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Theoretical model and Rasch analysis to develop a revised Foot Function Index.

Elly Budiman-Mak1, Kendon Conrad, Rodney Stuck

  • 1VA Hines Hospital HSR & D and Loyola University Stritch School of Medicine, 5th Ave and Roosevelt Rd, Hines, IL 60141, USA. elly.mak@va.gov

Foot & Ankle International
|July 18, 2006
PubMed
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The Foot Function Index was revised into the Foot Function Index-Revised (FFI-R), adding a psychosocial scale and demonstrating strong psychometric properties for both long and short forms.

Area of Science:

  • Podiatry
  • Rehabilitation Medicine
  • Health Outcomes Measurement

Background:

  • The Foot Function Index (FFI) is a common patient-reported outcome for foot function.
  • Previous FFI versions had areas for improvement.
  • This study aimed to refine the FFI.

Purpose of the Study:

  • Develop a theoretical model of foot functioning.
  • Create a revised Foot Function Index (FFI-R).
  • Field-test the FFI-R for reliability and validity.

Main Methods:

  • Literature review to build a theoretical model.
  • Item generation from original FFI and new literature.
  • Focus groups and patient interviews for FFI-R refinement.
  • Field testing on 92 patients and psychometric analysis using item response theory (IRT).

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Main Results:

  • A theoretical model of foot functioning was established.
  • The FFI-R was refined to 68 items with a 5-point scale after pilot testing.
  • Rasch analysis showed high person (0.96) and item (0.93) reliability.
  • Subscale reliability was generally >0.80, except for assistive devices.
  • Construct validity was supported by correlation with 50-ft walk time (r=0.306, p=0.018).
  • A 34-item short form was developed due to item fit analysis.

Conclusions:

  • The revised Foot Function Index (FFI-R) was developed with new items and a psychosocial scale.
  • Both the long and short forms of the FFI-R exhibit strong psychometric properties.
  • The FFI-R offers an improved measure of foot function.