{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:05:05Z","timestamp":1790355905928,"version":"4.1.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) is a leading cause of disability in young adults. While gait and lower limb dysfunction are well studied, foot- and ankle-specific impairments remain underexplored despite their potential impact on mobility, independence, and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between foot alterations and functional disability in MS using the Expanded Disability Status Scale (EDSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted in an endocrinology outpatient clinic and MS associations. Disability was classified as mild (EDSS\u2009&lt;\u20092.5) or moderate (EDSS 2.5-5.5). Foot assessments included digital deformities, foot posture, hyperkeratosis, dorsiflexion range of motion, and plantar tactile sensitivity using the Semmes-Weinstein monofilament at 8 anatomical foot sites. Multiple linear regression was applied to identify predictors of disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred individuals with MS participated; 78% were women. Mean EDSS was 2.5 (range: 1.5-4), with mild disability in 51% and moderate in 49%. Claw toes (P\u2009=\u2009.042), fewer metatarsal head hyperkeratoses (r\u2009=\u2009\u2212.024; P\u2009=\u2009.025), altered tactile sensitivity (P\u2009=\u2009.010), and a higher number of insensitive sites (r\u2009=\u2009.333; P\u2009&lt;\u2009.001) were linked to higher EDSS scores. In multivariate analysis, absent tactile sensitivity (\u03b2\u2009=\u20090.142, P\u2009=\u2009.004), anxiety (\u03b2\u2009=\u20090.838, P\u2009=\u2009.013), and occupational inactivity (\u03b2\u2009=\u20090.359, P\u2009=\u2009.057) emerged as significant predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Plantar tactile sensory loss was the only podiatric factor independently associated with disability in MS, with anxiety and occupational inactivity also contributing. Findings underscore the need for podiatric assessment within multidisciplinary care to help preserve mobility and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400261484267","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:00:45Z","timestamp":1790157645000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Foot Alterations and Disability in People With Multiple Sclerosis: A Cross-Sectional Study"],"prefix":"10.1177","author":[{"given":"Sara","family":"Z\u00fanica-Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, Miguel Hern\u00e1ndez University, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Pastor-Vidal","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, Miguel Hern\u00e1ndez University, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9643-4548","authenticated-orcid":false,"given":"Alba","family":"Gracia-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, Miguel Hern\u00e1ndez University, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9394-6799","authenticated-orcid":false,"given":"Mar\u00eda Isabel","family":"Jim\u00e9nez-Trujillo","sequence":"additional","affiliation":[{"name":"Department of Medical Specialties and Public Health, Preventive Medicine and Public Health Area, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-5723","authenticated-orcid":false,"given":"Esther","family":"Chicharro-Luna","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, Miguel Hern\u00e1ndez University, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0195-2834","authenticated-orcid":false,"given":"\u00c1ngel","family":"P\u00e9rez-Sempere","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dr. Balmis General University Hospital, Department of Clinical Medicine, Miguel Hern\u00e1ndez University, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Multiple Sclerosis International Federation. 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