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Open Access Highly Accessed Review

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

Elly Budiman-Mak12*, Kendon J Conrad3, Jessica Mazza4 and Rodney M Stuck56

Author Affiliations

1 Center for Management of Complex Chronic Care, Staff Physician, Medical Service, Hines, VA Hospital, 5000 South 5th Ave, Hines, IL, 60141-3030, USA

2 Department of Medicine Loyola University Stritch School of Medicine, Loyola University of Chicago, Maywood, IL, 60513, USA

3 Health Policy and Administration (MC 923) School of Public Health University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL, 60612-4394, USA

4 University of Illinois at Chicago School of Public Health (MC923), 1603 West Taylor Street, Chicago, Illinois, 60612, USA

5 Department of Orthopaedic Surgery, Loyola University Stritch School of Medicine, Loyola University of Chicago, 2160 South First Ave, Maywood, IL, 60153, USA

6 Surgical Service, Hines VA Hospital, 5000 South 5th Ave, Hines, IL, 60141-3030, USA

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Journal of Foot and Ankle Research 2013, 6:5  doi:10.1186/1757-1146-6-5

Published: 1 February 2013

Abstract

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.

Keywords:
FFI; FFI-R; FFI adaptation/translation; FFI scores; Foot health measures