{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T00:20:21Z","timestamp":1793838021196,"version":"4.6.1"},"reference-count":26,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,18]],"date-time":"2024-08-18T00:00:00Z","timestamp":1723939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The Foot Function Index (FFI) is a widely recognized patient-reported outcome measure (PROM) for assessing foot functionality and its impact on quality of life in individuals with rheumatoid arthritis (RA). This study aimed to observe the behavior of the tool in the Spanish population with RA, optimize the tool, and check its functionality. Materials and Methods: A total of 549 RA patients, with a predominant female participation (75.6%). This study involved a comprehensive statistical analysis, leading to a refined version of the FFI for a Spanish-speaking population. Results: The original 23-item FFI was revised, resulting in a 15-item version by excluding items that caused confusion or were considered redundant. This modified version maintained the original\u2019s subscales of pain, disability, and activity limitation, but with an adjusted item distribution. The construct validity was confirmed through exploratory factor analysis, demonstrating excellent fit indices (Kaiser\u2013Meyer\u2013Olkin test = 0.926, Bartlett\u2019s test of sphericity = 4123.48, p &lt; 0.001). The revised FFI demonstrated good internal consistency (Cronbach\u2019s alpha = 0.96) and test\u2013retest reliability (ICC = 0.89). Conclusions: This study highlights the applicability of the FFI in Spanish-speaking RA populations, offering a valid and reliable tool for clinicians and researchers. The modifications enhance the FFI\u2019s relevance for RA patients, facilitating better assessment and management of foot-related functional impairments.<\/jats:p>","DOI":"10.3390\/medicina60081339","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T03:43:28Z","timestamp":1724039008000},"page":"1339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Update of Modified Version of the Foot Function Index Tool Spanish Version (FFI-Sp), in Patients with Rheumatoid Arthritis: Cross Sectional Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Maria","family":"Gamez-Guijarro","sequence":"first","affiliation":[{"name":"Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Pe\u00f1alosa 3, Ampliaci\u00f3n de Campus de Teatinos, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1185-2941","authenticated-orcid":false,"given":"Andres","family":"Reinoso-Cobo","sequence":"additional","affiliation":[{"name":"Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Pe\u00f1alosa 3, Ampliaci\u00f3n de Campus de Teatinos, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Gordillo-Fernandez","sequence":"additional","affiliation":[{"name":"Department of Podiatry, Universidad de Sevilla, 41009 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Ortiz-Romero","sequence":"additional","affiliation":[{"name":"Department of Podiatry, Universidad de Sevilla, 41009 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5738-5691","authenticated-orcid":false,"given":"Ana Belen","family":"Ortega-Avila","sequence":"additional","affiliation":[{"name":"Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Pe\u00f1alosa 3, Ampliaci\u00f3n de Campus de Teatinos, 29071 Malaga, Spain"},{"name":"IBIMA Plataforma BIONAND, 29010 Malaga, 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 Behavioral Sciences and Health, Nursing Area, Faculty of Medicine, University Miguel Hern\u00e1ndez, 03202 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4558-3548","authenticated-orcid":false,"given":"Gabriel","family":"Gijon-Nogueron","sequence":"additional","affiliation":[{"name":"Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Pe\u00f1alosa 3, Ampliaci\u00f3n de Campus de Teatinos, 29071 Malaga, Spain"},{"name":"IBIMA Plataforma BIONAND, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8778-5837","authenticated-orcid":false,"given":"Eva","family":"Lopezosa-Reca","sequence":"additional","affiliation":[{"name":"Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Pe\u00f1alosa 3, Ampliaci\u00f3n de Campus de Teatinos, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1007\/s12016-012-8346-7","article-title":"Genetics of Rheumatoid Arthritis\u2014Comprehensive Review","volume":"45","author":"Besenyei","year":"2013","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1007\/s00296-017-3699-0","article-title":"Foot health in patients with rheumatoid arthritis\u2014A scoping review","volume":"37","author":"Stolt","year":"2017","journal-title":"Rheumatol. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1002\/acr.24042","article-title":"2019 Update of the American College of Rheumatology Recommended Rheumatoid Arthritis Disease Activity Measures","volume":"71","author":"England","year":"2019","journal-title":"Arthritis Care Res."},{"key":"ref_4","first-page":"279","article-title":"2014 update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological therapies in rheumatoid arthritis","volume":"11","author":"Andreu","year":"2015","journal-title":"Reum. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/acr.24596","article-title":"2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis","volume":"73","author":"Fraenkel","year":"2021","journal-title":"Arthritis Care Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rutkowski, R., Gizi\u0144ska, M., Ga\u0142czy\u0144ska-Rusin, M., Kasprzak, M.P., and Budiman-Mak, E. (2022). The Importance of Foot Function Assessment Using the Foot Function Index-Revised Short Form (FFI-RS) Questionnaire in the Comprehensive Treatment of Patients with Rheumatoid Arthritis. J. Clin. Med., 11.","DOI":"10.3390\/jcm11092298"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e036903","DOI":"10.1136\/bmjopen-2020-036903","article-title":"Foot health and quality of life in patients with rheumatoid arthritis: A cross-sectional study","volume":"10","year":"2020","journal-title":"BMJ Open"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s10067-009-1312-y","article-title":"Foot pain in rheumatoid arthritis prevalence, risk factors and management: An epidemiological study","volume":"29","author":"Otter","year":"2010","journal-title":"Clin. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/0895-4356(91)90220-4","article-title":"The Foot Function Index: A measure of foot pain and disability","volume":"44","author":"Conrad","year":"1991","journal-title":"J. Clin. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1177\/107110070602700707","article-title":"Theoretical model and rasch analysis to develop a revised Foot Function Index","volume":"27","author":"Conrad","year":"2006","journal-title":"Foot Ankle Int."},{"key":"ref_11","first-page":"2569","article-title":"2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Ann. Rheum. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.fas.2013.09.005","article-title":"Cross-cultural adaptation and validation of the Foot Function Index to Spanish","volume":"20","year":"2014","journal-title":"Foot Ankle Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e000140","DOI":"10.1136\/rmdopen-2015-000140","article-title":"Psychometric properties of three single-item pain scales in patients with rheumatoid arthritis seen during routine clinical care: A comparative perspective on construct validity, reproducibility and internal responsiveness","volume":"1","author":"Sendlbeck","year":"2015","journal-title":"RMD Open"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","article-title":"Quality criteria were proposed for measurement properties of health status questionnaires","volume":"60","author":"Terwee","year":"2007","journal-title":"J. Clin. Epidemiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1023\/A:1013138911638","article-title":"Smallest real difference, a link between reproducibility and responsiveness","volume":"10","author":"Beckerman","year":"2001","journal-title":"Qual. Life Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2896","DOI":"10.1080\/09638288.2020.1849428","article-title":"Transcultural adaptation and validation of the Spanish-French versions of the Self-reported Foot and Ankle Score (SEFAS)","volume":"44","author":"Lescure","year":"2022","journal-title":"Disabil. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1037\/0033-2909.86.2.420","article-title":"Intraclass correlations: Uses in assessing rater reliability","volume":"86","author":"Shrout","year":"1979","journal-title":"Psychol. Bull."},{"key":"ref_19","unstructured":"(2024, July 19). Flesch Reading Ease and the Flesch Kincaid Grade Level\u2014Readable. Available online: https:\/\/readable.com\/readability\/flesch-reading-ease-flesch-kincaid-grade-level\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1007\/s00264-016-3113-7","article-title":"The foot function index is more sensitive to change than the Leeds Foot Impact Scale for evaluating rheumatoid arthritis patients after forefoot or hindfoot reconstruction","volume":"40","author":"Muradin","year":"2016","journal-title":"Int. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1177\/107110070202300611","article-title":"An evaluation of two foot-specific, health-related quality-of-life measuring instruments","volume":"23","author":"Landorf","year":"2002","journal-title":"Foot Ankle Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.foot.2014.09.004","article-title":"17-Italian Foot Function Index with numerical rating scale: Development, reliability, and validity of a modified version of the original Foot Function Index","volume":"25","author":"Venditto","year":"2015","journal-title":"Foot"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.fas.2019.08.002","article-title":"Validation of the Turkish version of the Revised Foot Function Index for patients with foot and ankle disorders","volume":"26","author":"Yagci","year":"2020","journal-title":"Foot Ankle Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.rehab.2015.07.003","article-title":"French validation of the Foot Function Index (FFI)","volume":"58","author":"Pereira","year":"2015","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"M\u00f8rk, M., Hoksrud, A.F., Soberg, H.L., Zucknick, M., Heide, M., Groven, K.S., and R\u00f8e, C. (2022). Psychometric properties of the Norwegian foot function index revised short form. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05374-x"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.3113\/FAI.2008.1222","article-title":"Cross-cultural adaptation and validation of the Foot Function Index for use in german-speaking patients with foot complaints","volume":"29","author":"Naal","year":"2008","journal-title":"Foot Ankle Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/8\/1339\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:38:23Z","timestamp":1760110703000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/8\/1339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,18]]},"references-count":26,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["medicina60081339"],"URL":"https:\/\/doi.org\/10.3390\/medicina60081339","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,18]]}}}