A mediation analysis showcases the mechanisms underlying the effects of a cost-effective foot-ankle exercise program in modifying clinical and biomechanical outcomes.

A 12-week foot-ankle exercise program effectively improved foot function, mediated by reduced foot pain and enhanced ankle plantar flexion angle during push-off.

Foot function mediated the impact on forefoot peak pressure, while sagittal ankle ROM during gait stance phase mediated its effects on the forefoot pressure–time integral.

The growth in volume of randomized controlled trials (RCTs) of neurological physical therapy interventions in adults and paediatrics indexed to PEDro was accompanied by an increase in the methodological quality.

The methodological quality of RCTs of neurological physical therapy in adults and paediatrics is improving (mean=5.3), but is still suboptimal.

Journals Impact Factor and Journal Citation Indication were weakly correlated with the methodological quality of the trials.