Systematic review of measurement instruments for patients with juvenile idiopathic arthritis in the foot and ankle

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. The part of the body most commonly affected, and where cysts are most likely to form, is in the small joints of the foot. The aim of this review was to identify self-reported outcome measures specific to the foot and ankle in patients with JIA and to investigate the methodological quality and psychometric properties of these measures. EVIDENCE ACQUISITION: A search was conducted for JIA in the PubMed, SCOPUS, CINAHL, PEDro and Google Scholar databases. The systematic review performed was based on the following inclusion criteria: population (with JIA) aged under 16 years; validation studies of patient-reported outcomes specific to the foot and ankle, in various languages, with no time limit. Two authors independently evaluated and assessed the quality of the studies, and extracted data using Terwee's criteria and the COSMIN checklist. No meta-analysis was carried out. due to the heterogeneity of the dimensions and outcomes included in each study. EVIDENCE SYNTHESIS: Of the initial 67 studies considered, only five met the inclusion criteria for this review. Many of these studies presented significant methodological flaws, in areas such as construct validity, responsiveness, floor/ceiling effect and interpretability. CONCLUSIONS: Despite the very low quality of the available evidence, the Italian-language adaptation of the Oxford Ankle Foot Questionnaire presents acceptable methodological quality. However, further studies, with greater methodological rigor, are required. A review of psychometric properties and methodological quality of evidence for each Patient Reported Outcome Measures specific for the foot and ankle affected by juvenile idiopathic arthritis is provided.