New approach to the diagnosis and classification of chronic foot and ankle disorders: identifying motor control and movement impairments.

The prevalence of foot and ankle (F&A) disorders is high. While chronic and recurrent F&A disorders are broadly documented in the literature, their underlying mechanisms have not been well defined. Currently, patho-anatomical, biomechanical and signs and symptoms (Si&Sy) models are widely used to diagnose and classify musculoskeletal F&A disorders. Within a multi-factorial bio-psychosocial framework, these models have limitations in identifying the underlying mechanisms that maintain chronic pain and disability. Therefore, a new approach to the diagnosis and classification of chronic F&A disorders is suggested in this Masterclass. This new approach is based on identifying the underlying mechanisms of the F&A disorder. This Masterclass aims to define and describe patterns of directional motor control and movement impairment of the F&A region based on the principal author's clinical observations. Such definition and description should lead to improved identification of consistent patterns. The basis of directional motor control and movement impairment patterns is proposed. As an example, one motor control and one movement impairment pattern is described in more detail. This Masterclass can be regarded as a prerequisite for future validation studies investigating the clinical applicability of adapting and implementing this novel classification system.