Search

Background: This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions., Methods: A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle-Ottawa Scale. Descriptive statistic was used to present data., Result: The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal-toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters., Conclusions: Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.

Spatiotemporal parameters such as gait velocity and stride length are simple indicators of functional status and can be used to predict major adverse outcomes in older adults. A smartphone can be used for gait analysis by providing spatiotemporal parameters useful for improving the diagnosis and rehabilitation processes in frail people. The aim of this study was to review articles published in the last 20 years (from 2004 to 2024) concerning the application of smartphones to assess the spatiotemporal parameters of gait in older adults. This systematic review was performed in line with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), and original articles were identified by searching seven electronic databases: SciVerse (ScienceDirect), Excerpta Medica Database (EMBASE), Medline, Scopus, PubMed, Web of Science and the Cochrane Library. Studies were rigorously screened using the inclusion criteria of smartphones and mobile apps, older adults and spatiotemporal gait parameters, and results were narratively synthesized. Seventy-three articles were initially identified while searching the scientific literature regarding this topic. Eleven articles were selected and included in this review. Analysis of these studies covered information about gait assessment using mobile apps recorded in 723 older adults and 164 control cases. Analysis of data related to the application of smartphones to assess spatiotemporal parameters of gait in older adults showed moderate-to-excellent test-retest reliability and validity (ICCs around 0.9) of gait speed, the most common parameter reported. Additionally, gait speeds recorded with mobile apps showed excellent agreement when compared to gold standard systems. Smartphones and mobile apps are useful, non-invasive, low-cost and objective tools that are being extensively used to perform gait analysis in older adults. Smartphones and mobile apps can reliably identify spatiotemporal parameters related to adverse outcomes, such as a slow gait speed, as predictors and outcomes in clinical practice and research involving older adults.

Introduction: Subtalar Arthroereisis (STA) is a surgical intervention for pediatric flexible flatfoot (PFF), primarily targeting hindfoot alignment by limiting excessive subtalar eversion. However, its effects on forefoot parameters remain underexplored. This study aims to investigate radiological changes following STA in pediatric patients., Materials and Methods: A retrospective analysis was conducted on consecutive patients treated with STA for PFF. First ray-related angles, including the Hallux Valgus Angle (HVA) and the Intermetatarsal Angle (IMA), alongside hindfoot radiological parameters such as the Meary, Calcaneal Pitch, and Costa Bartani angles, were assessed. Subgroup analysis by gender was performed, and correlations between demographic and preoperative radiological parameters were examined., Results: Forty-one patients (81 feet) with an average age of 11.6 years were included, with a mean follow-up duration of 6.4 months. No significant differences were observed in first ray-related angles pre-and postoperatively, with the mean IMA changing from 7.97° to 7.18° and the mean HV angles changing from 9.51° to 8.66°. Noteworthy improvements were seen in flat foot angles, including the Meary, Calcaneal Pitch, and Costa Bartani angles, postoperatively. The age subgroup analysis revealed similar trends in IMA and HVA changes between Group A (who underwent surgery before peak growth) and Group B (who underwent surgery after peak growth). Higher preoperative angles tended to improve, while lower preoperative IMAs and HVAs tended to worsen postoperatively, all remaining within normal ranges., Conclusion: STA showed positive radiological outcomes for PFF treatment, while negligible changes in first ray-related angles were observed. The age subgroup analysis indicated similar trends regardless of operation timing. Higher preoperative angles tended to improve, while lower preoperative angles tended to worsen postoperatively, despite all falling within non-pathological ranges. Further research is warranted to confirm this correlation.

Background: Hallux valgus (HV) morphological alterations impact forefoot kinetics. Surgery aims to restore both the morphology and function. Plantar pressure (PP) distribution systems represent an innovative additional tool to evaluate the hallux functional outcome after surgery in order to assess the hallux dorsiflexion, coupled with plantar flexion of the first ray. However, the literature reports limited evidence regarding the rebalancing of the plantar pressure distribution following surgery. The purpose of the present study was to examine the PP distribution in HV patients before and after a distal metatarsal osteotomy using a novel anatomically based protocol for in-shoe plantar load analysis during gait. Methods: A consecutive series of 18 patients with mild-to-moderate symptomatic HV who underwent a distal metatarsal osteotomy (S.E.R.I. technique) were prospectively evaluated using clinical scores (AOFAS and NRS), radiographic parameters (hallux valgus angle, intermetatarsal angle), and PP measurements via W-INSHOE© (Medicapteurs, Balma, France). Data were collected preoperatively and 12 months after surgery. Results: At 12 months follow-up, 3 patients were lost to follow-up, leaving 15 patients (24 HV) for examination. Both clinical and radiographical outcomes showed significant improvements from the pre- to postoperative periods. The PP distribution pattern revealed a significant increase in the peak pressure under the first metatarsal head associated with a significant increase in the peak pressure under the central metatarsals area between the pre- and postoperative periods. Conclusions: PP measurement systems hold promise as an additional clinical tool, yet current findings remain inconclusive. Further long-term follow-up studies that incorporate additional parameters are warranted.

Background: The optimal surgical treatment of intra-articular calcaneal fractures (IACF) is still under debate. In the literature, results are based on clinical or radiographical findings. Few studies have evaluated the effect of patient expectations on patient-reported outcomes after surgery and little is known about outcomes directly reported by the patient who experienced it. Patient reported outcome measures (PROMs) may represent a viable and useful tool for evaluating the efficacy of the procedure and can be considered as an indicators of health-care quality. The aim of this study is to evaluate PROMs after minimally invasive reduction and percutaneous Kirschner-wires fixation for IACF, and to compare PROMs to pre-operative and last follow-up radiographic findings., Methods: 33 consecutive patients with IACF treated with minimally invasive reduction and percutaneous K-wires fixation were included. Data collection included demographics, pre-operative and last available Böhler and Gissane angle X-rays, foot function index (FFI), and foot and ankle outcome score (FAOS)., Results: At a mean follow up of 36.7 months, the mean FFI score was 24.3 ± 19.9 and the mean FAOS score was 68 ± 24.8. Patients with better Gissane angle showed better activity limitations FFI subscores. Moreover, worse pre-operative Gissane and Böhler angle were significantly associated with a worse total FAOS score and subscores., Conclusions: Minimally invasive reduction and percutaneous K-wires fixation provided satisfactory PROMs. Despite these results, prospective randomized studies are required to confirm the validity and reliability of PROMs in evaluating different treatments.

Hallux valgus (HV), one of the most common forefoot pediatric pathologies, is characterized by lateral deviation of the big toe and medial displacement of the first metatarsal bone. Different surgical techniques have been described to correct the deformity, but no consensus has been reached regarding the best surgical option. The aim of this retrospective study was to report the results of the SERI technique in 58 pediatric HV of 45 consecutive patients. Pre- and postoperative VAS, AOFAS score, HVA, IMA and DMAA were collected. Preoperatively 3 patients (5.2%) had a mild deformity, 52 patients (89.6%) had moderate deformity and 3 patients (5.2%) had severe deformity according to Coughlin et al. Mean VAS score decreased from 5.2 ± 2.2 preoperatively to 0.8 ± 0.4 postoperatively. Mean AOFAS score improved from 68.1 ± 6.8 (range 59−75) preoperatively to 96.3 ± 3.2 (range 88−100) postoperatively, mean HVA reduced from 28.4° preoperatively to 13.2° postoperatively, mean IMA decreased from 15.2° preoperatively to 9.5° postoperatively (p < 0.01); mean DMAA decreased from 13.7° preoperatively to 8.2° postoperatively (p < 0.01). SERI technique showed satisfactory results when treating mild to severe pediatric HV deformity. No major complications were reported., Competing Interests: The authors declare no conflict of interest.

Background: Diabetic peripheral neuropathy (DPN) is known to predict foot ulceration, lower-extremity amputation and mortality. Patients with diabetes mellitus have a predisposition toward developing chronic inflammatory demyelinating polyneuropathy, and this may also facilitate the formation of diabetic foot and cutaneous impairment, which are considered one of the most serious impairments of diabetes mellitus, with a prevalence of 4-10% in this population. Biomarkers research provides opportunities for the early diagnosis of these complications for specific treatments useful to prevent amputation and, therefore, physical inability and mental disturbance. The recent literature has suggested that glycemic levels may be a novel factor in the pathogenesis of diabetic foot complications and is an important mediator of axonal dysfunction. The aim of this systematic literary review is to determine whether hemoglobin A1c (HbA1c) is a positive predictor for diabetic foot peripheral neuropathy and its complications, such as foot cutaneous impairments. There is a lack of consensus regarding the effect of glycemic variability on diabetic foot peripheral neuropathy, unlike other complications such as retinopathy, nephropathy or micro/macrovascular pathology Methods: Relevant articles were searched in the Medline database using PubMed and Scopus and relevant keywords. The primary search terms used were "glycated hemoglobin" OR "HbA1c" AND "diabetic neuropathies" AND "Foot"., Results: A number of articles (336) were initially identified while searching the scientific literature regarding this topic, and 32 articles were selected and included in this review., Conclusions: This review highlights the role of HbA1c in diabetic foot peripheral neuropathy. Biomarkers play an important role in the decision-making process, and HbA1c levels are extensively used for diabetic foot clinical outcomes and settings, but biomarker research in diabetic foot peripheral neuropathy is in its infancy and will require careful attention to a number of factors and associations, since the consequences of DPN also include neurological alterations. HbA1c is an accurate and easy-to-administer test and can be an effective biomarker in establishing the diagnosis of diabetes, but future research should focus on standardizing the HbA1c level and selecting which DPN value and its correlated complications, such as foot cutaneous impairments, are the most informative.

Background: Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in older individuals. Neurorehabilitation-based interventions such as those improving gait are crucial for a holistic approach and to limit falls. Several studies have recently shown that mechanical plantar foot stimulation is a beneficial intervention for improving gait impairment in PD patients. The objective of this scoping review is to evaluate the beneficial effects of this stimulation on gait parameters, and to analyse protocols of foot stimulation and other effects in non-motor symptoms. Relevant articles were searched in the Medline database using Pubmed and Scopus, using the primary search terms 'foot stimulation' OR 'plantar stimulation' AND 'Parkinson's disease*'. Several protocols have been used for mechanical plantar foot stimulation (ranging from medical devices to textured insoles). The gait parameters that have been shown to be improved are stride length and walking speed. The beneficial effects are achieved after both acute and repeated plantar foot stimulation. Beneficial effects are observed in other organs and systems, such as muscle activation, brain connectivity, cardiovascular control in the central nervous system, and the release of brain-derived neurotrophic factor and cortisol in blood added evidence about this intervention's impact on brain function. Mechanical plantar foot stimulation is a safe and effective add-on treatment able for improving gait impairments in PD patients during the L-dopa off state. Randomized and controlled clinical trials to study its eventual potentiating effect with different pharmacotherapy regimens are warranted.

: Parkinson's disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various methods and tools with very high variability have been developed. The aim of this study is to review published articles of the last 10 years (from 2008 to 2018) concerning the application of wearable sensors to assess spatio-temporal parameters of gait in patients with PD. We focus on inertial sensors used for gait analysis in the clinical environment (i.e., we do not cover the use of inertial sensors to monitor walking or general activities at home, in unsupervised environments). Materials and Methods : Relevant articles were searched in the Medline database using Pubmed. Results and Discussion : Two hundred ninety-four articles were initially identified while searching the scientific literature regarding this topic. Thirty-six articles were selected and included in this review. Conclusion: Wearable motion sensors are useful, non-invasive, low-cost, and objective tools that are being extensively used to perform gait analysis on PD patients. Being able to diagnose and monitor the progression of PD patients makes wearable sensors very useful to evaluate clinical efficacy before and after therapeutic interventions. However, there is no uniformity in the use of wearable sensors in terms of: number of sensors, positioning, chosen parameters, and other characteristics. Future research should focus on standardizing the measurement setup and selecting which spatio-temporal parameters are the most informative to analyze gait in PD. These parameters should be provided as standard assessments in all studies to increase replicability and comparability of results., Competing Interests: All other authors declare no competing interests.