Evaluation of Validity, Reliability, and Feasibility of 3 Patient-Reported Foot and Ankle Outcome Measures.

BACKGROUND: A wide range of patient-reported outcome measures have been developed to assess the impact of foot and ankle pathology on patients' function. In this study, Manchester-Oxford Foot Questionnaire (MOXFQ), Foot and Ankle Ability Measure (FAAM), and Revised-Foot Function Index (R-FFI) scores were assessed independently of their developers for validity, reliability, item bias, acceptability, and feasibility. METHODS: We prospectively recruited 100 consecutive patients with a range of foot and ankle disorders over a 6-month period. Patients completed a set of 3 questionnaires at initial consultation. Patients were subsequently sent questionnaires in a random order with a prepaid envelope and asked to complete them with 2 to 14 days. To assess feasibility in routine clinical practice, the time taken to complete questionnaires was evaluated in a cohort of 65 patients. RESULTS: The mean age of patients was 51.7 years (range 20 to 85). The majority were females (64 of 96). The internal consistency of all 3 questionnaires was high, suggesting good intercorrelation among the items of each questionnaire. The questionnaires were reproducible and valid. There was strong correlation between the total scores of all 3 questionnaires. There was no item bias on the overall scores by the assumed independent variables such as age, sex, site, and pathology. Form completion rates were 98% for MOXFQ, 89% for FAAM, and 75% for FFI. MOXFQ was the easiest to understand and complete. No significant difference was found in the time taken to complete each questionnaire. CONCLUSION: All 3 scores correlate with the level of function and have very good reproducibility. For routine use, the MOXFQ has good practical properties of patient acceptability, high item response rate, and ease of completion.

A Comparison of Two Monofilament Suture Materials for Repair of Partial Flexor Tendon Lacerations: A Controlled In-vitro Study.

BACKGROUND: Surgical repair is advocated for flexor tendon lacerations deeper than 70%. Repair can be undertaken with different suturing techniques and using different materials. Different materials used for tendon repair will have a different gliding resistance (GR) at the joint. Previous studies have compared strength of repair and gliding resistance for various braided suture materials and for 100% laceration of flexor tendons. We directly compare the GR of two monofilament sutures when used for a peripheral running suture repair of partially lacerated tendons. METHODS: Sixteen flexor tendons and A2 pulleys were harvested from Turkey feet. They were prepared, partially lacerated to 50% depth, and then repaired with a core suture (modified Kessler technique with 4-0 Ethibond) as well as an additional superficial running suture of either 6-0 Prolene or Nylon (half randomised to each). Gliding resistance was measured for all tendons before and after repair, at different flexion angles (40 and 60 degrees) and for different loads (2N and 4N). RESULTS: After surgical repair, gliding resistance was increased for all tendons (P < 0.01). The tendons repaired with Prolene had a higher mean gliding resistance than those repaired with Nylon (P = 0.02). Increased flexion angle and load amplified the gliding resistance (both P < 0.01). CONCLUSIONS: 6-0 Nylon was associated with a lower gliding resistance than 6-0 Prolene but the minor differences bare unknown clinical significance.

THE IMMEDIATE AND LONG-TERM EFFECTS OF KINESIOTAPE® ON BALANCE AND FUNCTIONAL PERFORMANCE.

BACKGROUND: The application of Kinesio Tex® tape (KT) results, in theory, in the improvement of muscle contractibility by supporting weakened muscles. The effect of KT on muscle strength has been investigated by numerous researchers who have theorized that KT facilitates an immediate increase in muscle strength by generating a concentric pull on the fascia. The effect of KT on balance and functional performance has been controversial because of the inconsistencies of tension and direction of pull required during application of KT and whether its use on healthy individuals provides therapeutic benefits. HYPOTHESES/PURPOSE: The purpose of the present study was to investigate the immediate and long-term effects of the prescribed application (for facilitation) of KT when applied to the dominant lower extremity of healthy individuals. The hypothesis was that balance and functional performance would improve with the prescribed application of KT versus the sham application. STUDY DESIGN: Pretest-posttest repeated measures control group design. METHODS: Seventeen healthy subjects (9 males; 8 females) ranging from 18-35 years of age (mean age 23.3 ± 0.72), volunteered to participate in this study. KT was applied to the gastrocnemius of the participant's dominant leg using a prescribed application to facilitate muscle performance for the experimental group versus a sham application for the control group. The Biodex Balance System and four hop tests were utilized to assess balance, proprioception, and functional performance beginning on the first day including pre- and immediately post-KT application measurements. Subsequent measurements were performed 24, 72, and 120 hours after tape application. Repeated measures ANOVA's were performed for each individual dependent variable. RESULTS: There were no significant differences for main and interaction effects between KT and sham groups for the balance and four hop tests. CONCLUSION: The results of the present study did not indicate any significant differences in balance and functional performance when KT was applied to the gastrocnemius muscle of the lower extremity. LEVEL OF EVIDENCE: Level 1- Randomized Clinical Trial.