Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany

Objective After cross-cultural adaption for the German translation of the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS-AHS) and agreement analysis with the Foot Function Index (FFI-D), the following gait analysis study using the Oxford Foot Model (OFM) was carried o...

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Main Authors: Frank Krummenauer, Tanja Kostuj, Felix Stief, Kirsten Anna Hartmann, Katharina Schaper, Mohammad Arabmotlagh, Mike H Baums, Andrea Meurer, Sebastian Lieske
Format: Article
Language:English
Published: BMJ Publishing Group 2018-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/8/4/e019872.full
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author Frank Krummenauer
Tanja Kostuj
Felix Stief
Kirsten Anna Hartmann
Katharina Schaper
Mohammad Arabmotlagh
Mike H Baums
Andrea Meurer
Sebastian Lieske
author_facet Frank Krummenauer
Tanja Kostuj
Felix Stief
Kirsten Anna Hartmann
Katharina Schaper
Mohammad Arabmotlagh
Mike H Baums
Andrea Meurer
Sebastian Lieske
author_sort Frank Krummenauer
collection DOAJ
description Objective After cross-cultural adaption for the German translation of the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS-AHS) and agreement analysis with the Foot Function Index (FFI-D), the following gait analysis study using the Oxford Foot Model (OFM) was carried out to show which of the two scores better correlates with objective gait dysfunction.Design and participants Results of the AOFAS-AHS and FFI-D, as well as data from three-dimensional gait analysis were collected from 20 patients with mild to severe ankle and hindfoot pathologies.Kinematic and kinetic gait data were correlated with the results of the total AOFAS scale and FFI-D as well as the results of those items representing hindfoot function in the AOFAS-AHS assessment. With respect to the foot disorders in our patients (osteoarthritis and prearthritic conditions), we correlated the total range of motion (ROM) in the ankle and subtalar joints as identified by the OFM with values identified during clinical examination ‘translated’ into score values. Furthermore, reduced walking speed, reduced step length and reduced maximum ankle power generation during push-off were taken into account and correlated to gait abnormalities described in the scores. An analysis of correlations with CIs between the FFI-D and the AOFAS-AHS items and the gait parameters was performed by means of the Jonckheere-Terpstra test; furthermore, exploratory factor analysis was applied to identify common information structures and thereby redundancy in the FFI-D and the AOFAS-AHS items.Results Objective findings for hindfoot disorders, namely a reduced ROM, in the ankle and subtalar joints, respectively, as well as reduced ankle power generation during push-off, showed a better correlation with the AOFAS-AHS total score—as well as AOFAS-AHS items representing ROM in the ankle, subtalar joints and gait function—compared with the FFI-D score.Factor analysis, however, could not identify FFI-D items consistently related to these three indicator parameters (pain, disability and function) found in the AOFAS-AHS. Furthermore, factor analysis did not support stratification of the FFI-D into two subscales.Conclusions The AOFAS-AHS showed a good agreement with objective gait parameters and is therefore better suited to evaluate disability and functional limitations of patients suffering from foot and ankle pathologies compared with the FFI-D.
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spelling doaj-art-c5061eef5d464717a7d94f5cf4bb5db32025-02-11T14:50:11ZengBMJ Publishing GroupBMJ Open2044-60552018-04-018410.1136/bmjopen-2017-019872Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in GermanyFrank Krummenauer0Tanja Kostuj1Felix Stief2Kirsten Anna Hartmann3Katharina Schaper4Mohammad Arabmotlagh5Mike H Baums6Andrea Meurer7Sebastian Lieske8Institute for Medical Biometry and Epidemiology, University Witten Herdecke Faculty of Health, Witten, Germany1 Department of Orthopedics and Traumatology, Catholic Hospital Bochum, St. Josefs-Hospital, University Hospital of Ruhr-University-Bochum, Bochum, Germany2 Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany2 Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany3 Institute for Medical Biometry and Epidemiology, University of Witten/Herdecke, Witten, Germany2 Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany2 Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany2 Orthopedic University Hospital Friedrichsheim gGmbH, Frankfurt, Germany7 Department of Orthopedic Surgery, St. Marienstift Hospital Magdeburg, Magdeburg, GermanyObjective After cross-cultural adaption for the German translation of the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS-AHS) and agreement analysis with the Foot Function Index (FFI-D), the following gait analysis study using the Oxford Foot Model (OFM) was carried out to show which of the two scores better correlates with objective gait dysfunction.Design and participants Results of the AOFAS-AHS and FFI-D, as well as data from three-dimensional gait analysis were collected from 20 patients with mild to severe ankle and hindfoot pathologies.Kinematic and kinetic gait data were correlated with the results of the total AOFAS scale and FFI-D as well as the results of those items representing hindfoot function in the AOFAS-AHS assessment. With respect to the foot disorders in our patients (osteoarthritis and prearthritic conditions), we correlated the total range of motion (ROM) in the ankle and subtalar joints as identified by the OFM with values identified during clinical examination ‘translated’ into score values. Furthermore, reduced walking speed, reduced step length and reduced maximum ankle power generation during push-off were taken into account and correlated to gait abnormalities described in the scores. An analysis of correlations with CIs between the FFI-D and the AOFAS-AHS items and the gait parameters was performed by means of the Jonckheere-Terpstra test; furthermore, exploratory factor analysis was applied to identify common information structures and thereby redundancy in the FFI-D and the AOFAS-AHS items.Results Objective findings for hindfoot disorders, namely a reduced ROM, in the ankle and subtalar joints, respectively, as well as reduced ankle power generation during push-off, showed a better correlation with the AOFAS-AHS total score—as well as AOFAS-AHS items representing ROM in the ankle, subtalar joints and gait function—compared with the FFI-D score.Factor analysis, however, could not identify FFI-D items consistently related to these three indicator parameters (pain, disability and function) found in the AOFAS-AHS. Furthermore, factor analysis did not support stratification of the FFI-D into two subscales.Conclusions The AOFAS-AHS showed a good agreement with objective gait parameters and is therefore better suited to evaluate disability and functional limitations of patients suffering from foot and ankle pathologies compared with the FFI-D.https://bmjopen.bmj.com/content/8/4/e019872.full
spellingShingle Frank Krummenauer
Tanja Kostuj
Felix Stief
Kirsten Anna Hartmann
Katharina Schaper
Mohammad Arabmotlagh
Mike H Baums
Andrea Meurer
Sebastian Lieske
Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany
BMJ Open
title Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany
title_full Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany
title_fullStr Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany
title_full_unstemmed Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany
title_short Using the Oxford Foot Model to determine the association between objective measures of foot function and results of the AOFAS Ankle-Hindfoot Scale and the Foot Function Index: a prospective gait analysis study in Germany
title_sort using the oxford foot model to determine the association between objective measures of foot function and results of the aofas ankle hindfoot scale and the foot function index a prospective gait analysis study in germany
url https://bmjopen.bmj.com/content/8/4/e019872.full
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