An Evaluation of Two Foot-Specific, Health-Related Quality-of-Life Measuring Instruments

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Abstract
In the past decade, health-related quality-of-life (HRQoL) assessment has become an important tool to measure change as a result of treatment in clinical trials. The aim of this project was to compare and contrast two foot-specific HRQoL questionnaires: the Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ). To assist in this process, a quasi-experimental trial was performed to evaluate the effectiveness of foot orthoses in improving HRQoL in people suffering from plantar fasciitis. The results from this study found that the FFI is generally less responsive to change, particularly in the domain of Activity Limitation. Nevertheless, significant improvements were found for two out of the three domains (Pain and Disability, but not Activity Limitation) for the FFI, as well as the overall score of FFI. In contrast, all four domains (Pain, Function, Footwear and General Foot Health) of the FHSQ showed significant improvement. Our experience with the questionnaires also revealed that certain questions in the Activity Limitation domain of the FFI can lead to inconsistent scoring, thus casting doubts over the suitability of this domain for use with patients with plantar fasciitis. Therefore, the FHSQ has several advantages when evaluating HRQoL in patients being treated with foot orthoses for plantar fasciitis, and should be viewed as the preferred questionnaire.

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