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The aim of the present study was to determine the gender respiratory differences of bilateral diaphragm thickness, respiratory pressures, and pulmonary function in patients with low back pain (LBP). A sample of 90 participants with nonspecific LBP was recruited and matched paired by sex (45 women and 45 men). Respiratory outcomes included bilateral diaphragm thickness by ultrasonography, respiratory muscle strength by maximum inspiratory (MIP) and expiratory (MEP) pressures, and pulmonary function by forced expiratory volume during 1 s (FEV 1 ), forced vital capacity (FVC) and FEV 1 /FVC spirometry parameters. The comparison of respiratory outcomes presented significant differences ( p < 0.001), with a large effect size ( d = 1.26-1.58) showing means differences (95% CI) for MIP of -32.26 (-42.99, -21.53) cm H 2 O, MEP of -50.66 (-64.08, -37.25) cm H 2 O, FEV 1 of -0.92 (-1.18, -0.65) L, and FVC of -1.00 (-1.32, -0.69) L, with lower values for females versus males. Gender-based respiratory differences were presented for maximum respiratory pressures and pulmonary function in patients with nonspecific LBP. Women presented greater inspiratory and expiratory muscle weakness as well as worse lung function, although these differences were not linked to diaphragm thickness during normal breathing.

Background: The Rheumatoid Arthritis Foot Disease Activity Index (RADAI-F5) questionnaire, based on five questions, is used to assess the severity of rheumatoid arthritis disease in the foot. Nowadays, RADAI-F5 has been validated in different languages; however a Spanish version was lacking. Therefore, the purpose of this research was to translate and validate the Spanish version (RADAI-F5-es). Methods: A cross-cultural translation of the RADAI-F5 questionnaire was performed from English to Spanish. To validate its use, 50 subjects with rheumatoid arthritis who responded to the translated questionnaire two times in an interval of less than 3 months were selected in order to verify the psychometric properties. Results: Excellent agreement between the two versions according to the Cronbach's α was shown. Five domains with regards to arthritis activity in foot joint tenderness and swelling, foot arthritis pain, general foot health and joint stiffness were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for joint stiffness on awakening and foot arthritis pain domains. There were no significant differences among any domains ( p > 0.05). There were no statistically significant differences ( p = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75-102.43] and 97.96 ± 13.88 [94.5-101.86] points, respectively). Bland-Altman plots or clinically pertinent variations were not statistically significantly different. Conclusions: The RADAI-F5-es is considered a valid and strong tool with adequate repeatability in the Spanish community.

In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with ( n = 32) and without ( n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences ( p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences ( p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.

The use of rehabilitative ultrasound imaging (RUSI) to evaluate diaphragm thickness during breathing in athletes who suffer from non-specific lumbopelvic pain presents some measurement errors. The purpose of this study was to evaluate intra- and inter-sessions, intra- and inter-rater reliabilities, and concurrent validity of diaphragm thickness measurements during breathing using transcostal RUSI with a novel thoracic orthotic device that was used to fix the US probe versus those measurements obtained using manual fixation. A total of 37 athletes with non-specific lumbopelvic pain were recruited. Intra- (same examiner) and inter-rater (two examiners) and intra- (same day) and inter-session (alternate days) reliabilities were analyzed. All measurements were obtained after manual probe fixation and after positioning the thoracic orthotic device to fix the US probe in order to correctly correlate both measurement methods. Both left and right hemi-diaphragm thickness measurements were performed by transcostal RUSI at maximum inspiration, expiration, and the difference between the two parameters during relaxed breathing. Intra-class correlation coefficients (ICC), standard errors of measurement (SEM), minimum detectable changes (MCD), systematic errors, and correlations ( r ) were assessed. Orthotic device probe fixation showed excellent reliability (ICC = 0.852-0.996, SEM = 0.0002-0.054, and MDC = 0.002-0.072), and most measurements did not show significant systematic errors ( p > 0.05). Despite manual probe fixation with a reliability ranging from good to excellent (ICC = 0.714-0.997, SEM = 0.003-0.023, and MDC = 0.008-0.064 cm), several significant systematic measurement errors ( p < 0.05) were found. Most significant correlations between both orthotic device and manual probe fixation methods were moderate ( r = 0.486-0.718; p < 0.05). Bland-Altman plots indicated adequate agreement between both measurement methods according to the agreement limits. The proposed novel thoracic orthotic device may allow ultrasound probe fixation to provide valid and reliable transcostal RUSI measurements of diaphragmatic thickness during relaxed breathing thus reducing some measurement errors and avoiding systematic measurement errors. It may be advisable to measure diaphragm thickness and facilitate visual biofeedback with respect to diaphragm re-education during normal breathing in athletes with non-specific lumbopelvic pain.

Background: Kinesiophobia can be an obstacle to physical and motor activity in patients with Parkinson's disease (PD). PD affects patients' independence in carrying out daily activities. It also impacts a patient's biopsychosocial well-being. The objective of this study was to analyze the levels and scores of kinesiophobia in PD patients and compare them with healthy volunteers., Methods: We deployed a case-control study and recruited 124 subjects (mean age 69.18 ± 9.12). PD patients were recruited from a center of excellence for Parkinson's disease (cases n = 62). Control subjects were recruited from the same hospital (control n = 62). Kinesiophobia total scores and categories were self-reported using the Spanish version of the Tampa Scale of Kinesiophobia (TSK-11)., Results: Differences between cases and control groups were analyzed using the Mann-Whitney U test. Statistically significant differences ( p < 0.05) were shown between groups when comparing kinesiophobia categories (or levels) and total scores, revealing higher kinesiophobia symptoms and levels in PD patients. All of the PD patients reported some degree of kinesiophobia (TSK-11 ≥ 18), while the majority of PD patients (77.3%) had kinesiophobia scores rated as moderate to severe (TSK-11 ≥ 25). On the other hand, ~45.1% of controls reported no or slight kinesiophobia and 53.2% reported moderate kinesiophobia., Conclusions: Total kinesiophobia scores were significantly higher in PD patients compared with healthy controls, with moderate to severe kinesiophobia levels prevailing in PD patients. Therefore, individuals living with PD should be evaluated and controlled in order to detect initial kinesiophobia symptoms.

Background: The analysis of the center of pressure (COP) is a method used to assess the foot function, but its reliability and repeatability have not been evaluated. COP can be altered by diverse conditions, like an excessive foot pronation. Low-Dye taping is commonly used for the treatment of symptoms related to an excessive pronation. To date, no study has evaluated the effects of the Low-Dye taping on COP and the duration of its effects. Thus, the main purpose of this manuscript was to assess the reliability and repeatability of the percentage of center of pressure locus area (%CLA) in feet with an excessive pronation, and secondarily, to assess that the Low-Dye taping modifies the %CLA during the immediate 48 h., Methods: An observational study of the reliability and repeatability of the %CLA variable with the Low-Dye taping in feet with excessive pronation was carried out. We used the EPS-Platform to evaluate the results of the variable in 6 conditions in a first session to evaluate the reliability of the results. We compared the results of the first session with the results in a second session to evaluate the repeatability of the results. We also carried out an ANOVA test to evaluate the changes that the taping produced in the variable between without taping with the rest of the 6 conditions., Results: For the %CLA, we observed a reliability greater than 0.80, measured by the interclass ratio index, both in the first session before taping, and in the second session before taping, thus being a repeatability variable. In the following times, with taping, at 10 min with tape, at 20 min with tape, at 24 h with tape and at 48 h with tape; an interclass ratio coefficient (ICC) higher than 0.80 was again obtained, thus being a reliable variable in all measurements made. The Low-Dye taping did not change %CLA from the time the tape was put in until 48 h ( p -value = 1.000)., Conclusions: The %CLA variable, in feet with excessive pronation, proved to be a reliable variable in all the measurements obtained before putting on the tape and during the following 48 h with the tape, and a repeatable variable. The Low-Dye taping did not change the %CLA from the time the tape was put in until 48 h.

Parkinson's disease is a common neurodegenerative disease and it is known to cause motor disturbances associated with musculoskeletal problems of the locomotor apparatus, and non-motor symptoms, that are believed to have a harmful effect on health, social functioning and mobility. The aim of this study was to evaluate depression in patients with Parkinson's Disease (PD) compared to subjects who do not have it. The sample consisted of 124 participants (mean age 69.18 ± 9.12). Patients with PD were recruited from a center of excellence for Parkinson's disease (cases n = 62) and healthy subjects without PD from their relatives and caregivers (control n = 62). The Spanish version of Beck's Depression Inventory (BDI) scores and categories were collected. A clear statistically significant difference ( p < 0.05) was evident in the BDI scores between both groups. Parkinson's patients presented worse results on the BDI = 15.48 ± 7.24 points compared to healthy subjects with BDI = 7.03 ± 6.99 points. Regarding BDI categories, there were statistically significant differences ( p < 0.001) for the greater BDI categories in the Parkinson's group compared with healthy subjects. The depression represents an important potential risk for increased symptoms and negative impact among patients with PD compared with healthy subjects.

Frailty is a condition that can increase the risk of falls. In addition, foot pain can influence older adults and affect their frail condition. The main objective was to measure the frailty degree in older adults in a Spanish population with foot pain from moderate to severe., Method: This is a cross-sectional descriptive study. A sample of people older than 60 years ( n = 52), including 26 males and 26 females, were recruited, and frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS)., Results: Spearman's correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69), or strong (0.70 ≤ rs ≥ 1.00). There was a statistically significant correlation for the total score ( p < 0.001) and most of the subscales of the 5-Frailty scale compared with the EFS, except for Mood ( p > 0.05). In addition, females and males showed similar 5-Frailty and Edmonton Frail scales scores with no difference ( p > 0.05)., Conclusion: Foot pain above 5 points, i.e., from moderate to severe, does not affect the fragility more in one sex than another.

Objectives : Our primary aim was to develop a transcultural adaptation of a cycling questionnaire using the Borg CR-10 scale as a tool to describe the discomfort among motorcyclists during the riding process in two trial sessions. Design : A transcultural adaptation and descriptive cross-sectional study. Settings : Jarama motorcycling circuit (Madrid, Spain). Participants : The participants were riders recorded across in a final motorcycling race. Interventions: The study design is based in two tools, the adapted Motorcyclist Questionnaire (MQ-21) with 21 items and Borg CR10 Scale ® was used to determine discomfort level during motorcycling performance. The translation procedure, reliability, and reproducibility were performed. Results : All items showed an almost perfect intraclass correlation coefficient (ICC) (ICC = 0.909-1.00), except for item 9 (ICC = 0.881). Almost perfect internal consistency was shown for the total score (Cronbach α = 0.899). No systematic differences existed among test and retest in all items ( p > 0.05) according to Bland-Altman plots. Respondents experienced slight discomfort on their body parts during the test-retest 1 h riding process. Foot discomfort was scored as 1.20, being the eighth of the 12 studied body parts. Conclusions: Internal consistency and test-retest reliability of the MQ-21 questionnaire were excellent and this questionnaire may be recommended to be used in motorcycling sports and clinical settings to evaluate the discomfort.

: Nowadays, the use of insoles in sport practice have been recognized to decrease the foot and lower limb injury patterns. The aim of this study was to analyse the effect of four types of hardness insoles (HI) in the activity patterns of the hip and thigh muscles (HTM) in motoriders during motorcycling sport. The study was a crossover trial. Subjects were elite motoriders. The mean age was 33 ± 5.14 years. Electromyography (EMG) of hip and thigh muscles (HTM) data was registered via surface while subjects were riding on an elite motorcycle simulator. Subjects had to complete different tests with randomly hardest insoles (HI ) : 1: only polypropylene (58° D Shore); 2: Polypropylene (58° D Shore) with selective aluminium in hallux and metatarsal heads (60 HB Brinell hardness); 3: Ethylene vinyl acetate (EVA) (52° A Shore); and finally, 4: Ordinary EVA (25° A Shore) as the control. EMG patterns of the HTM, riding on an elite motorcycle simulator, showed the lowest peak amplitude with the insoles with polypropylene and selective aluminium. Using the hardest insoles in our study (selective aluminium) the EMG amplitude peaks decreased in all HTM., Competing Interests: The authors declare no conflict of interest.

Background: Hallux valgus (HV) has been previously associated with psychological disorders. Thus, the purposes of this study were to associate kinesiophobia and pain intensity with HV deformity degrees, as well as predict kinesiophobia and pain intensity based on HV deformity and demographic features., Methods: A cross-sectional study was carried out recruiting 100 subjects, who were divided into HV deformity degrees, such as I-no HV (n = 25), II-mild (n = 25), III-moderate (n = 25), and IV-severe (n = 25) HV. Kinesiophobia total and domains (activity avoidance and harm) scores and levels were self-reported by the Tampa Scale of Kinesiophobia (TSK-11). Pain intensity was self-reported by the numeric rating scale (NRS)., Results: Statistically significant differences ( p < 0.01; η 2 = 0.132-0.850) were shown for between-groups comparison of kinesiophobia total and domain scores (activity avoidance and harm) and levels, as well as pain intensity among HV deformity degrees. Post hoc comparisons showed statistically significant differences with a large effect size ( p < 0.05; d = 0.85-4.41), showing higher kinesiophobia symptoms and levels and pain intensity associated with greater HV deformity degrees, especially for III-moderate and/or IV-severe HV deformity degrees versus I-no HV and/or II-mild deformity degrees. Both statistically significant prediction models ( p < 0.05) for kinesiophobia ( R 2 = 0.300) and pain intensity ( R 2 = 0.815) were predicted by greater HV deformity degree and age., Conclusions: Greater kinesiophobia symptoms and levels and pain were associated with higher HV deformity degrees, especially severe and/or moderate HV with respect to no and/or mild HV. The kinesiophobia and pain intensity were predicted by greater HV deformity degree and age.

Background and Objectives : Foot problems may be considered to be a prevalent condition and impact the health-related quality of life (QoL). Considering these Spanish-validated tools, the Foot Health Status questionnaire (FHSQ) may provide a health-related QoL measurement for specific foot conditions and general status. To date, the domains of the FHSQ and Medical Outcomes Study Short Form 36 (SF-36) have not been correlated. Therefore, the main aim of this study was to correlate the domains of the FHSQ and SF-36 in patients with foot problems. Materials and Methods: A cross-sectional descriptive study was carried out. A sample of 101 patients with foot problems was recruited. A single researcher collected descriptive data, and outcome measurements (FHSQ and SF-36) were self-reported. Results: Spearman's correlation coefficients ( r s ) were calculated and categorized as weak ( r s = 0.00-0.40), moderate ( r s = 0.41-0.69), or strong ( r s = 0.70-1.00). In all analyses, statistical significance was considered with a p -value < 0.01 with a 99% confidence interval. Statistically significant differences ( p < 0.01) were found between all domains of FHSQ and SF-36, except for the mental health domain of the SF-36 with foot pain, foot function, and general foot health of the FHSQ, as well as between the vitality domain of the SF-36 and the general foot health domain of the FHSQ ( p > 0.01). Statistically significant correlations varied from week to strong ( r s = 0.25-0.97). The strongest correlations ( p < 0.001) were found for physical activity and physical function ( r s = 0.94), vigor and vitality ( r s = 0.89), social capacity and social function ( r s = 0.97), and general health domains of the SF-36 and FHSQ. Conclusions: The FHSQ and SF-36 showed an adequate concurrent validity, especially for the physical activity or function, vigor or vitality, social capacity or function, and general health domains. Nevertheless, the mental health domain of the SF-36 should be considered with caution., Competing Interests: The authors declare no conflict of interest.

Background and objectives : Stress in nursing students is a very common experience, especially when they face clinical practice. The aims of this study were to perform a transcultural adaptation and to examine the reliability and repeatability of the Instrument for the Assessment of Stress in Nursing Students for a Spanish population. Methods : A test-retest analysis was carried out in two face-to-face sessions with the students with a lapse of 10 days between the two sessions. A cross-sectional descriptive study was carried out between the months of May and June 2018. Sixty-four nursing students were recruited with a consecutive sampling method that targeted individuals in the freshman class. Results : A good internal consistency was shown for the total score (α = 0.8861) and for each of the six domains. The test-retest reliability, using the Wilcoxon paired test, was not significant, indicating no differences between the total scores or the domain scores ( p ≥ 0.05). Finally, Bland and Altman plots of visual distributions did not show differences between the total scores and the domain scores. Conclusion : The Instrument for the Assessment of Stress in Nursing Students was shown to be a reliable tool for measuring stress factors among Spanish nursing students., Competing Interests: The authors declare no conflict of interest.

Background: The main purpose of this research was to determine the stability of three different sanitary shoes on nurses with eyes open and closed with respect to barefoot condition. In addition, the secondary aim was to determine the reliability of stability measurements under these different conditions., Methods: A crossover quasi-experimental study (NCT03764332) was performed. Twenty-six nurses who wore different sanitary shoes (Eva Plus Ultralight ® , Gym Step ® and Milan-SCL Liso ® ) were evaluated with respect to barefoot condition for stability measures on the Podoprint ® podobarometric and stabilometry tool and with eyes open and closed. Furthermore, the reliability of stability measurements was determined by the intraclass correlation coefficient (ICC) under these different conditions., Results: Between-groups comparisons of the static and stabilometry podobarometric data with eyes open showed statistically significant differences ( p < 0.05). Milan-SCL Liso ® sanitary shoes improved podobarometric data of forefoot force and distribution with respect to barefoot condition. Eva Plus Ultralight ® and Gym Step ® sanitary shoes increased the stroke length mean, stroke surface mean, and anterior speed mean as well as reduced y axis displacement mean with respect to barefoot condition. Similar findings were determined for measurements with eyes closed. ICCs ranged from poor to excellent reliability (ICC = 0.010-0.995)., Conclusions: Sanitary shoes improved podobarometric and stabilometry stability with respect to barefoot condition.

Customized foot insoles (CFI) have been recognized to reduce the prevalence of foot disorders in sport. The aim of this study was to evaluate the effect of four types of CFI on the activity patterns of the lower limb muscles (LLM) in healthy people during sport motorcycling., Methods: This was a cross-over trial (NCT03734133. Participants were recruited from an outpatient foot specialist clinic. Their mean age was 33 ± 5.14 years. While participants were sport motorcycling in a simulator, the electromyography (EMG) function was registered for LLM via surface electrodes. Participants completed separate tests while wearing one of four types of CFI: (1) only polypropylene (58° Shore D), (2) selective aluminum (60 HB Brinell hardness) in metatarsal and first hallux areas and polypropylene elsewhere (58° Shore D), (3) ethylene vinyl acetate (EVA) (52° Shore A), and (4) standard EVA (25° Shore A) as the control., Results: The activity patterns of the LLM while sport motorcycling showed significantly lower peak amplitude for the selective aluminum CFI than the other types of CFI., Conclusion: EMG amplitude peaks for several LLM were smaller for the hardest CFI (selective aluminum 60 HB Brinell hardness) than the other CFIs (polypropylene 58° Shore D, EVA 52° Shore A, and standard EVA 25° Shore A), except for the fibularis longus in right curves that is increased when the knee touches the road increasing the stability.

Background: Asthma may be considered as a non-communicable condition associated with higher bronchial responsiveness that may impair quality of life (QoL). Purpose: The research aim was to compare scores of depression, as well as general and foot health-related QoL, in patients who suffered from asthma with respect to healthy subjects. Methods: A total sample of 152 subjects, median age of 37.00 ± 16.00 years, were recruited from a respiratory and allergy department of a hospital and divided into patients with asthma ( n = 76) and healthy subjects ( n = 76). The scores of the Spanish foot health status questionnaire (SFHSQ) domains as well as the Spanish Beck's Depression Inventory (BDI) scores and categories were collected. Results: The only statistically significant difference ( p < 0.05) was shown for the difference of the FHSQ footwear domain establishing that patients who suffered from asthma presented a worse QoL related to foot health for footwear (lower FHSQ scores) compared to healthy matched-paired participants (higher FHSQ scores). Regarding the rest of the outcome measurements, there were no statistically significant differences ( p > 0.05) for the other FHSQ domains scores as well as the BDI scores and categories. Conclusions: Patients with allergic asthma presented impairment of the QoL related to foot health for footwear, which seemed to be linked to the presence of asthma.

Background: Hallux abductus valgus (HAV) is a forefoot condition produced by extrinsic and intrinsic factors. Shoes with a high heel height and a typical narrow tip toe box can induce deviations in both the proximal phalanx of the hallux (PPH) and the first metatarsal (IMTT) bones. Nevertheless, the isolated role of heel height remains unclear in the development of HAV pathology. Objectives: The goal was to determine if the heel height increase of shoes without a narrow box toe could augment the PPH and IMTT deviation in frontal, sagittal, and transverse planes toward the first metatarsophalangeal joint (MPJ) and the first metatarsocuneiform joint (MCJ), respectively, during static and dynamic conditions in relation to precursor movements of HAV. Methods: Women with an average age of 25.10 ± 4.67 years were recruited in this cross-sectional study to assess the three planes of motion of PPH and IMTT while wearing high heels with heights at 3, 6, 9 cm and unshod conditions via sandals. The measurements used an electromagnetic goniometer device with sensors placed on medial aspects of the PPH and IMTT bones under static and dynamic conditions. Results: Wearing shoes with a 6 cm heel in dynamic condition may increase the PPH valgus and abduction deviation from 3.15 ± 0.10° to 3.46 ± 0.05° (p < 0.05) and from 1.35 ± 0.28° to 1.69 ± 0.30° (p < 0.001), respectively. In addition, a PPH abduction increase from 1.01 ± 0.36° to 1.31 ± 0.46° (p < 0.05) after wearing shoes with a 6 cm heel height was observed under static conditions. Conclusions: Wearing shoes with a heel height of 6 cm without a narrow box toe interference may produce PPH abduction and valgus deviations related to HAV formation., Competing Interests: The authors declare no conflict of interest.

Onychomycosis is a fungal infection of nails that is widespread and difficult to treat because of the impermeable nature of human nails. Topically applied anti-fungal agents cannot penetrate this structure, and treatment regimens often resort to systemic antifungals with concomitant side effects. One recent clinical study suggested that mechanical fenestration of the nail using an intelligent nail drill might be a possible solution to this problem. In this work, an in vitro model of the transungual delivery of antifungal agents is presented, which utilizes real nail tissue and an inline flow system. This system was deployed to measure transungual delivery of ciclopirox and determined that nail fenestration improved drug delivery by 3⁻4-fold after 42 days. This study bolsters the argument that nail fenestration should be accepted as a pretreatment for onychomycosis and offers a way of evaluating new drugs or formulations designed to combat this condition.

Background : The Podiatric Health Questionnaire (PHQ) is a health-related questionnaire consisting of six questions designed for measuring foot health status. To date, the PHQ has only been validated in the English-language version. Thus, this study aimed to perform the Spanish translation and test⁻retest procedures of the PHQ (PHQ-S). Method : The forward/backward translation and test⁻retest reliability methods were applied from English to Spanish languages. Regarding the total score for each domain, internal consistency and reliability were determined by the Cronbach α and intraclass correlation coefficient (ICC) with a confidence interval (CI) of 95%. Results : High internal consistency was shown for the six domains: (1) walking with a Cronbach α of 0.97; (2) hygiene and nail care with 0.93 and 093, respectively; (3) foot pain with 0.91; (4) worry and concern domain with 0.904; (5) quality of life with 0.87; and (6) the self-perception of how their feet are feeling measured by a visual analogic scale with 0.92. Excellent test⁻retest reliability (ICC = 0.99 (95% CI = 0.96⁻0.98)) was shown for the total score. Conclusions : The PHQ-S was shown to be a valid and reliable tool for an acceptable use in the Spanish population.

Background: Variations in the foot structure related with the high or low arch are identified common lower limb conditions, and it is supposed to be the effect on the quality of life (QoL) associated to foot health in adults. Here we aimed to determine the relationships between relatively high and low feet arches and QoL., Methods: A cross-sectional study was carried out. Among 138 adults enrolled in the study, 66 had a high arch, 21 had a low arch, and 51 were within the normal range. Changes related to the foot structure were analyzed using Area Calc version 2.6 software, and data obtained using the Foot-Health-Status-Questionnaire (FHSQ), whose domains were compared between foot arch groups by means of the one-way analysis of variance (ANOVA)., Results: The results of the FHSQ comparison between the three groups within the sample population did not show any statistically significant difference ( p > 0.05) for any domains of specific foot (pain, function, general health and footwear) and general (general health, physical activity, social function and vigor) health-related QoL., Conclusions: Specific foot and general health-related QoL did not seem to be influenced by the foot arch height between high, normal and low feet arches heights. Nevertheless, further studies with higher sample sizes and matched-paired groups should be carried out.

Background : Down syndrome is the most common chromosomal abnormality and a cause of intellectual disability. It is also associated with orthopaedic and musculoskeletal problems of the locomotive apparatus, especially of the feet. These problems are believed to have a harmful effect on health, social functioning, and mobility. In addition, these persons generally don't have access to podiatric health services, even when their foot problems are well known, because of limited access to healthcare facilities. The goal of our research was to evaluate and compare the foot health status of study participants with and without Down syndrome and to determine whether inadequate footwear is being used with normalized reference values. Methods : A total of 105 participants with and without Down syndrome, with a mean age of 35.71 (SD = 12.93) years, were enrolled in the study. They self-reported demographic data and their clinical characteristic data were recorded. Measurements of their foot and shoe fitting were taken at all stages of the research process. Ninety-two percent of the participants with Down syndrome had foot problems. Results: Only 12 (24%) participants with Down syndrome used bilateral shoes that met the requirements of their feet compared to their controls (50 participants, 90.9% for the right foot; 46 participants, 83.6% for the left foot). Participants with Down syndrome presented statistically significant differences with respect to controls and wore incorrectly sized shoe. Conclusions : Evaluation of foot length and width may prevent development of foot deformities, as well as to improve general health., Competing Interests: The authors declare no conflict of interest.

Alzheimer's disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65-95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot., Competing Interests: The authors declare no conflict of interest.