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Table 4 The most frequent ICF categories linked to concepts derived from PsA-related foot involvement for each ICF component and the extent of coverage by the LFIS-RA

From: Linking the effect of psoriatic arthritis-related foot involvement to the Leeds Foot Impact Scale using the International Classification for Functioning, Disability and Health: a study to assess content validity

ICF component

ICF category

Concepts derived from PsA-related foot involvement

Percentage coverage by the LFIS-RA, n (%)

Body structures

s75021: Ankle joint and joints foot and toes

‘joints’, ‘ankle joint’, ‘toes’

 
 

s8104: Skin of lower extremity

‘skin’

 
 

s8301: Toenails

‘toenails’

 
 

s7502: Structure of ankle and foot

‘ankle’, ‘heel’, ‘arch’, ‘midfoot’, ‘ball of foot’, ‘forefoot’, ‘sole’

5 (100%)

 

s75022: Muscles of ankle and foot

‘tendons’, ‘Achilles tendon’

 
 

S75023: Ligaments and fascia of ankle and foot

‘plantar fascia’

 

Body functions

b28015: Pain in lower limb

‘sore’, ‘throbbing’, ‘sharp’, ‘burning’, ‘aching’, ‘severe’, ‘tender’, ‘unbearable’, ‘unpredictable’, ‘constant’

9 (22%)

 

b152: Emotional functions

‘frustrating’, ‘sad’, ‘upset’, ‘embarrassed’, ‘frightening’, ‘envy’, ‘helpless’, ‘depressed’, ‘bad tempered’

11 (27%)

 

b1801: Body image

‘revolting’, ‘ugly’, ‘not normal’, ‘I hate the way they look’, ‘disfiguring’, ‘everybody’s eyes goes there’, ‘hide my feet’, ‘I cover up the legs’, ‘don’t want to look outwardly disabled’, ‘it doesn’t feel good’, ‘I don’t want to be noticeable’

2 (5%)

 

b810: Protective functions of skin

‘psoriasis’, ‘hard skin’, ‘thin skin’, ‘dry cracked’, ‘splits’, ‘thick skin’, ‘corn’

 
 

b860: Functions of nails

‘thick’, ‘lift-up’, ‘hard’, ‘pitting’, ‘split’, ‘thin’, ‘discoloured’, ‘wave-shaped’, ‘break off easily’, ‘build-up under the nail’

 
 

b126: Temperament and personality functions

‘I like to hide my pain’, ‘if I was in pain I would still force myself to participate’, ‘I just put up with it’, ‘plan for my feet and shoes’

 
 

b770: Gait pattern functions

‘slower’, ‘limping’, ‘shuffle’, ‘hobbling’

5 (12%)

Activities and participation

d450: Walking

‘limited walking activity’, ‘cannot walk barefoot’, ‘painful walking’, ‘cannot walk for long’

7 (22%)

 

d5702: Maintaining one’s health

‘you name it I’ve tried it’, ‘getting advice and getting feet checked’, ‘I can’t actually look under the sole of my foot’, ‘I try to look after myself as much as I can’

 
 

d850: Remunerative employment

‘unemployed’, ‘I quit my job, because it was mostly you have to stand’, ‘difficulty sitting for long periods at work’, ‘walking at work’, ‘I want to continue working’

 
 

d5200: Caring for skin

d5204: Caring for toenails

‘moisturising feet’, ‘foot baths’, ‘filing callus’, ‘corns removed’, ‘difficult to cut’, ‘nail polish’, ‘I can’t cut my toenails’

 
 

d230: Carrying out daily routine

‘can’t do what I want to do’, ‘limits daily activities’, ‘have to keep doing things’, ‘I don’t do much’, ‘difficulty with housework’, ‘makes things difficult’, ‘I can’t do a quarter of the stuff I used to do’, ‘I still have to do what I have to do, I just try and rest in between’

6 (18%)

 

d760: Family relationships

‘want to stay healthy for my family and kids’, ‘loss of family time’, ‘burdening the family’, ‘parenting’, ‘affects relationships’, ‘I’m a disappointment to my wife’

 
 

d920: Recreation and leisure

‘my social life was ruined’, ‘gym’, ‘I used to play soccer’, ‘with my ankle now I can’t exercise’, ‘wedding and formal functions’, ‘stuck at home’, ‘I can’t really go out with friends much’, ‘I don’t like to go out’

1 (3%)

Environmental factors

e1150: General products and technology for personal use in daily living

‘difficulty finding nice looking shoes’, ‘unable to find comfortable shoes’, ‘need wide shoes - bigger size’, ‘cannot wear high-heels’, ‘very limited in the type of shoe’, ‘cannot find suitable shoes for work’, ‘wear the same shoes all the time’, ‘can’t wear open shoes’, ‘closed-in’, ‘need a flexible heel-counter’, ‘can’t wear the clothes you want’

9 (60%)

 

e580: Health services, systems and policies

‘accessing podiatry services’, ‘under the care of rheumatology’, ‘delayed diagnosis’

 
 

e1151: Assistive products and technology for personal use in daily living

‘insoles’, ‘insert’, ‘foot orthotic’

 
 

e355: Health professionals

‘podiatrist’, ‘rheumatologist’, ‘physiotherapist’, ‘orthopaedic surgeon’

 
 

e225: Climate

‘summer’, ‘winter’, ‘low-pressure systems’, ‘in summer I find like my foot is quite swollen’

 
 

e1101: Drugs

‘cortisone injection’, ‘biologics’, ‘pain killers’, ‘steroid creams’

 
 

e445: Attitudes of strangers

‘other people just don’t realise’, ‘feeling judged’, ‘they think I look healthy’, ‘they don’t understand how it does affect your life with getting up, walking, just simple things’, ‘there’s just no recognition, understanding or acceptance at all’

 
 

e310: Immediate family

‘my son has got skin psoriasis…a worse state than mine’, ‘thankfully they’re quite understanding’, ‘they helped me a lot’, ‘supportive’

 
  1. ICF international Classification of Functioning, Disability and Health, LFIS-RA Leeds Foot Impact Scale in rheumatoid arthritis, PsA Psoriatic arthritis