John W. A. Osborne

Background: There is growing research evidence related to musculoskeletal and sports podiatry published by Australian researchers. This short report presents data from the musculoskeletal and sports podiatry stream of a national bibliometric review which aimed to map all Australian podiatry‐related research from 1970 to 2024. Methods: A systematic search of the literature was conducted via Scopus until December 2024. Studies were screened for eligibility using Covidence. Study meta‐data was analysed using Biblioshiny to describe publications volume, authors, institutions, journals, and research collaborations. Via manual processes, each publication was categorised for: level of evidence using National Health and Medical Research Council criteria; research type using the United Kingdom Clinical Research Collaboration Health Research Classification System; and funding source, using Higher Education Research Data Collection specifications. Results: The search strategy yielded 288 records published by 774 authors (19% international), with a total 12,593 citations, with 44.1 mean citations per article from 1991 to 2024 were included. A total of 65 articles (23%) were categorised as level I evidence. The British Journal of Sports Medicine and the Journal of Science and Medicine in Sport were equally the most frequent publication sources, publishing 23 (8%) articles respectively. Podiatry‐related musculoskeletal and sports research is usually undertaken without dedicated funding (67%). The majority of published articles focussed on the evaluation of treatments and therapeutic interventions (36%) and on the aetiology of conditions (34%). Conclusion: The musculoskeletal and sports podiatry stream was the most widely researched, with the highest proportion of level I evidence among all streams of the national bibliometric review. Given the high burden of disease and adverse impacts on activities of daily living associated with musculoskeletal conditions, further attention in preventative care and the promotion of wellbeing in sports and musculoskeletal research would be beneficial.

Background: Fatty infiltration, or fatty atrophy, of the abductor digiti minimi (ADM) muscle of the foot is proposed to be associated with entrapment of the first branch of the lateral plantar nerve (i.e., Baxter's neuropathy) as part of plantar heel pain (PHP). However, this association has not been rigorously investigated. The aim of this study was to determine if there is an association between PHP and fatty infiltration of ADM. Methods: This cross‐sectional observational study compared 50 participants with PHP to a control group of 25 participants without PHP who were matched at recruitment for age (± 5 years), sex and body mass index (BMI) (± 10%). Fatty infiltration of ADM was assessed on all participants using magnetic resonance imaging (MRI). Prior to assessment, four grading scales of fatty infiltration were investigated for reliability by two independent assessors using Kappa or weighted Kappa and the most reliable scale was chosen for the primary data analysis. Following this, participant characteristics were compared between the PHP and the no‐PHP groups using Chi‐squared, Mann‐Whitney U or independent samples t ‐tests to ensure there were no significant differences between the two groups in characteristics that could have confounded the findings. The association between PHP and fatty infiltration was analysed using the Chi‐square test ( χ ² ). Results: In the PHP and no‐PHP groups, respectively, the mean age was 49.1 and 48.9 years, women comprised 58% and 56%, and the mean BMI was 30.6 and 30.2 kg/m ² . A four‐point grading scale was found to be the most reliable scale (0.87 and 0.92 for inter‐ and intra‐rater reliability, respectively). There were no significant differences ( p > 0.05) for important participant characteristics (e.g., age, sex and BMI). There was some fatty infiltration (grades 1–3) in 78% and 96% of participants in the PHP and no‐PHP groups respectively. No significant association was found ( χ ² = 6.176, df = 3, p = 0.103) between PHP and fatty infiltration according to the four‐point grading scale. Conclusions: After accounting for age, sex and BMI, there was no association between PHP and fatty infiltration of ADM. These findings suggest that adults with PHP do not have a greater predisposition for or amount of fatty infiltration of ADM compared to adults without PHP. Therefore, fatty infiltration of ADM is likely to be an incidental finding on MRI rather than a diagnostic sign of PHP, where Baxter's neuropathy may be present. Accordingly, clinicians should not focus on fatty infiltration of ADM on MRI to diagnose Baxter's neuropathy, or view it as a proxy marker, particularly when surgery for PHP is being considered.

Background: Foot and ankle muscle strengthening exercises are common interventions for many musculoskeletal conditions that are associated with pain and limited function in the lower limb. The scientific literature has a multitude of strengthening exercises recommended, and they have been criticized for not adhering to best practice and for being poorly reported. The aims of this scoping review were to (i) describe what foot and ankle strengthening exercises have been recommended in the scientific literature, (ii) compare the prescription of these exercises to best practice recommendations, and (iii) assess the completeness of the reporting of these exercises and exercise programs.Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. A systematic search of peer‐review journal articles was conducted on 23 February 2023. Study designs that were included were experimental, quasi‐experimental, feasibility, pilot studies, and observational. For each study included in the review, study design and participant details such as age, sex, and conditions treated were noted. To describe the foot and ankle strengthening exercises, each exercise was noted, which included its name, the number of sets and repetitions recommended, the load type and its magnitude, and whether there were any progression strategies. Exercises were grouped according to primary movement and a general exercise descriptor. To compare to best practice, each program's prescription parameters of frequency, intensity, and time were compared to the American College of Sports Medicine's (ACSM) guidelines. To assess completeness of reporting, each study was assessed with the Consensus on Exercise Reporting Template (CERT).Results: The search yielded 1511 documents, and 87 were included after full‐text screening. Of the included studies, most were randomized controlled trials, and the most common participants were healthy adults (mean age range: 18–83 years). Across all studies, a total of 300 foot and ankle exercises were prescribed. The most common strengthening exercise category involved ankle plantar flexion (25% of 300 exercises), followed by plantar foot intrinsics (16%). The most common prescription of strengthening exercises included 3 sets (37%) of 10 repetitions (38%) performed 3 times per week (34%), often without a prescribed load (66%). Prescribed sets per muscle group met ACSM recommendations for novice lifters in 93% of studies. In contrast, load intensity (for increasing muscle strength) was prescribed at the recommended dose of 60% of 1 repetition maximum or greater in only 2% of exercises. The median score for completeness of reporting according to the CERT checklist was 31% of all items.Conclusions: This scoping review found that the studies predominantly included ankle plantar flexion and plantar foot intrinsic muscle strengthening exercises, typically prescribed at 3 sets of 10 repetitions, 3 times per week. When compared to best practice recommendations, load intensity in exercise prescription is commonly less than recommended or is not reported. In addition, the review highlights deficiencies in the reporting of exercise programs. We propose using established best‐practice exercise prescription guidelines like those from the ACSM and the adoption of CERT for reporting exercises in the scientific literature.

Background: People with plantar heel pain (PHP) have reduced foot and ankle muscle function, strength and size, which is frequently treated by muscle strengthening exercises. However, there has been little investigation of what exercises are used and there is no sound evidence base to guide practice. This study aimed to develop a consensus‐driven progressive muscle strengthening program for PHP. Methods: Thirty‐eight experts were invited to participate in the study over three rounds. Round 1 was an open‐ended questionnaire that provided the core characteristics of progressive strengthening programs designed for three different adult patient types with PHP (younger athletic, overweight middle‐aged, older), which were presented as vignettes. In Round 2, experts indicated their agreement to the proposed exercises and training variables. In Round 3, experts were presented with amendments to the exercises based on responses from Round 2 and indicated their agreement to those changes. Consensus was achieved when > 70% of experts agreed. Results: Two experts were ineligible and 12 declined, leaving 24 (67%) who participated in Round 1. Eighteen (75%) completed all three rounds. From Round 1, progressive strengthening programs were developed for the three vignettes, which included 10 different exercises and three training variables (sets / repetitions, weight, and frequency). In Round 2, 68% (n = 17) of exercises and 96% (n = 72) of training variables reached consensus. In Round 3, only exercise changes were presented and 100% of exercises reached consensus.Conclusions: This study provides three progressive strengthening programs agreed to by experts that can be used in future clinical trials to determine the effectiveness of muscle strengthening for PHP. In addition, clinicians could use the programs as part of a rehabilitation strategy with the caveat that they may change as more research is conducted.