) post- surgery |
FFI |
VAS |
FFI pain scores were no different between OA and RA groups. The FFI scores were improved and were similar to that of FAAM. |
| |
|
|
Mean age: 60.9 (Range: 26–90) |
|
23 items |
|
Conclusion: useful |
| |
|
|
Dx: OA: 100 RA: 40 |
|
3 domains |
|
|
| |
|
|
Location: France |
|
|
|
|
| FFI, 2009 |
Potter, MQ
[54] |
Surgery- Intraarticular fracture of the Calcaneus; Correlation with AOFAS hind foot scores |
N: 73; 52 Male |
Retrospective observational FFI applied at follow up of 12.8 years (5–18.5) |
FFI |
VAS |
Scored of FFI, AOFAS hind foot and Calcaneal scores were correlated. |
| |
|
|
Dx: Calcaneal fracture |
|
23 items |
|
Conclusion: useful |
| |
|
|
Location: USA |
|
3 domains |
|
|
| FFI, 2010 |
Aurich, M
[66] |
Surgery-Arthroscopic chondrocyte implant; Correlation with AOFAS hind foot scores and Core Scale of the foot and ankle module of the Academy of Orthopedic Surgeon (AAOS) |
N: 18; 13 Male |
Retrospective observational FFI was applied at pre-arthroscopy and at follow-up, with mean duration of 19 months |
FFI 18 items; Pain and function subscales |
Likert |
FFI scores improved comparable with those of AOFAS results and Core Scale scores |
| |
|
|
Mean age: 29.2 (SD 10.2 years) |
|
|
|
Limitation: Use of FFI measures with caution in individual whose. functional level is better than the level of activities of daily living. |
| |
|
|
Dx: Osteochondral lesion of talus/tibia |
|
|
|
Conclusion: useful |
| |
|
|
Location:Australia |
|
|
|
|
| FFI, 2010 |
Van der Heide, HJL
[59] |
Surgery-Correction pes cavo varus; Validation AOFAS lesser toe module |
N: 39; 6 Male |
Pre-post surgery; FFI applied at pre-surgery and 40 month post-surgery |
FFI-Dutch |
VAS |
FFI pain and function scores improved post-surgery |
| |
|
|
Mean age: 59 (Range: 29–81) |
|
|
|
Conclusion: useful |
| |
|
|
Dx: RA lesser MTP |
|
23 items |
|
|
| |
|
|
Location: Netherlands |
|
3domains |
|
|
| FFI- Dutch, 2010 |
Kroon, M
[60] |
Surgery-Correction pes cavo varus; Validation AOFAS hind foot scale |
N: 15; 8 Male |
Pre-post surgery FFI applied at pre and 50 month post surgery |
FFI-Dutch |
Likert |
Pain and function scores improved post surgery |
| |
|
|
Mean age:40 (SD 14) |
|
18 items |
|
Conclusion: useful |
| |
|
|
Dx: Cavo varus foot deformity |
|
Pain and function subscales |
|
|
| |
|
|
Location: The Netherlands |
|
|
|
|
| FFI, 2010 |
Van Doeselaar, DJ
[46] |
Surgery-Fusion of MTP; Correlation with VAS pain and satisfaction |
N: 62 |
Pre-post surgery; FFI applied at pre-surgery and 12 month post-surgery |
FFI Dutch; 18 items |
Likert |
FFI-5 pts scores were improved. |
| 2 groups | |||||||
| |
|
|
Dx: H rigidus; N: 27; 9 Male |
|
|
|
Conclusion: useful |
| |
|
|
Mean age: 58 (Range: 42–72) |
|
|
|
|
| |
|
|
Dx: H valgus; N: 35; 6 Male |
|
|
|
|
| |
|
|
Mean age: 61 (Range: 37–76) |
|
|
|
|
| |
|
|
Location: Netherlands |
|
|
|
|
| FFI, 2010 |
Doets, HC
[44] |
Surgery-Salvage arthrodesis for failed TAA; Correlating with AOFAS and VAS pain scale |
N: 18; 4 Male |
Retrospective observational FFI applied at follow up, 3–12 years |
FFI-Dutch |
5 point rating scale |
FFI scores improved similar to that of AOFAS, VAS pain, disability and satisfaction measure |
| |
|
|
Mean age: 55 (Range: 27–76) |
|
15 items |
|
Conclusion: useful |
| |
|
|
Dx: Failed TAA |
|
Pain and function subscales |
|
|
| |
|
|
Location: Netherlands |
|
|
|
|
| FFI, 2010 |
Niki, H
[47] |
Surgery-TMT fusion and osteotomy; Concurrent assessment of FFI and SF-36 and Japanese Society for Surgery of the Foot and Ankle Score |
N: 30; 1 Male |
Pre-post surgery FFI was applied at pre-surgery and at 36 mos follow-up |
FFI |
VAS |
The scores of all instruments were improved at post-surgery. |
| |
|
|
Mean age: 53.6 (Range: 45–67) |
|
23 items |
|
Conclusion: useful |
| |
|
|
Dx: RA fore-foot deformity |
|
3 domains |
|
|
| |
|
|
Location: Japan |
|
|
|
|
| FFI, 2010 |
Schlegel, UJ
[58] |
Surgery-Club foot correctional; Post-surgery foot health assessment |
N: 98; 72 Male |
Retrospective observational FFI was applied at 8.2 years (0–11.2); Post surgery N: 46 (50%) |
FFI |
VAS |
FFI scores indicated good foot health. |
| |
|
|
Mean follow-up: 4.5M (Range: 1–68) |
|
23 items |
|
Conclusion: useful |
| |
|
|
Dx: Club foot |
|
3 domains |
|
|
| |
|
|
Location: Germany |
|
|
|
|
| FFI, 2010 |
Gaskill, T
[55] |
Surgery- Internal fixation of the instraarticular Calcaneal fracture; Concurrent evaluation with OAFAS hind foot |
N: 146; 99 Male |
Retrospective observational FFI was applied at post-surgery 8.98 years |
FFI |
VAS |
FFI scores of Group 1 were better than Group 2 at post surgery. |
| |
|
|
Group 1 <50 yrs; N: 99; 65 male |
|
23 items |
|
Conclusion: useful |
| |
|
|
Mean age: 36 (Age range) |
|
3 domains |
|
|
| |
|
|
Group 2 >50 years; N: 47; 33 male |
|
|
|
|
| |
|
|
Mean age: 58 (Range: 50–84) |
|
|
|
|
| |
|
|
Dx: Calcaneal fracture |
|
|
|
|
| |
|
|
Location: USA |
|
|
|
|
| FFI, 2010 |
Eberl, R
[67] |
Surgery- Various surgical techniques were applied; Post surgery outcomes |
N: 24; 18 Male |
Retrospective observational |
FFI |
VAS |
FFI scores improved in both groups. Group 1 scored better than Group 2. |
| |
|
|
Mean age: 13.2 (Range: 5–17 yrs) |
Follow-up 3.2 years (7 months-8.2 years) |
23 items |
|
Limitation: The author stated that use of self-report in instrument in children may result in spurious outcomes, due to their pronounced potential for compensation. |
| |
|
|
Group 1 <12 years; N: 9; Age : 9.2 |
FFI applied at follow up |
3 domains |
|
Conclusion: useful |
| |
|
|
Group 2 >12 years; N: 15; Age: 14.6 |
|
|
|
|
| |
|
|
Dx: Complex ankle injuries |
|
|
|
|
| Location: Australia |