Charcot-Marie-Tooth (CMT) disease is the most frequent hereditary neuromuscular disorder, characterized by progressive motor sensory neuropathy.
The cavovarus foot deformity is usually one of the first symptoms arising from an imbalance between agonistic and antagonistic leg muscles. This affects the gait pattern, increases the risk of falling, and limits everyday activities. Many scales have been used in clinical practice and research for foot assessment in Charcot-Marie-Tooth patients.
New scoping review in MerloBioEngineering archive
We have just published a new scoping review that maps all the clinical scales used in the literature to evaluate foot posture in CMT samples. This paper resulted from great teamwork by Andrea Merlo, the Gait Analysis Laboratory clinicians of the Sol et Salus Hospital, and Professor Stefano Masiero from Padua University.
Scales for foot assessment
A first comprehensive search string was created to investigate Medline, the Cochrane Library, PEDro, Web of Science, and Google Scholar. Six different scales were retrieved from the included paper assessing foot characteristics in CMT patients: the Foot Posture Index, the Foot Function Index, the Maryland Foot Score, the American Orthopedic Foot & Ankle Society’s Hindfoot Evaluation Scale, the Foot Health Status Questionnaire, and the Wicart Seringe Grade.
When dealing with clinical scales, researchers and clinicians should pay particular attention to their psychometric properties to choose the most appropriate one (e.g., face and construct validity, internal consistency, and reliability). For this reason, we conducted a second systematic search to examine whether these properties had been tested for the six scales during their validation process.
Which scale is the best one?
The literature search revealed two types of scales: those specifically built for neurologic populations and those taken from orthopedic or rheumatologic fields.
The Foot Posture Index – 6 items (FPI-6) turned out to be the most appropriate tool to be employed for foot assessment in Charcot-Marie-Tooth patients. The FPI-6 has very good intra- and inter-rater reliability and internal consistency, and was confirmed as uni-dimensional. Moreover, the Rasch analysis was conducted during the validation process and normative data are available online. This makes the FPI-6 the best scale for foot assessment in the CMT population, along with other functional scales.
The full-text free article is downloadable here. Congrats to the first author, Dr. Chiara Rambelli!
Critical analysis of the scales that measure a specific construct in a given population is a challenging process involving the knowledge of psychometric properties and the ability to interpret them. Only by choosing the most appropriate assessment method studies in the rehabilitation field will we be able to achieve relevance and spread knowledge.
Our twenty-year experience in the research and rehabilitation field is at your service. Do not hesitate to contact us for any request.
If you want to know more about Charcot-Marie-Tooth disease, we already published one article about functional surgery in this population and one on the effect of intensive physiotherapy.
