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BACKGROUND: The Foot Health Status Questionnaire (FHSQ) is recommended as a valid and reliable patient-reported outcome for individuals with plantar heel pain (PHP). The aim of this study was to translate and culturally adapt the FHSQ into Danish and investigate face and construct validity among patients with PHP.METHODS: The translation was made using the dual-panel approach. The first panel of bilingual translators translated the questionnaire and the translation was then presented to a lay panel who reviewed and revised the translated version. This version was presented to patients with PHP (n=6) who were interviewed about the comprehensibility, if they found it easy to fill out, and if they found the questionnaire to be relevant to them. Correlation between mean weekly heel pain and FHSQ scores were used to assess construct validity in another patient sample (n=30).RESULTS: The first panel of five translators reached consensus on all 13 items. The layman panel of five participants rephrased two items. Both the layman panel and patients had difficulties with differentiating between items 12 and 13 but concluded that making better phrasings that would work in Danish was not possible. The questionnaire was evaluated as relevant and comprehensible. No revisions were made after the interviews. Pain and function domains correlated with heel pain but not footwear or general foot health.CONCLUSION: The FHSQ was translated into a Danish version (FHSQ-DK) which demonstrated both face and construct validity. More psychometric properties of the FHSQ-DK should be established in future studies.

Background and objectives: Type 2 Diabetes Mellitus (T2DM) is a chronic disease characterized by hyperglycemia. T2DM affects millions of people, and has a lot of complications such as impaired sensation in the feet. Moreover, it is important to know the health of the feet of people with T2DM. The aim of this study is to know the preliminary values of the Foot Health Status Questionnaire (FHSQ) in people with T2DM. Materials and Methods: A total of 87 patients with T2DM with an average age of 65.56 years, divided in 54 men and 33 women, participated in this cross-sectional study. The main outcome was the health of the foot as measured by the FHSQ questionnaire. This questionnaire collects data on eight dimensions: Foot Pain, Foot Function, Shoe, General Foot Health, General Health, Physical Activity, Social Capacity, and Vigor. Results: Patients with T2DM have lower values in Foot Pain, median values in General Foot Health and high values in Foot Function, Shoe, Physical Activity and Social Capacity. Some of these dimensions are affected by age, diabetes control, Body Mass Index (BMI), and years of diagnosis. Females with T2DM have more problems than males in the Shoe, General Foot Health, Physical Activity and Vigor dimensions. Conclusions: this research gives us preliminary values of the FHSQ in Spanish patients with T2DM and divided by gender, age, diabetes control, BMI, and years of diagnosis in people with T2DM.

Introduction: To date, the Foot Health Status Questionnaire (FHSQ) has not been applied to women who suffer from fibromyalgia. The main purpose of this study was to compare both foot and general health-related quality of life between women with fibromyalgia and healthy matched women. We hypothesized that women with fibromyalgia may present an impaired quality of life related to foot and general health. Material and methods: A sample of 208 women, mean age of 55.00 +/- 8.25 years, was recruited from an outpatient clinic and divided into 2 groups, 104 women with fibromyalgia (for the case group) and 104 healthy matched women (for the control group). Demographic data and the domains of the FHSQ scores were registered. Results: Statistically significant differences (p < 0.001) between case and control groups were found for both all specific foot domains (pain, foot function, foot health and footwear) and all general wellbeing domains (general health, physical activity, social capacity and vigor), showing a worse foot and general health-related quality of life (with lower scores for all FHSQ domains) in the women with fibromyalgia compared to healthy matched women. Conclusions: Impaired foot and general health-related quality of life was observed in women who suffered from fibromyalgia compared to healthy matched women. Sin financiación 2.807 JCR (2019) Q2, 46/165 Medicine, General & Internal 0.895 SJR (2019) Q1, 631/2754 Medicine (miscellaneous) No data IDR 2019 UEM

Objective This study compared the effectiveness of extracorporeal shockwave therapy (ESWT) with ultrasound therapy (US-control group) in preventing social limitations and the improvement of foot health status (FHS) in men with a chronic calcaneal spur (CS). Material and methods Forty men were randomly allocated and then received ESWT or US therapy. Two people from the US group ignored the call for study 3 months later, so they were excluded. Therefore, 38 men were analyzed. The ESWT group received 5 treatments once a week, and sessions took place at weekly intervals. Meanwhile, the US group received 10 treatments, 3 times per week. The FHS was assessed using a foot health status questionnaire (FHSQ). The scores were recorded and compared within the groups and between the groups pre treatment, immediately post treatment, and 3 months post treatment. Results We found a significant improvement of FHS and reduction of social limitations immediately post treatment (up to 3 months post treatment in patients with chronic CS). Conclusion The results of this study provide evidence that patients with CS can obtain greater significant health benefits of the foot care when treated by ESWT, rather than by US.

Patricia Palomo-López,1 Ricardo Becerro-de-Bengoa-Vallejo,2 Marta Elena Losa-Iglesias,3 David Rodríguez-Sanz,4 César Calvo-Lobo,5 Daniel López-López6 1Department of Nursing, University Center of Plasencia, Universidad de Extremadura, Spain; 2School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Spain; 3Faculty of Health Sciences, Universidad Rey Juan Carlos, Spain; 4Physiotherapy Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain; 5Nursing and Physical Therapy Department, Faculty ofHealth Sciences, University of León, Ponferrada, León, Spain; 6Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain Background and purpose: Plantar fasciitis (PF) is a foot disorder in adults secondary to an inflammatory response caused by repetitive micro-trauma. We evaluated and compared the impact on quality of life (QoL) related to foot health and general health between males and females with PF. Methods: In this cross-sectional descriptive study, patients with PF were recruited from a podiatry clinic. Physical examination, sociodemographic data, and the self-reported Foot Health Status Questionnaire (FHSQ) were recorded. The FHSQ has three sections and provides two composite scores from 0 to 100. Higher scores (close to 100) reflect better QoL related to foot health and health in general; lower scores (close to 0) denote a worse QoL related to these health items. Results: One hundred patients (49 males [42.38 ± 14.065 years old] and 51 females [43.90 ± 14.305 years old]) were recruited. Section one of the FHSQ evaluates four foot domains, and significant differences (P0.05). Section two assesses four domains of general wellbeing, and significant differences (P

The presence of flexible flat feet is often reported to negatively impact foot health, and endurance during walking. Foot orthoses are commonly prescribed for symptoms associated with flat feet. This study aimed to investigate the impact of individually prescribed foot orthoses on foot health and endurance measures when used in a flat foot population. Methods This study was a pilot parallel-group single-blinded RCT comparing customised foot orthoses and sham inserts for impact on foot pain, fatigue and function following four weeks of use, and changes in distance travelled measures (m) during the six-minute walk test following four weeks of use and at immediate wear. Results Thirteen participants were recruited (8 female), seven received foot orthoses and six received sham inserts. The study was underpowered to detect change (range 0.05 to 0.20). A statistically significant difference existed between groups at baseline for foot pain. No statistically significant results were observed for the use of foot orthoses or sham inserts after four weeks of use or at immediate wear. The sham insert group were observed to improve their distance travelled (median increase 23.5 m), and foot pain (VAS) in accordance with minimally importance difference when compared to the foot orthoses group (between group difference 15.5 mm) following four weeks of use, however, large variations in response were observed (IQR 34.7 m and 50.5 mm respectively). Discussion No significant differences were found between the foot orthoses and sham insert group for foot health or endurance measures following four weeks of use, however, outcomes should be viewed with caution due to small sample size and variation in individual response. Further investigations comparing customised foot orthoses and sham inserts in the adult flexible flat foot population are recommended.

The aim of this study was to analyze the effects of an 8-week whole-body vibration (WBV) on the quality of life, physical fitness, body composition, glycosylate hemoglobin (HbA1c), lipid profile, and foot health status in people with type II diabetes mellitus (T2DM). It was performed as a double-blinded randomized controlled trial of 90 people with T2DM. Primary care facilities were used. The 8-week WBV training consisted of maintaining a knee flexion at 45° during five to nine series of 30−60 s in a vibration frequency that oscillated between 12.5−18.5 and 30 s of recovery between series. The placebo group had to perform the same protocol but without vibration. Participants performed the protocol three times per week. The WBV training significantly reduced the fat mass (%) of people with T2DM. However, significant effects of WBV training were not found in the quality of life, physical fitness, foot health status, lipid profile, blood pressure, fasting blood glucose, or HbA1c. Nevertheless, within groups enhances were found in HbA1c, blood pressure, fasting blood glucose, foot health status, health-related quality of life, timed-up and go test, and chair-stand test in both WBV and placebo groups. WBV was shown to be beneficial for reducing the fat mass and lipid profile of people with T2DM. The improvements of the placebo group could be due to both the social benefits of enrolling in an intervention and the physical fitness benefits of isometric contractions. Further studies are needed to clarify the effects of WBV and to establish a dose−response relationship in people with T2DM.

Background. Criterion-related validity of a self-administered questionnaire listed as gold standard requires objective testing. The aim of this study was to analyze the Foot Health Status Questionnaire (FHSQ) using functional variable measures (dynamic plantar pressure and foot strength). Materials and methods. A total of 22 elderly healthy participants (13 women and 9 men) were screened by interview and physical examination for foot or gait abnormalities. Foot strength, footprint pressure, and foot health status were measured. Results. All the items of the FHSQ show significant correlation with functional variables, but general foot health shows the highest correlation with the 4 physical variables related to plantar pressure (R2 = 0.741), followed by foot pain (R2 = 0.652). Conclusion. A set of different, directly measured physical variables related to foot strength and plantar pressure significantly correlate with the FHSQ dimensions. Level of Evidence: Cross-sectional trial

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 (rs) were calculated and categorized as weak (rs = 0.00–0.40), moderate (rs = 0.41–0.69), or strong (rs = 0.70–1.00). In all analyses, statistical significance was considered with a p-value &lt, 0.01 with a 99% confidence interval. Statistically significant differences (p &lt, 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 &gt, 0.01). Statistically significant correlations varied from week to strong (rs = 0.25–0.97). The strongest correlations (p &lt, 0.001) were found for physical activity and physical function (rs = 0.94), vigor and vitality (rs = 0.89), social capacity and social function (rs = 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.

Purpose: Clinical studies suggest that foot pain may be problematic in one-third of patients in early disease. The Foot Health Status Questionnaire (FHSQ) was developed and validated to evaluate the effectiveness of conservative (orthoses, taping, stretching) and surgery interventions. Despite this fact, there are few validated instruments that measure foot health status in Spanish. Thus, the primary aim of the current study was to translate and evaluate psychometrically a Spanish version of FHSQ. Methods: A cross-sectional study was designed in a university community-based podiatric clinic located in south of Spain. All participants (n = 107) recruited consecutively completed a Spanish version of FHSQ and EuroQoL Health Questionnaire 5 dimensions, and 29 participants repeated these same measures 48 h later. Data analysis included test–retest reliability, construct and criterion-related validity and factor analyses. Results: Construct validity was appropriate with moderate-to-high corrected item–subscale correlations (α = ≥0.739) for all subscales. Test–retest reliability was satisfactory (ICC > 0.932). Factor analysis revealed four dimensions with 86.6 % of the common variance explained. The confirmatory factor analysis findings demonstrated that the proposed structure was well supported (comparative fit index = 0.92, standardized root mean square = 0.09). The Spanish EuroQoL 5D score negatively correlated with the FHSQ pain (r = −0.445) and positively with general foot health and function (r = 0.261 − 0.579), confirming criterion-related validity. Conclusion: The clinimetric properties of the Spanish version of FHSQ were satisfactory.

Arthrodesis of the first MTP joint is an accepted and long established joint destructive procedure for the management of hallux rigidus.This paper presents the results of 29 consecutive first MTP joint arthrodesis procedures for the treatment of hallux rigidus.The outcomes of 29 (18 female and 11 male) consecutive arthrodesis procedures were analysed with the Foot Health Status Questionnaire (FHSQ), minimal important difference scores, and a patient satisfaction questionnaire.FHSQ foot pain scores improved for 27 (93%) patients; foot function improved for 23 (79%) patients; shoe scores improved for 18 (62%) patients; foot health improved for 20 (68%) patients; general health improved for 12 (41%) patients; physical activity improved for 21 (72%) patients; social capacity improved for 21 (21%) patients; vigour improved for 15 (51%) patients. FHSQ minimal important difference scores were achieved for foot pain in 25 patients (86%); foot function in 17 patients (58%); and general foot health in 19 (65%) patients. Analysis with the matched pairs Wilcoxon rank sum test (p0.05) revealed statistically significant improvement in all FHSQ domains. Female patients appeared to fare better than male patients in all FHSQ categories other than general health and vigour.Arthrodesis of the first MTP joint can reliably reduce pain relating to hallux rigidus and can improve foot function and allow a return to physical activity.

To determine self-awareness of diabetes-related foot problems and its associates in a community-based cohort of people with Type 2 diabetes.A survey concerning diabetic foot problems was administered to 358 consecutive patients with Type 2 diabetes [mean ± SD age 67.4 ± 10.8 years, 56.1% males, median (interquartile range) diabetes duration 9.0 (3.9-16.8) years] attending for detailed clinical, biochemical and questionnaire assessment as part of the longitudinal observational Fremantle Diabetes Study Phase II.Compared with the 213 patients (59.5%) who considered their feet to be normal, the 145 (40.5%) who considered their feet to be abnormal were older, had longer diabetes duration and were more likely to have sensory neuropathic symptoms and self-reported poor circulation (P0.001). In those who considered their feet to be normal, 67.9% had peripheral sensory neuropathy (score2/8 on the Michigan Neuropathy Screening Instrument clinical portion), 9.9% had an ankle-brachial index0.9, 6.1% had both peripheral sensory neuropathy and an ankle-brachial index0.90, and 86.9% had one or more features on inspection, such as deformity, dry skin, callus and fissures that could facilitate more serious complications, despite the majority having had at least one foot examination by a healthcare professional in the previous year.Self-assessment of diabetes-related foot problems by patients in the Fremantle Diabetes Study Phase II was unreliable. The present data suggest that self-perceived foot health should be assessed together with foot examination findings. Intensive education and monitoring may be necessary in those who consider their feet to be normal but who have neurovascular, structural and/or other precursors of serious foot pathology.

The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.

Background There is a common misperception that a statistically significant result in clinical research equates to a meaningful or worthwhile outcome for patients. However, not all statistically significant findings are considered important by patients. Objective This research project aimed to calculate the minimal important difference for commonly used outcome measures in research related to the feet. Methods Data from 175 participants from two trials that evaluated conservative interventions for plantar fasciitis were used to determine minimal important differences for the following outcome measures: the Foot Health Status Questionnaire, the original Foot Function Index and a Visual Analogue Scale used to measure pain. The mean change in the outcome measure was compared to a simple global question of improvement. The amount of change in the outcome measure that related to "a little change" in the global improvement question represented the minimal important difference. Results For the Foot Health Status Questionnaire the following minimal important differences were found: 14 for pain, 7 for function and 9 for general foot health. Similar results were found for the Foot Function Index: 12 for pain, 7 for disability and 7 for Total Foot Function Index. The minimal important difference for the Visual Analogue Scale was 9mm. Conclusion Our findings can be used to help interpret results from clinical trials that have used these outcome measures to evaluate the effectiveness of interventions, particular for the treatment of plantar fasciitis. Researchers can also utilise these minimal important differences to assist in prospective sample size calculations for clinical trials, although caution is required for trials on disorders other than plantar fasciitis.

The foot is one of the most complex, yet understudied musculoskeletal systems in the body. However, with the growing interest in foot health in rheumatology and because of its pivotal role in gait and posture, researchers and clinicians have developed a number of surveys and assessments for measuring foot health and its impact on quality of life. This systematic review will focus on questionnaires and surveys for patient/participant perception of foot health and its impact on quality of life, commonly referred to as patient-reported outcome measures. The system we employed to determine the patient-reported outcome measures included in this review is provided as a flow chart (Figure 1). Figure 1 Identification of studies for inclusion in the review. AAOS-FAM = American Academy of Orthopedic Surgeons Lower Limb Outcomes Assessment: Foot and Ankle Module; BFS = Bristol Foot Score; FFI-R = Revised Foot Function Index; FHSQ = Foot Health Status Questionnaire; ... AMERICAN ACADEMY OF ORTHOPEDIC SURGEONS LOWER LIMB OUTCOMES ASSESSMENT: FOOT AND ANKLE MODULE (AAOS-FAM) Description Purpose To evaluate patient perception of foot health and to measure surgical outcomes (1).

OBJECTIVE: To conduct a cross-cultural adaptation of the Foot Health Status Questionnaire into Brazilian-Portuguese and to assess its measurement properties. INTRODUCTION: This instrument is an outcome measure with 10 domains with scores ranging from 0-100, worst to best, respectively. The translated instrument will improve the examinations and foot care of rheumatoid arthritis patients. METHODS: The questions were translated, back-translated, evaluated by a multidisciplinary committee and pre-tested (n = 40 rheumatoid arthritis subjects). The new version was submitted to a field test (n = 65) to evaluate measurement properties such as test-retest reliability, internal consistency and construct validity. The Health Assessment Questionnaire, Numeric Rating Scale for foot pain and Sharp/van der Heijde scores for foot X-rays were used to test the construct validity. RESULTS: The cross-cultural adaptation was completed with minor wording adaptations from the original instrument. The evaluation of measurement properties showed high reliability with low variation coefficients between interviews. The a-Cronbach coefficients varied from 0.468 to 0.855, while correlation to the Health Assessment Questionnaire and Numeric Rating Scale was statistically significant for five out of eight domains. DISCUSSION: Intra- and inter-observer correlations showed high reliability. Internal consistency coefficients were high for all domains, revealing higher values for less subjective domains. As for construct validity, each domain revealed correlations with a specific group of parameters according to what the domains intended to measure. CONCLUSION: The FHSQ was cross-culturally adapted, generating a reliable, consistent, and valid instrument that is useful for evaluating foot health in patients with rheumatoid arthritis. Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas Federal University of São Paulo Center for Health Economics Department of Medicine Federal University of São Paulo Rheumatology Department Universidade de São Paulo Faculdade de Medicina Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy UNIFESP, Center for Health Economics Department of Medicine UNIFESP, Rheumatology Department SciELO

Background Clinicians involved in the management of children with chronic conditions are encouraged to utilise self-report outcome measures to inform clinical management and ensure patient preferences are considered throughout care provision. The use of self-report measures in the paediatric patient is not without challenges and alternative parent/proxy responders are often considered more appropriate. Despite this, the validity of parent/proxy responders reporting on behalf of children can be challenged and further work evaluating concordance between children and parents/proxy raters is needed. Through use of a foot-specific patient reported outcome measure in girls with Turner syndrome, the aim of this study was to measure agreement between children and parent/proxy responders for self-reporting on foot health.

OBJECTIVE The present study was undertaken to assess the comparative responsiveness of outcome measures used for the assessment of pain and function in individuals with osteoarthritis (OA) of the first metatarsophalangeal (MTP) joint. METHODS Eighty-eight patients (mean ± SD age 57.2 ± 10.2 years) with OA of the first MTP joint who participated in a randomized trial completed the Foot Health Status Questionnaire (FHSQ), the Foot Function Index Revised Short Form (FFI-RS), and 100-mm visual analog scales (VAS) of pain and stiffness at baseline and 12 weeks. Responsiveness of the subscales for each outcome measure was determined using paired t-tests, Cohen's d coefficient, the standardized response mean (SRM), and the Guyatt index (GI). Sample size estimations were calculated based on minimal important differences (MIDs). RESULTS All outcome measures were sensitive to change and demonstrated at least medium effect sizes. Three outcome measures exhibited large or very large effect sizes for Cohen's d coefficient, the SRM, and the GI: the FHSQ pain subscale (d = 1.03; SRM 1.10, GI score 1.30), the FFI-RS pain subscale (d = 1.09; SRM 1.05, GI score 1.73), and the 100-mm VAS of pain severity while walking (d = 1.22; SRM 1.07, GI score 1.78). Sample size calculations indicated that between 20 and 33 participants per group would be required to detect MIDs using these measures. CONCLUSION The FHSQ pain subscale, FFI-RS pain subscale, and the 100-mm VAS of pain severity while walking are the most responsive outcome measures for the assessment of pain and function in individuals with OA of the first MTP joint. These findings provide useful information to guide researchers in selecting appropriate outcome measures for use in future clinical trials.

Financiado para publicación en acceso aberto: Universidade da Coruña/CISUG [Abstract] Background Parkinson's disease (PD) is a common neurodegenerative disorder, characterised by the presence of motor disturbances. Therefore, it can be related to musculoskeletal and orthopaedic problems, particularly in the foot status, that are linked to a negative effect on overall health, mobility and social function. Objective The aim was to analyse the impact of foot health and quality of life in patients with Parkinson's disease and people without Parkinson's disease, with normalised reference scores, in the light of the values recorded with regard to foot health status and overall health. Material and methods This is a prospective case-control investigation. A sample of Parkinson's patients (n = 62) including 24 men and 38 women was recruited, and foot HQoL was measured using the Foot Health Status Questionnaire Spanish (Sp_FHSQ). Results The PD group recorded lower levels of foot health quality of life (HQoL) with lower scores on the Sp_FHSQ in general foot health, general health, physical activity, social capacity and vigour sub-scales. Regarding the rest of the sub-scales of the Sp_FHSQ, foot pain showed higher values in the PD group. Differences between the cases and control groups were analysed by means of a Mann–Whitney U test, showing statistical significance (P < 0.05). Conclusions PD presents an increased negative impact on foot health and quality of life which appears to be related to the chronic neurodegenerative disease. This study was funded by Generalitat Valenciana (grant number GV/2020/061). Funding for open access charge: Universidade da Coruña/CISUG Generalitat Valenciana; GV/2020/061

Use of Instrument-Assisted Soft Tissue Massage has increased in popularity, and the plantar fascia is a superficial tissue that may benefit from this treatment. The objective of this study was to determine the effectiveness of Graston Technique® (GT) for decreasing pain and increasing function in participants with chronic plantar heel pain over a six-week period. A single blind, pretest-posttest control/comparison group design, with a sample of 22 adults (5 males, 17 females) was utilized. Participants were assigned to three groups: GT/stretching, effleurage/stretching, and stretching only. After completion, effleurage/stretching and stretching only groups were later offered GT with posttest scores recorded. Participants were pretested/posttested using the Foot Health Status Questionnaire (Foot Pain, Foot Function, and General Foot Health), McGill Pain Questionnaire, and Visual Analog Scale. A posttest Kruskal-Wallis analysis between the three groups demonstrated a significant difference of the Visual Analog Scale between the GT/stretching and effleurage/stretching groups. From pre to posttest, Wilcoxon Test resulted in GT/stretching group significantly improving in 4 out of 5 variables, with effleurage/stretching significant in 1 out of 5, and stretching only demonstrating significance in 3 out of 5. Friedman’s Test for effleurage and stretching only groups resulted in significant differences in all the variables when GT was later administered. The mean differences between pre and posttest for the groups demonstrated a minimal important difference of 4 out of 4 variables for GT/stretching, 2 out of 4 variables for effleurage/stretch, 2 out of 4 variables for the stretching only group. Participants improved in variables measured over a six week treatment of GT. This was both shown to be not only statistically significant, but clinically significant utilizing minimal important difference.

Objective Pain experienced by patients with plantar heel pain has been associated with fascia thickness. It is possible that referred muscle pain may also be related to symptoms experienced by these patients. Our aim was to systematically investigate if the referred pain elicited by trigger points in the leg and foot musculature reproduces the symptoms in individuals with plantar heel pain and to determine the association of trigger points (TrPs) with pain and related disability. Methods A case–control study was conducted. Thirty-five individuals with unilateral chronic plantar heel pain and 35 matched comparable healthy controls participated. An assessor blinded to the subject’s condition explored TrPs in the flexor hallucis brevis, adductor hallucis, quadratus plantae, and internal gastrocnemius. Pain and related disability were assessed with a numerical pain rating scale (0–10), the Foot Function Index, and the Foot Health Status Questionnaire. Results The number of TrPs for each patient with plantar heel pain was 4 ± 3 (2.5 ± 2 active TrPs, 1.5 ± 1.8 latent TrPs). Healthy controls only had latent TrPs (mean = 1 ± 1). Active TrPs in the quadratus plantae (N = 20, 62.5%), and flexor hallucis brevis (N = 19, 59%) were the most prevalent in patients with plantar heel pain. A greater number of active, but not latent, TrPs was associated with higher foot pain variables (0.413 < rs < 0.561, P Conclusions The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in patients with plantar heel pain. A greater number of active TrPs was associated with higher pain and related disability in patients with plantar heel pain.

espanolIntroduccion: El hallux valgus es una patologia muy frecuente, mas en mujeres, que aumenta con la edad provocando dolor y afectando a la calidad de vida. Es importante analizar la calidad de vida de los pacientes para conocer su satisfaccion y comprobar la efectividad de los tratamientos e intervenciones. El objetivo general de este estudio es conocer la calidad de vida de estos pacientes. Material y metodos: Revision sistematica de articulos con fecha entre 2015 y 2020 en ingles o espanol, que analizan la calidad de vida en pacientes mayores de 18 anos con hallux valgus mediante los cuestionarios Short Form-36 Health Status Questionnaire, Short Form-12 Health Status Questionnaire y Foot Health Status Questionnaire. Resultados: Se seleccionaron 10 estudios realizados en distintos paises, el mayor numero de ellos en Espana, en los que el 62.6 % de participantes fueron mujeres, la media de edad fue 55.58 anos, y el Short Form-36 fue el cuestionario mas utilizado. Las puntuaciones medias de los cuestionarios resultaron disminuidas (51.3 sobre 100 en el Short Form-12, 62.9 sobre 100 en el Foot Health Status Questionnaire y 58.8 sobre 100 en el Short Form-36). Conclusiones: La calidad de vida esta disminuida en pacientes con hallux valgus, influyendo en ella la edad, el sexo, los valores angulares radiograficos y el mayor grado de deformidad del hallux valgus en la escala Manchester, pero mejora tras el tratamiento quirurgico. Las limitaciones del estudio incluyen riesgo de errores sistematicos, muestra analizada pequena y alta heterogenicidad de los estudios. EnglishBackground: Hallux valgus is a very frequent pathology, more in women, that increases with age causing pain, affecting the quality of life. It is important to analyze the quality of life of the patients to know their satisfaction and to check the effectiveness of the treatments and interventions. The general objective of this study is to know the quality of life of these patients. Materials and methods: Systematic review of studies dated between 2015 and 2020 in English or Spanish, analysing the quality of life in patients over 18 years with hallux valgus using the Short Form-36 Health Status Questionnaire, Short Form-12 Health Status Questionnaire and Foot Health Status Questionnaire. Results: 10 studies from different countries were selected, the largest number of them in Spain, in which 62.6 % of participants were women, the mean age was 55.58 years, and the Short Form-36 was the most used questionnaire. The mean scores of the questionnaires were decreased (51.3 out of 100 in the Short Form-12, 62.9 out of 100 in the Foot Health Status Questionnaire and 58.8 out of 100 in the Short Form-36). Conclusions: The quality of life is decreased in patients with hallux valgus, influencing it by age, sex, radiographic angular values and the greater degree of hallux valgus deformity on the Manchester scale, but improves after surgical treatment. Study limitations include risk of systematic errors, small sample analysed, and high heterogeneity of studies.

Foot problems are highly prevalent conditions, being a frequent reason for medical and podiatric consultation. The aim of this study was to compare the differences of quality of life (QoL) related to foot health in people with and without the presence of foot problems. A case–control study was carried out in an outpatient centre, where a clinician recorded data related to sociodemographic and clinical characteristics. In addition, self-reported data on foot health-related quality of life were recorded using the Spanish version of the Foot Health Status Questionnaire. The sample consisted of 498 participants (249 cases and 249 controls), with a median age of 30 years and an interquartile range of 23 years. The differences between the groups were statistically significant for gender, age, footwear, general health, foot health, and physical activity. Cases showed lower scores for the domain of footwear, physical activity and vitality compared to controls. Foot pathologies have a negative impact on quality of life related to foot health, and the domains of footwear, general health and physical activity seem to be the factors that are associated with the presence of alterations and foot deformities.

Question: For people with plantar fasciopathy, is a 12-week self-dosed heavy-slow resistance training program more beneficial than a 12-week pre-determined heavy-slow resistance training program? Design: A randomised trial with concealed allocation, partial blinding, and intention-to-treat analysis. Participants: Seventy people with plantar fasciopathy confirmed on ultrasonography. Intervention: Both groups performed a repeated heel raise exercise in standing for 12 weeks. Participants in the experimental group were self-dosed (ie, they performed as many sets as possible with as heavy a load as possible, but no heavier than 8 repetition maximum). The exercise regimen for the control group was pre-determined (ie, it followed a standardised progressive protocol). Outcome measures: The primary outcome was the Foot Health Status Questionnaire pain domain. Secondary outcomes included: a 7-point Likert scale of Global Rating of Change dichotomised to ‘improved’ or ‘not improved’; Patient Acceptable Symptom State defined as when participants felt no further need for treatment; and number of training sessions performed. Results: There was no significant between-group difference in the improvement of Foot Health Status Questionnaire pain after 12 weeks (adjusted MD −6.9 points, 95% CI −15.5 to 1.7). According to the Global Rating of Change, 24 of 33 in the experimental group and 20 of 32 in the control group were improved (RR = 1.16, 95% CI 0.83 to 1.64). Only four participants achieved Patient Acceptable Symptom State: three of 35 in the experimental group and one of 35 in the control group. No significant between-group difference was found in the number of training sessions that were performed (MD −2 sessions, 95% CI −8 to 3). Conclusion: Self-dosed and pre-determined heavy-slow resistance exercise programs are associated with similar effects on plantar fasciopathy pain and other outcomes over 12 weeks. Advising people with plantar fasciopathy to self-dose their slow-heavy resistance training regimen did not substantially increase the achieved dose compared with a pre-determined regimen. These regimens are not sufficient to achieve acceptable symptom state in the majority of people with plantar fasciopathy. Registration: ClinicalTrials.gov NCT03304353. Key words: Tendinopathy, Plantar fasciopathy, Exercise, Rehabilitation, Strengthening

OBJECTIVE: To evaluate the efficacy of carbon-fibre shoe-stiffening inserts in individuals with first metatarsophalangeal joint osteoarthritis. \ud \ud DESIGN: This was a randomised, sham-controlled, participant- and assessor-blinded trial. One hundred participants with first metatarsophalangeal joint osteoarthritis received rehabilitation therapy and were randomised to receive either carbon fibre shoe-stiffening inserts (n = 49) or sham inserts (n = 51). The primary outcome measure was the Foot Health Status Questionnaire (FHSQ) pain domain assessed at 12 weeks. \ud \ud RESULTS: All 100 randomised participants (mean age 57.5 (SD 10.3) years; 55 (55%) women) were included in the analysis of the primary outcome. At the 12 week primary endpoint, there were 13 drop-outs (7 in the sham insert group and 6 in the shoe-stiffening insert group), giving completion rates of 86 and 88%, respectively. Both groups demonstrated improvements in the FHSQ pain domain score at each follow-up period, and there was a significant between-group difference in favour of the shoe-stiffening insert group (adjusted mean difference of 6.66 points, 95% CI 0.65 to 12.67, P = 0.030). There were no between-group differences for the secondary outcomes, although global improvement was more common in the shoe-stiffening insert group compared to the sham insert group (61 vs 34%, RR 1.73, 95% CI 1.05 to 2.88, P = 0.033; number needed to treat 4, 95% CI 2 to 16). \ud \ud CONCLUSION: Carbon-fibre shoe-stiffening inserts were more effective at reducing foot pain than sham inserts at 12 weeks. These results support the use of shoe-stiffening inserts for the management of this condition, although due to the uncertainty around the effect on the primary outcome, some individuals may not experience a clinically worthwhile improvement.

Introduction Distal tarsal tunnel syndrome (DTTS) is characterised by compression of the tibial nerve as it passes underneath the abductor hallucis muscle belly. There is no current consensus on treatment for DTTS. This study was conducted to compare and evaluate the effect of ultrasound-guided botulinum toxin A (BTX-A) versus ultrasound-guided corticosteroid injection (CSI) for the treatment of DTTS. Methods This study was a single-centre, randomized, and double-blinded trial. The study protocol was submitted to the local ethics committee board and subsequently registered in a research registry. 88 patients with DTTS were randomly divided into 2 groups according to the treatment received. The patients were evaluated over 12 weeks. Evaluation was via the Foot Health Status Questionnaire (FHSQ). The primary outcome measures were pain and the secondary outcomes were function and the use of oral analgesics. All of the assessments were performed at baseline and at 3, 6, and 12 weeks after treatment. Results This is a randomized controlled trial evaluating the efficacy of BTX-A versus CSI in the treatment of DTTS. This study has limited inclusion and exclusion criteria and a well-controlled intervention. Conclusions The results of this trial will provide more evidence on which method can better treat DTTS. Trial registration We have registered this trial with the Australian New Zealand Clinical Trials Registry and the temporary trial number is 380,105.

Background Foot health of Aboriginal and Torres Strait Islander Australians’ has not been established. Additionally, studies have shown that there is a lack of engagement of this population with general preventive foot care services. The aim of this study was to establish foot health in Aboriginal and Torres Strait Islander people attending two recently developed, culturally safe podiatry services in rural and regional New South Wales (NSW), Australia. Secondarily the relationship between self-perceived foot health and some medical and demographic characteristics was investigated. Methods This descriptive cross-sectional study included participants attending the culturally safe foot health care services managed by the University of Newcastle on the Central Coast or in Wellington, both located in NSW, Australia. At the consultation, participants completed the Foot Health Status Questionnaire (FHSQ) with the assistance of an Aboriginal health care worker, underwent basic vascular and neurological screening, and podiatric treatment. Results A total of 111 Aboriginal and Torres Strait Islander Australians (48 from the Central Coast, and 63 from Wellington) were included. FHSQ scores for pain (75.7 ± 26.8), function (80.2 ± 25.2), footwear (53.9 ± 33.4), and general foot health (62.0 ± 30.9) were generally good, but below the optimal score of 100. The presence of diabetes (n = 39 of 111 participants or 35.1%) was associated with lower levels of self-perceived foot function (r = − 0.20, n = 107, p = 0.04). Conclusion We found that community-based foot health care services that are culturally safe are utilised by Aboriginal and Torres Strait Islander Peoples not currently at high risk of foot complications. This supports the use of culturally safe foot care services to improve engagement with preventative foot care. Future research should continue to be driven by Aboriginal and Torres Strait Islander Peoples and investigate ways to implement additional screening measures and undertake prospective evaluation of the impact of such services on health related outcomes in these communities.

OBJECTIVE The objective of this study was to determine the feasibility of shoe stiffening inserts to reduce pain in first metatarsophalangeal joint osteoarthritis. DESIGN Thirty-one participants with first metatarsophalangeal joint osteoarthritis were prescribed shoe stiffening inserts and were evaluated at baseline and at 1 and 3 mos. The primary outcome measure was foot pain, assessed using the foot pain domain of the Foot Health Status Questionnaire (possible score ranges from 0 to 100). Secondary outcome measures included foot-related disability (foot function domain of the Foot Health Status Questionnaire), self-reported treatment effectiveness, use of rescue medication and other co-interventions, and adverse events. RESULTS At 1 and 3 mos, statistically significant improvements in foot pain and foot-related disability were observed (mean difference at 3 mos: foot pain = 18.8, 95% confidence interval, 13.3-24.3; foot function = 11.8, 95% confidence interval, 4.3-17.3). Treatment was reported to be effective by 78% of participants. Few participants (4%) reported using pain-relieving medication. Minor adverse events were reported by 30% of participants. CONCLUSIONS Full-length shoe stiffening inserts may be an effective intervention in first metatarsophalangeal joint osteoarthritis. However, further controlled studies are required.

Patricia Palomo-López,1 David Rodríguez-Sanz,2 Ricardo Becerro-de-Bengoa-Vallejo,3 Marta Elena Losa-Iglesias,4 Jorge Guerrero-Martín,5 Cesar Calvo-Lobo,6 Daniel López-López7 1Department of Nursing, University Center of Plasencia, University of Extremadura, 2Department of Physical Therapy and Podiatry, Physical Therapy and Health Sciences, Research Group, Universidad Europea de Madrid, Madrid, 3School of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 4Faculty of Health Sciences, University Rey Juan Carlos, 5Department of Nursing, Faculty of Medicine, Badajoz. University of Extremadura, 6Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, Ponferrada, León, 7Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain Purpose: The aim of this study was to analyze and compare foot health and general health in a sample of women divided into two groups: 1) those with breast cancer and undergoing chemotherapy treatment and 2) healthy women without breast cancer and with normalized reference values.Methods: A case–control observational study was performed. Two-hundred women with a mean age of 51.00±8.75 years were recruited from podiatric medicine and surgery clinics from the University of Extremadura (Plasencia, Spain) and the Hospital Infanta Cristina (Badajoz, Spain). The women were divided into case and control groups (undergoing chemotherapy treatment and healthy women, respectively). The Foot Health Status Questionnaire was used to assess foot health domain scores.Results: Significant differences between both groups were seen for foot pain (P=0.003), foot function (P

[Purpose] To verify the effects of individual and group exercise programs on pain, balance, mobility and perceived benefits of rheumatoid arthritis patients (RA) with pain and foot deformities. [Subjects and Methods] Thirty patients with RA pain and foot deformity were allocated into two groups: G1: individual exercise program and G2: group exercise program. The variables analyzed were Numerical Rating Scale (NRS) for pain, Berg Balance Scale (BBS) for balance, Timed Up & Go Test (TUG) and Functional Reach (FR) for mobility, and Foot Health Status Questionnaire (FHSQ-Br) for perceived benefits. Both exercise programs consisted of functional rehabilitation exercises and self-care guidance aimed at reducing pain and improving balance and mobility. Intragroup comparisons of variables between A1 (pre-intervention) and A2 (post-intervention) were performed. [Results] Patients in both groups were similar in A1 (pre-intervention) in all the variables analyzed. Comparison between A1 and A2 for each variable showed improvement for G1 in the NRS, BBS, FR, TUG and in four out of ten domains of FHSQ-Br. G2 showed improvement in the NRS, BBS and eight out of ten domains of FHSQ-Br. [Conclusion] Both individual and group programs revealed benefits for patients with RA, however, group exercise programs showed better perception of benefits.

The purpose of this study is to analyse and compare the impact of hallux valgus (HV) in a sample of adult women with varying degrees of HV scores obtained with regard to foot health and health in general. A total 100 female patients of mean age 43·04 ± 16·84 years who attended a podiatric clinic were asked to answer a questionnaire. The degree of deformity, HV, was determined on both feet of the patients using the Manchester Scale tool and the scores from the Foot Health Status Questionnaire were compared. Participants with varying degrees of HV recorded lower scores in Section 1 for the footwear and general foot health and higher scores for foot pain and foot function. In Section 2, they obtained lower scores in physical activity and social capacity and higher scores in vigour and general health. Differences between the four groups were evaluated by means of a t-test for independent samples, showing statistical significance (P < 0·001). This study has detected measurable differences of association between varying degrees of HV with impaired quality of life related to foot health in women.

BackgroundPlatelet-rich plasma (PRP) has been gaining popularity as a treatment for plantar fasciitis (PF).Aim of the workTo compare local autologous PRP and steroid injections both clinically and sonographically within 3-months and also regarding its safety.Patients and methodsThis study was carried out on 50 patients with chronic PF divided into two groups: steroid and PRP groups (n=25 each). Patients were assessed by visual analog scale (VAS), Foot Health Status Questionnaire (FHSQ) and ultrasonography at 1.5 and 3months post-injection.ResultsThe 50 patients had comparable disease duration (p>0.5). At 1.5months post-injection, there was more improvement in the PRP than in the steroid group both clinically (as assessed by the VAS) and ultrasonographically (as regards the echogenicity) (p=0.008 and p0.05). No significant difference was present between the 2 groups regarding the reduction plantar fascia thickness at 1.5 (p=0.89) and 3months (p=0.64) post-injection. Regarding the safety of both injections, none of our patients in either group developed any significant complications.ConclusionsWe suggest that the PRP injection is a new, readily available, well tolerated and safe choice of therapy for chronic PF and is not inferior to steroid injection in a short term 3month follow up. Comparing the long-term efficacy both clinically and sonographically is necessary to confirm their sustained effect.

Objective: To describe and compare the impact of foot health and health in general on quality of life in a sample of menopausal women and non-menopausal women with normalized reference values. Methods: A total of 146 participants with a mean age of 50.51 ± 3.977 years came to a health center where self-reported data were registered. Participants were divided into menopausal and non-menopausal groups. Scores obtained were compared by the Foot Health Status Questionnaire (FHSQ), which assesses four foot health domains: pain, function, general health and footwear. Results: The menopausal women showed a lower quality of life related to health in general and to foot health specifically. Differences between the two groups were evaluated by means of a t-test for independent samples, showing statistical significance in foot pain, general foot health and social capacity (p < 0.05). Conclusions: Menopausal women had a lower quality of life related to foot health, which appears to be associated with menopause. Sin financiación 2.271 JCR (2016) Q2, 34/80 Obstetrics and Gynecology 0.787 SJR (2016) Q2, 820/2886 Medicine (miscellaneous), 65/186 Obstetrics and Gynecology No data IDR 2016 UEM

Aim: The aim was to evaluate self-assessed foot health status and working efficiency of healthcare workers when using composite insoles to treat foot problems. Introduction: Foot pain and fatigue are two of the most common problems facing healthcare workers owing to many hours of walking and standing per day. Many choices of conservative treatment are available such as the use of insoles and orthotic support. Commercially prefabricated insoles are one of the most widely used treatments for foot pain and fatigue as they are easily accessible at reasonable prices. However, there is limited evidence supporting the effectiveness of these treatments. Methodology: Test subjects included 49 volunteers from Tung Song Hospital screened by an Original Research Article Siwawut; BJMMR, 5(10): 1294-1300, 2015; Article no.BJMMR.2015.147 1295 orthopedist and physical therapist to meet predetermined criteria. Data collected included demographic data, validated foot function score of a Foot Health Status Questionnaire (FHSQ), and a synthetic working efficiency score generated using the Thai Questionnaire of Working Efficiency for Healthcare workers. A self-evaluation form was designed to record the efficacy of using Smile feetTM insoles before and after one month of treatment. Statistical analysis was performed using the Wilcoxon signed rank test. Results: Responses to the Foot Heath Status Questionnaire showed a statistically significant change in several foot health metrics (p-value < 0.01) after using the composite insoles for 1 month: Improvement greater than the minimal important difference was achieved by 75.5% in foot pain, 44.9% in foot function, 89.8% in foot wear, and a 57.1% in general foot health. Respondents to the Thai Working Efficiency questionnaire reported improvement in sections of working, reducing muscle soreness and fatigue in 30 of the 49 volunteers (61.2%). Among those that experienced improvement, [self-reported] work productivity increased by 73%. Conclusion: Healthcare workers reported improvements after using a commercially available composite insole in all criteria on a self assessment questionnaire, including muscle soreness, working efficiency, work productivity, fatigue, foot pain, foot function, foot wear, and general foot health. Level of Evidence: Level IV, therapeutic case series.

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 &plusmn, 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&rsquo, s Depression Inventory (BDI) scores and categories were collected. Results: The only statistically significant difference (p &lt, 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 &gt, 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.

[Abstract] Generalized ligamentous hyperlaxity (GLH) has been shown to predispose an individual to a number of orthopaedic conditions. Little is known about how GLH affects people’ foot health-related quality of life. This study analyses a sample of people with GLH and people without GLH with normalised reference values of the scores collected with regard to using the Foot Health Status Questionnaire (FSHQ). A total of 100 respondents with mean age of 22.69 ± 3.78 years old, who attended a health centre were classified as GLH (n = 50) or non-GLH (n = 50). The GLH was determined of the patients with and without GLH using assessment with Beighton tool and the scores on the FHSQ were compared. The control group recorded higher scores in the First Section for foot pain, foot function and general foot health, and lower scores in footwear. In the Second Section, they obtained higher scores in social capacity and lower scores in physical activity, vigour and general health. Differences between the two groups were evaluated through a t-test for independent samples, showing statistical significance (P

Background:. Hispanics represent the largest minority group in the United States and are projected to represent 29% of the US population by 2060. Enrolling Hispanic patients in clinical outcome trials is critical to study a representative sample of the general population. Lack of translated and validated survey tools has been identified as a major barrier to enrolling Spanish speaking patients. The purpose of this validation study was to study the correlation between the Spanish translation of the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes questionnaire (AAOS-FAOQ) and the Spanish versions of the Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ) in Hispanics from Mexican lineage with traumatic foot and ankle injuries. Methods:. A cross-sectional validation study in 36 Hispanic patients from Mexican lineage with foot and ankle injuries was performed. The Hispanic version of the AAOS-FAOQ and the Spanish translations of the FAOQ, FHSQ, FFI, and the Short-Form 36 questionnaire (SF-36) were distributed among all patients. Subsequent statistical analysis correlating the Hispanic version of the AAOS-FAOQ to the FFI, FHSQ, and SF-36 was performed. Additional analysis on the Hispanic AAOS-FAOQ included test–retest reliability and internal consistency. Results:. The Hispanic AAOS-FAOQ Global Foot and Ankle subscale showed statistically significant (P

People working at sea show a marked presence of musculoskeletal pain as well as an important coexistence of pain in diverse anatomical regions, which is believed to have a harmful effect on the quality of life related to foot health. The aim is to describe and compare the impact in a sample of sea workers and people who work on the ground in the light of the scores obtained with regard foot health and health in general.A sample of 94 participants of a mean age of 41.29 ± 10.603 came to a health centre where self-reported data were registered, informants' professional activity was determined and the scores obtained were compared in the Foot Health Status Questionnaire.The sea workers group showed a worse quality of life related to health in general and to foot health specifically. Differences between the two groups were evaluated by means of a t-test for independent samples, showing statistical significance (P 0.05) for the dimensions of pain and general health related to the foot.People working at sea present a negative impact on the quality of life related to foot health, which appears to be associated with the presence of deformities, sprains, plantar warts and fungus.

Objective The treatment of plantar heel pain is highly challenging. We report ultrasound-guided pulsed radiofrequency treatment (UG-PRF) in the gastrocnemius to treat plantar heel pain and minimize the safety issues. Design This study compared UG-PRF with sham treatment in 100 patients with plantar heel pain. Primary outcome measures include the pain subscale of the Foot Health Status Questionnaire (FHSQ-pain) and “first step” pain as measured on a visual analogue scale (VAS-“first-step” pain). The secondary outcome measures include the FHSQ-foot function and general foot health, and health related quality of life (assessed using the Short Form-36 questionnaire [SF-36]). All outcomes were measured at 3 and 6 months post-treatment. Results The results showed the efficacy of UG-PRF in terms of pain management, as reflected by higher FHSQ-pain score (increased by 20.0 (P

Objective To compare the efficacy of different injection therapies for plantar fasciopathy (historically known as ‘plantar fasciitis’). Design Systematic review and network meta-analysis. Data sources Electronic databases (MEDLINE, CENTRAL, Web of Science and Scopus) were searched up to 11 July 2015 for completed studies. Eligibility criteria for selecting studies We considered randomised trials comparing various injection therapies in adults with plantar fasciopathy. The primary outcome was pain relief. Secondary outcomes included functional disability, composite and health-related outcomes. All outcomes were assessed (1) in the short term (up to 2 months), (2) the intermediate term (2–6 months) and (3) the medium term (more than 6 months to 2 years). Quality assessment was performed using the Cochrane risk of bias tool. Results We included 22 trials comprising 1216 patients. Dehydrated amniotic membrane injections were significantly superior to corticosteroids in the short term in achieving the primary and composite outcomes (mean difference (MD) in visual analogue scale (VAS) was −7.32, 95% CIs −11.2 to −3.38; and MD in the foot health status questionnaire was 31.2, 95% CIs 13.9 to 48.6, respectively). For pain relief, botulinum toxin-A provided a significant short-term advantage over placebo, which was still present at 6 months (MD in VAS was −2.9, 95% CIs −4.44 to −1.39; and MD −4.34, 95% CIs −7.18 to −1.54, respectively). Summary Although the dehydrated amniotic membrane provided significant clinical relief at 0–2 months, there were no data about this treatment at 2 months and beyond. Botulinum toxin-A injections significantly reduced pain intensity at 0–6 months. Systematic review registration number CRD42015017353.

Aim of the workThis randomized controlled study was designed to compare the effectiveness of local injection of autologous platelet rich plasma (PRP) and local steroid in reducing pain and improving function in a cohort of patients with tennis elbow (TE) and plantar fasciitis (PF).Patients and methodsThe study population comprised two groups; Group 1 patients with TE (n=30) and Group 2 patients with PF (n=30). In each group patients were allocated randomly to receive either a steroid or PRP injections. All patients filled in visual analog scale (VAS), disability of arm, shoulder and hand (DASH) score for TE and foot health status questionnaire (FHSQ) for PF at base line and after 6weeks.ResultsRelative to TE group of patients significant differences were observed between VAS and DASH scores at base line and 6weeks after treatment in both groups (p0.05). In PF patients comparison of VAS and FHSQ at base line and 6weeks after treatment between control group and PRP group showed significant differences for VAS (p=0.005 and p

Background: There are few studies to evaluate the effectiveness of orthoses on foot function and pain whilst playing golf. Objectives: The study aimed to evaluate the capacity of three different types of orthoses to alleviate levels of pain, whilst playing golf. Method: Over a period of 3 months, 32 amateur golfers took part in a Randomised Control Trial which looked at a prefabricated over-thecounter golf orthosis against a placebo and a cushioning Poron insole using two validated tools—the Foot Health Status Questionnaire and the Foot Posture Index. Results: Of the 27 golfers that completed the trial, the results showed that the use of orthoses whilst playing golf reduced the levels of pain experienced, with equally positive responses in the placebo group. Of statistical significance (where p > 0.05) was the improvement in foot posture of the right foot ( p= 0.053), for those using the Golf Orthaheel. A visual analogue scale showed statistically significant pain reduction ( p= 0.007) when using the Poron insole. The results from this trial suggest that orthoses may have an effect in reducing pain and improving foot posture by controlling pronatory movements in golfers.

Objectives : To investigate the efficacy of a topical wheatgrass cream for improving pain and function in patients with chronic plantar fasciitis. Design : Randomized, double-blind, placebo-controlled trial. Setting : Eighty participants with chronic plantar fasciitis were randomly assigned to a treatment group (wheatgrass cream) or a control group (placebo cream). All participants applied a cream twice daily for 6 weeks. Follow up was conducted at 6 and 12 weeks. Main outcome measures : Visual Analogue Scale (VAS) for daily first-step pain and the Foot Health Status Questionnaire (FHSQ) for overall foot function. Secondary measures of foot posture, calf muscle strength and range of ankle dorsiflexion were also assessed. Results : No significant differences were found between groups with respect to main outcomes of first-step pain or foot function at any time. Both groups improved significantly from baseline to 6 weeks, and these improvements were maintained at 12 weeks. Conclusions : The topical application of wheatgrass cream is no more effective than a placebo cream for the treatment of chronic plantar fasciitis.

Objective: To determine whether the efficacy of botulinum toxin type A in chronic plantar fasciitis was maintained for more than six months after treatment. Design: Observational follow-up study. Subjects: Twenty-four patients who received botulinum toxin type A injection in a previous randomized study of chronic plantar fasciitis (active treatment group) and who presented a benefit one month after treatment. Methods: A visual analogue scale for pain and the Foot Health Status Questionnaire were used to re-evaluate results 12 months after the botulinum toxin injection. No further injections of botulinum toxin had been administered during the follow-up period. Patients were also asked to give a subjective assessment of treatment outcome. Results: At 12 months, compared with the six-month evaluation, there was a further improvement in foot pain measured using the visual analogue scale, though this did not reach significance (1.78 at 6 months versus 1.22 at 12 months; P = 0.142). However, there were significant improvements in two domains of Foot Health Status Questionnaire: foot pain (91.11 at 6 months versus 80.00 at 12 months; P = 0.001) and foot function (96.19 at 6 months versus 89.38 at 12 months; P = 0.047). There was a small, non-significant deterioration in the shoe and foot health domains. Satisfaction with the outcome was good or very good in the large majority of patients. Conclusions: In patients with chronic plantar fasciitis, the positive effect detected six months after treatment with botulinum toxin type A was maintained at 12 months and there was a further improvement in pain and foot function.

Measuring the outcome of surgical intervention is an integral part of modern-day healthcare provision. The increasing requirement to monitor patient-reported outcomes highlights the need for patients to be able to read and understand health outcomes questionnaires. The present study compared the readability of 2 commonly used, validated, foot surgery outcome questionnaires (the Foot Health Status Questionnaire and the Manchester-Oxford Foot Questionnaire) using the Flesch Reading Ease score and the Flesch-Kincaid grade level score. The Manchester-Oxford Foot Questionnaire had a significantly greater (p < .003) score for reading ease and a significantly lower reading grade score (p < .005) than the Foot Health Status Questionnaire. These findings suggest the Manchester-Oxford Foot Questionnaire is a more suitable instrument in terms of readability and comprehension for a greater proportion of the population undergoing hallux valgus surgery.

Plantar heel pain is aggravated by weight-bearing, yet limited evidence exists regarding how people with heel pain load their feet during walking. Knowledge of loading patterns in people with plantar heel pain would enhance the understanding of their foot function and assist in developing intervention strategies. Plantar pressure using the Emed-AT platform (Novel Gmbh, Germany) was collected from 198 people with plantar heel pain and 70 asymptomatic controls during normal walking. Maximum force, force-time integral, peak pressure, pressure-time integral and contact time were measured in four quadrants of the heel, the midfoot and the medial and lateral forefoot. The symptomatic group was sub-divided into equal low-pain and high-pain groups using the Foot Health Status Questionnaire pain score. Following age and body mass comparison, multivariate analyses of covariance were performed to compare the heel pain group to the controls, and the low-pain group to the high-pain group, for each loading variable. The heel pain group displayed lower maximum force beneath the heel, lower peak pressure beneath the postero-lateral heel and lower maximum force beneath the medial forefoot. Force-time integrals were lower beneath the posterior heel regions and higher at the lateral forefoot. People with heel pain also had longer midfoot and forefoot contact time. Higher pain level was associated with lower peak pressure and maximum force beneath regions of the heel. Compared to the controls, people with plantar heel pain demonstrated reduced heel loading and modified forefoot loading consistent with a strategy to offload the painful heel.