A Rasch Analysis of the Manchester Foot Pain and Disability Index

Background: There is currently no interval-level measure of foot-related disability and this has hampered research in this area. The Manchester Foot Pain and Disability Index (FPDI) could potentially fill this gap. Objective: To assess the fit of the three subscales (function, pain, appearance) of the FPDI to the Rasch unidimensional measurement model in order to form interval-level scores. Methods: A two-stage postal survey at a general practice in the UK collected data from 149 adults aged 50 years and over with foot pain. The 17 FPDI items, in three subscales, were assessed for their fit to the Rasch model. Checks were carried out for differential item functioning by age and gender. Results: The function and pain items fit the Rasch model and interval-level scores can be constructed. There were too few people without extreme scores on the appearance subscale to allow fit to the Rasch model to be tested. Conclusion: The items from the FPDI function and pain subscales can be used to obtain interval level scores for these factors for use in future research studies in older adults. Further work is needed to establish the interval nature of these subscale scores in more diverse populations and to establish the measurement properties of these interval-level scores.