Quality of life of children with calcaneal apophysitis

Ms Alicia James1,2, Dr.  Cylie  Williams1,2, Professor  Terry Haines2,3

1Peninsula Health , Frankston, Australia, 2Monash University, Peninsula Campus, Australia, 3Monash Health, Cheltenham, Australia


The aim of this study was to assess and compare the child and parent perceptions of health related quality of life (HRQOL) associated with calcaneal apophysitis.


This is a longitudinal repeated measure study nested within a randomized comparative effectiveness trial. Children who had symptoms of calcaneal apophysitis were recruited from the caseload of podiatrists. The Oxford Ankle Foot Questionnaire for Children (OxAFQ-C) was completed at five time points by both child and parent.

The demographic data were summarised with means and standard deviations and OxAFQ-C summarised with medians and interquartile ranges. The intraclass correlation coefficient (ICC) (Model 2 (2)) analysis was undertaken to compare the inter rater reliability between the child and parent proxy report. Criterion validity between parent and child for the domains of the OxAFQ-C was explored with the Bland Altman plot and the mean difference.


A total of 124 participated in the study with 101 completing the OxAFQ-C at all five time points. The inter-rater reliability between the child and parent for the physical domain ranged between poor (0.06) to good (0.77) agreement, and the footwear domain ranged between poor (0.09) to good (0.66) across the time points. Both the school and emotional domains had moderate (0.46) to good (0.77) agreement.


Children with calcaneal apophysitis have differing perceptions of health related HRQOL impact compared to their parents. Parents initially reported greater impact than their child however there was convergence of agreement over time. These findings suggest understanding the impact from both child and parent perspective is imperative during treatment.