Outcome measures for first MPJ pain

NewsBot · Mar 25, 2019

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Comparative Responsiveness of Outcome Measures for the Assessment of Pain and Function in First Metatarsophalangeal Joint Osteoarthritis
Hylton B. Menz Maria Auhl Jade M. Tan Pazit Levinger Edward Roddy Shannon E. Munteanu
25 March 2019

Objective
To assess the comparative responsiveness of outcome measures used for the assessment of pain and function in individuals with first metatarsophalangeal joint osteoarthritis (1st MTPJ OA).

Methods
Eighty‐eight people (mean age [SD] 57.2 [10.2] years) with 1st MTPJ OA who participated in a randomised trial completed the Foot Health Status Questionnaire (FHSQ), the Foot Function Index Revised Short Form (FFI‐RS), and 100 mm visual analog scales (VAS) of pain and stiffness at baseline and 12 weeks. Responsiveness of the subscales for each outcome measure was determined using paired t‐tests, Cohen's d, the standardised response mean (SRM), and the Guyatt index (GI). Sample size estimations were calculated based on minimal important differences (MIDs).

Results
All outcome measures were sensitive to change and demonstrated at least medium effect sizes. Three outcome measures exhibited large or very large effect sizes for Cohen's d, SRM, and GI: the FHSQ pain subscale (d=1.03; SRM=1.10, GI=1.30), the FFI‐R pain subscale (d=1.09; SRM=1.05, GI=1.73), and the 100 mm VAS of pain severity while walking (d=1.22; SRM=1.07, GI=1.78). Sample size calculations indicated that between 20 and 33 participants per group would be required to detect MIDs using these measures.

Conclusion
The FHSQ pain subscale, FFI‐RS pain subscale, and the 100 mm VAS of pain severity while walking are the most responsive outcome measures for the assessment of pain and function in individuals with 1st MTPJ OA. These findings provide useful information to guide researchers in selecting appropriate outcome measures for use in future clinical trials.
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NewsBot · Jun 16, 2023

First Metatarsophalangeal Joint Pain in Athletes: Diagnosis, Management, and Return to Play Considerations
Lim, Sara MD; Liem, Brian MD
Author Information
Current Sports Medicine Reports 22(6):p 217-223, June 2023. | DOI: 10.1249/JSR.0000000000001076

The first metatarsal-phalangeal joint plays a key role for athletes of various disciplines. When an athlete presents for evaluation of pain at this joint, there are several causes that should be considered. The purpose of this article is to review common injuries including turf toe, sand toe, extensor and flexor hallucis longus tendinopathy, sesamoiditis, and metatarsalgia and provide current evidence-based recommendations for diagnosis, management, and return to play considerations. Conditions not specific to athletes like gout and hallux rigidus also are discussed. Mechanism of injury, physical examination, and imaging such as weight-bearing radiographs and point-of-care ultrasound can help with diagnosis. Treatment of many of these injuries begins with nonsurgical management strategies including footwear or activity modification, physical therapy, and select interventions.
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