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Based on the high prevalence of asthma in the population, and its relationship with various musculoskeletal and postural disorders, the aim of this study was to evaluate the plantar pressures in asthmatic patients compared to a control group. A case-control study involving 90 participants was conducted, consisting of 45 asthma patients and 45 healthy paired controls. Static plantar pressure data were recorded using a portable pressure sensor platform. Statistically significant differences were shown in the body weight on the left heel (p = 0.031), and the right forefoot maximum peak pressure was lower in the case group (p = 0.042). The findings of this study show alterations in static plantar pressures in asthmatic patients compared to healthy individuals. Specifically, the subjects with asthma showed less maximum pressure in the right forefoot and less weight on the left heel, which appear to be associated with the asthma disease.

Segundo a Organização Pan-Americana de Saúde (OPAS), o envelhecimento é definido como um processo sequencial, individual, acumulativo, irreversível, universal, não patológico, de deterioração de um organismo maduro. Considerando o aumento progressivo da população idosa e todas as alterações funcionais envolvidas no processo do envelhecimento, destacam-se as alterações provenientes por declínio imunológico, como doenças por contaminações fúngicas, como onicomicose e Tinea pedis. Os fungos possuem características oportunistas e utilizam fatores como doenças sistêmicas, deficiência imunológica e uso de medicamentos, que são muito comuns aos idosos, e acabam por predispor a contaminação. As doenças causadas por fungos em idosos são frequentes e necessitam de tratamentos e orientações adequadas [6]. No entanto, observa-se a falta de orientação e cuidados básicos que são essenciais e atuam tanto na prevenção, quanto no tratamento dessas doenças. Segundo Pinto, 2018, [8], o podólogo possui um importante papel através dos serviços prestados pela podologia, demonstrando a importância dos cuidados básicos, associados a prática de higiene diária. Objetivo deste trabalho foi demonstrar que a correta orientação de higiene e cuidados com os pés podem auxiliar na prevenção de podopatias relacionadas a contaminação de fungos em idosos. Este estudo se caracterizou por uma revisão da literatura. Foi feita uma Pesquisa de Campo através de questionário, com aprovação do Comitê de Ética da Universidade Anhembi Morumbi.

Penetration and shared nodes between muscles, tendons and the plantar aponeurosis mesh elements in finite element models of the foot may cause inappropriate structural behavior of the tissues. Penetration between tissues caused using separate mesh without motion constraints or contacts can change the loading direction because of an inadequate mesh displacement. Shared nodes between mesh elements create bonded areas in the model, causing progressive or complete loss of load transmitted by tissue. This paper compares by the finite element method the structural behavior of the foot model in cases where a shared mesh has been used versus a separated mesh with sliding contacts between some important tissues. A very detailed finite element model of the foot and ankle that simulates the muscles, tendons and plantar aponeurosis with real geometry has been used for the research. The analysis showed that the use of a separate mesh with sliding contacts and a better characterization of the mechanical behavior of the soft tissues increased the mean of the absolute values of stress by 83.3% and displacement by 17.4% compared with a shared mesh. These increases mean an improvement of muscle and tendon behavior in the foot model. Additionally, a better quantitative and qualitative distribution of plantar pressure was also observed.

Introduction Patients with rheumatoid arthritis frequently consult for pain resulting from involvement of the tendons of the foot. This pain negatively affects foot biomechanics and quality of life. The most widely used treatment option for this condition is ultrasound-guided steroid injection, while other treatments were recommended such as heel pad, splints, and footwear. Objective To evaluate a joint intervention (rheumatology and podiatry) comprising an orthotic-podiatric treatment and infiltrations. We evaluated the response using ultrasound monitoring, a pain scale, functional tests, and assessment of patient satisfaction. Methods We performed a non-controlled blinded prospective interventional study of 96 patients with foot pain and selected those with ultrasound-confirmed tendon involvement. Patients enrolled started intervention treatment and were followed for 6 months. The outcome of the intervention was compared with the patient’s baseline status. The pre-post differences in the secondary variables (pain, disability) were analyzed using the t test and contingency tables or the Mann–Whitney test. Results Using our protocol, we recorded a rapid and significant reduction in the intensity of pain, in the foot function index, and in the ultrasound parameters (grayscale and Doppler). Structural damage to the tendon improved more slowly, with significant outcomes only at the last visit with respect to baseline. Abnormal foot support was detected in 50% of patients, and 79.5% were using inappropriate footwear. Conclusions Our multidisciplinary therapeutic protocol enabled a very significant improvement in tendon involvement. It was well-tolerated, with a high degree of satisfaction, and was easily evaluated using ultrasound. No changes in background medication were necessary. Key Points• Multidisciplinary evaluation of patients with RA is advisable because it improves the treatment management in cases of inflammatory activity and structural abnormalities of the foot.• Comprising orthopedic-podiatric treatment (heel, splints, and suitable footwear) and infiltrations, in terms of clinical, ultrasound, and functional recovery of the foot tendons.• The therapy protocol we propose led to a significant improvement in pain relief and functional recovery.

Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology. Purpose: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects. Methods: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels. Results: The stance time of the short leg had no significant changes. The stance time of the long leg increased by 3.51% (p &lt, 0.001), mean pressure of the short leg increased by 1.23% (p = 0.005), and decreased by 5.89% in the long leg (p &lt, 0.001). Peak pressure of the short leg decreased by 2.58% (p = 0.031) and the long leg decreased by 12.11% (p &lt, 0.001). Conclusions: This study demonstrates that increasing LLD causes an asymmetrical foot-loading pattern, with decreased mean and peak pressure on the longer limb, and consequently an overload on the short side. Furthermore, an increasing LLD causes increased stance time on the long leg.

Multidrug-resistant organism infections have become important in recent years due to the increased prevalence of diabetic foot ulcers and their possible consequences. This study aimed to systematically review and evaluate ulcer duration, healing time, hospital stay, amputation, and mortality rates in patients with diabetic foot ulcers caused by infection with multidrug-resistant organisms. PubMed, the Cochrane Library, and Web of Science were searched in May 2020 to find observational studies in English about the clinical outcomes of multidrug-resistant organism infection in diabetic foot ulcers. Eight studies met the inclusion criteria, and these studies included 923 patients. The overall methodological quality of the study was moderate. Ulcer duration was described in six studies, and there was no practical association with multidrug-resistant organisms. Two out of three studies reported a longer healing time in multidrug-resistant organism infections than in non-multidrug-resistant organism infections. Clinical outcomes included the duration of hospitalisation, surgeries, amputations, and deaths. Lower limb amputation was the most reported clinical outcome in the included studies, and was more prevalent in the multidrug-resistant organism infections. We concluded that there was not enough evidence that multidrug-resistant organisms hindered the healing of diabetic foot ulcers. In contrast to the clinical outcomes, multidrug-resistant organisms affect both amputation rates and mortality rates.

Aim: To compare long-term complications according to the treatment received for management of diabetic foot osteomyelitis (surgical or medical) at 1 year follow up. Design and Participants: A prospective observational study was conducted involving 116 patients with diabetic foot osteomyelitis. The patients received surgical or medical treatment based on the principles described in the literature. To register the development of a complication, both groups of treatments were followed-up 1 year after the ulcer had healed. Results: Ninety-six (82.8%) patients received surgical treatment and 20 (17.2%) medical treatment. No differences were found in the time to healing between both groups of treatment, 15.7 ± 9.2 weeks in the surgical group versus 16.4 ± 12.1 weeks in the medical group, p = 0.103. During follow up, 85 (73.3%) patients developed complications without differences between both groups, 68 (70.8%) in the surgical group versus 17 (85%) in the medical group (p = 0.193). The most common complication in both groups was re-ulceration. We did not observe significant differences comparing complication-free time survival between both treatments (p = 0.665). Conclusion: The onset of complications after healing in patients who suffered from diabetic foot osteomyelitis was not associated with the treatment received. Surgical and medical approaches to the management of diabetic foot osteomyelitis produced similar results in long-term follow up.

To evaluate the metatarsal head that was associated with the highest plantar pressure after metatarsal head resection (MHR) and the relations with reulceration at one year, a prospective was conducted with a total of sixty-five patients with diabetes who suffered from the first MHR and with an inactive ulcer at the moment of inclusion. Peak plantar pressure and pressure time integral were recorded at five specific locations in the forefoot: first, second, third, fourth, and fifth metatarsal heads. The highest value of the four remaining metatarsals was selected. After resection of the first metatarsal head, there is a displacement of the pressure beneath the second metatarsal head (p &lt, 0.001). Following the resection of the minor metatarsal bones, there was a medial displacement of the plantar pressure. In this way, plantar pressure was displaced under the first metatarsal head following resection of the second or third head (p = 0.001) and under the central heads after resection of the fourth or fifth metatarsal head (p &lt, 0.009 and p &lt, 0.001 respectively). During the one-year follow-up, patients who underwent a metatarsal head resection in the first and second metatarsal heads suffered transfer lesion in the location with the highest pressure. Patients who underwent a minor metatarsal head resection (second–fifth metatarsal heads) showed a medial transference of pressure. Additionally, following the resection of the first metatarsal head there was a transference of pressure beneath the second metatarsal head. Increase of pressure was found to be a predictor of reulceration in cases of resection of the first and second metatarsal heads.

A systematic review and quality assessment was performed to assess the management of diabetic foot osteomyelitis by medical or surgical treatment. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used. All selected studies were evaluated using the Cochrane Risk of Bias Tool to assess the risk of bias for randomized controlled trials. The literature was revised using PubMed (Medline) and Embase (Elsevier) up to September 2020 to identify clinical trials assessing medical or surgical treatment to manage diabetic foot osteomyelitis. A total of six clinical trials that met our inclusion criteria, with a total of 308 participants. Healing rate, complete closure of the wound, and type of complications were the outcomes evaluated. Risk of bias assessment showed that only two of the six clinical trials included in the systematic review had a low risk of bias. Based on our findings, we believe that the management of diabetic foot osteomyelitis remains challenging. There are few high-quality clinical trials that both stratify clinical presentations and compare these treatments. We conclude that the available evidence is insufficient to identify the best option to cure diabetic foot osteomyelitis.

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.

Tailor&rsquo, s bunion (TB) disease should be considered one of the foot injuries that causes disability in feet as well as general health. This case&ndash, control descriptive study investigated and contrasted the effects of different TB types in a sociodemographic population using the Foot Health Status Questionnaire (FHSQ). A sample of 100 subjects with a mean age of 51.70 &plusmn, 17.78 years was recruited and requested to reply to a foot health survey. Results were self-reported. Subjects were scored. Participants with TB type III (TB3) registered lower scores for foot pain, foot function, footwear, and foot health. Physical activity and social capacity had higher scores, and vigor and general health were lower. A Kruskal&ndash, Wallis test was used for systematic differences between the FHSQ and different TB types. In all analyses, statistical significance was considered a p-value &lt, 0.05 with a 95% confidence interval. Statistically significant differences were found between all domains of the FHSQ and TB, except for the social capacity domain and vigor. The FHSQ is an important measurement tool in TB subjects, showing that factors such as sex, age, and footwear used throughout an individual&rsquo, s life are significantly associated with the development of TB3 and its influence on foot pain and foot health.

[Abstract] Reduced plantar foot sensation, postural instability, and gait difficulties are characteristic of Parkinson´s disease patients. A systematic review was carried out to determine the effect of the different types of insoles and shoes in these patients. Several databases were used to search for relevant articles reporting Parkinson´s disease patients undergoing treatment with any type of insole and footwear. All titles and abstracts were reviewed independently by two reviewers and the available data were extracted. The study eligibility criteria were any type of experimental study that included Parkinson’s disease patients treated with any type of insole or footwear. Eight studies were selected. Interventions used were textured insoles, footwear modifications, and habitual footwear. Three different outcomes were evaluated in each study: gait parameters, balance, and plantar sensation. According to the data available from this systematic review, the most important conclusion is that more controlled studies are needed in this research field. There are indications to suggest that textured insoles have positive effects on gait parameters, balance, and plantar sensation in Parkinson’s disease patients. This research was funded by the Generalitat Valenciana, grant number GV/2020/061 Generalitat Valenciana; GV/2020/061

Background: The effects of the dry needling technique and pain reduction have been demonstrated in numerous quality studies. However, the mechanical effects of dry needling are largely unknown. Methods: A total of 18 subjects with flexor digitorum brevis muscle myofascial trigger point were evaluated pre- and post-deep dry needling. We measured static footprint variables in a pre&ndash, post study. Main findings: We found differences in rearfoot maximum pressure (119.22&ndash, 111.63 KPa, p = 0.025), midfoot maximum pressure (13.68&ndash, 17.26 KPa, p = 0.077), midfoot medium pressure (4.75&ndash, 6.24 KPa, p = 0.035) and forefoot surface (86.58&ndash, 81.75 cm2, p = 0.020). All variables with significant differences decrease, with the exception of forefoot surface which showed an increase. Conclusions: After flexor digitorum brevis muscle dry needling, midfoot plantar pressures (maximum and medium) and forefoot surface were increased, and rearfoot maximum pressure was decreased.

The Catalan diabetic foot health program was established in 2009 in order to prevent complications caused by type 2 diabetes. This study aims to describe its application from 2009 to 2018. The objective was to describe diabetic foot care provision in the National Health System of Catalonia between 2009 and 2018, including the number of patients and professionals involved, the causes behind patients’ visits, and the most demanded codes for diagnosis and treatment filled by the podiatrist in each consultation during 2018–2020. This description was addressed through an analysis of the database provided by the Association of Podiatrists to evaluate the implementation of the program. The results for the diabetic foot health program in Catalonia showed a growth in demand from 2009 (1,726) to 2018 (213,095) in terms of visits and from 2009 (1,541) to 2018 (104,629) in terms of patients. The number of registered podiatrists from 2009 to 2018 increased from 165 to 470. The most commonly used diagnosis codes were (a) without sensory alterations in control and treatment of grade 1 lesions, (b) grade 0 without neuropathic, vascular, structural, or biomechanical alteration, (c) no sensory structural alterations in the foot, (d) keratopathies. The treatments most commonly used were (a) conservative (chiropody), (b) without ortho-podiatric treatment, and (c) plantar supports. The conclusions show that the health program is in great demand amongst the population. Similarly, the coding system has made it possible to identify the diagnosis and treatment of such demand.

Background: The mobility of the first metatarsophalangeal joint (I MPTJ) has been related to the proper windlass mechanism and the triceps surae during the heel-off phase of running gait, the orthopedic treatment of the I MPTJ restriction has been made with typical Morton extension orthoses (TMEO). Nowadays it is unclear what effects TMEO or the novel inverted rocker orthoses (NIRO) have on the EMG activity of triceps surae during running. Objective: To compare the TMEO effects versus NIRO on EMG triceps surae on medialis and lateralis gastrocnemius activity during running. Study design: A cross-sectional pilot study. Methods: 21 healthy, recreational runners were enrolled in the present research (mean age 31.41 &plusmn, 4.33) to run on a treadmill at 9 km/h using aleatory NIRO of 6 mm, NIRO of 8 mm, TMEO of 6 mm, TMEO of 8 mm, and sports shoes only (SO), while the muscular EMG of medial and lateral gastrocnemius activity during 30 s was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was calculated and the Wilcoxon test of all five different situations were tested. Results: The reliability of values was almost perfect. Data showed that the gastrocnemius lateralis increased its EMG activity between SO vs. NIRO-8 mm (22.27 &plusmn, 2.51 vs. 25.96 &plusmn, 4.68 mV, p &lt, 0.05) and SO vs. TMEO-6mm (22.27 &plusmn, 2.51 vs. 24.72 &plusmn, 5.08 mV, p &lt, 0.05). Regarding gastrocnemius medialis, values showed an EMG notable increase in activity between SO vs. NIRO-6mm (22.93 &plusmn, 2.1 vs. 26.44 &plusmn, 3.63, p &lt, 0.001), vs. NIRO-8mm (28.89 &plusmn, 3.6, p &lt, 0.001), and vs. TMEO-6mm (25.12 &plusmn, 3.51, p &lt, 0.05). Conclusions: Both TMEO and NIRO have shown an increased EMG of the lateralis and medialis gastrocnemius muscles activity during a full running cycle gait. Clinicians should take into account the present evidence when they want to treat I MTPJ restriction with orthoses, and consider the inherent triceps surae muscular cost relative to running economy.

Subungual osteochondroma (SO) is an infrequent and non-malignant bone tumour of the distal phalanx, especially prominent in paediatric populations. The aim of this research was to describe a case series of paediatric feet with SO which received surgical treatments. The secondary purpose was to compare these descriptive data by sex distribution. Methods: Twenty-three paediatric feet with SO confirmed by clinical or radiological features received surgical treatment. Socio-demographic (age, sex, height, weight and BMI) and clinical features (side, location, tumour or pain presence, and nail lift before surgery, as well as recurrence and adverse effects at one month after intervention) were reported. Results: Regarding clinical features before intervention, the most frequent locations of SO were the first toe (86.8%) and the right lower limb (56.5%). In addition, the presence of the tumour, pain and nail lift showed a prevalence of 91.3%, 69.5% and 47% of the study sample, respectively. Considering clinical features at one month after intervention, the most frequent adverse effect was the pain presence (69.5%). In addition, one case (4.4%) presented ulceration. Only one patient (4.4%) suffered from recurrence with a new tumour. There were not statistically significant differences by sex distribution (p &gt, 0.05). Conclusions: This novel study showed that surgery treatment for SO in paediatric populations presented a very low recurrence degree with minor adverse effects and without differences by sex distribution. Thus, further randomized clinical trials should be carried out in order to determine the effectiveness of this intervention in this special population.

Background: In onychocryptosis surgery, incisional and non-incisional matricectomy is indicated according to the stage. The chemical matricectomy with 88% phenol solution is the gold standard and a wedge resection is indicated for more advanced stages. The aesthetic reconstruction has the advantages of the incisional procedure without eponychium incisions and an effectiveness similar to the chemical matricectomy with phenol. Objective: To compare the recurrence and the healing time between the chemical matricectomy with phenol and the aesthetic reconstruction. Methods: A comparative, prospective, parallel, randomized, and one-blinded clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2019-001294-80. Thrity-four patients (56 feet) with 112 onychocryptosis were randomized in two groups. Thirty-six were treated with chemical matricectomy with phenol and 76 with aesthetic reconstruction. Each patient was blind to the surgical procedure assigned by the investigator. The primary outcome measurements were healing time and recurrence. The secondary outcome measurements were post-surgical bleeding, pain, inflammation, and infection rate. Results: The aesthetic reconstruction procedure presents a shorter healing time (8.2 &plusmn, 1.4 days vs. 21.3 &plusmn, 3.1 days, p &lt, 0.001) with a similar recurrence rate (p = 0.98). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p &gt, 0.05). Conclusions: The aesthetic reconstruction presents a shorter healing time, favoring the patients&rsquo, recuperation, with a recurrence similar to the chemical matricectomy with 88% phenol solution.

Background: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities. Objective: The main purpose was to determine the anatomic and histological features of the EDL&rsquo, s insertion to the proximal nail matrix of the second toe. Methods: A sample of fifty second toes from fresh-frozen human cadavers was included in this study. Using X25-magnification, the proximal nail matrix limits and distal EDL tendon bony insertions were anatomically and histologically detailed. Results: The second toes&rsquo, EDLs were deeply located with respect to the nail matrix and extended superficially and dorsally to the distal phalanx in all human cadavers. The second toe distal nail matrix was not attached to the dorsal part of the distal phalanx base periosteum. Conclusions: The EDL is located plantar and directly underneath to the proximal nail matrix as well as dorsally to the bone. The proximal edge of the nail matrix and bed in human cadaver second toes are placed dorsally and overlap the distal EDL insertion. These anatomic and histological features should be used as reference landmarks during digital surgery and invasive procedures.

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 &plusmn, 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&deg, D Shore), 2: Polypropylene (58&deg, D Shore) with selective aluminium in hallux and metatarsal heads (60 HB Brinell hardness), 3: Ethylene vinyl acetate (EVA) (52&deg, A Shore), and finally, 4: Ordinary EVA (25&deg, 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.

Objective: to evaluate the level of physical activity and sedentary behavior of Brazilian podiatry professionals. Methods: 103 podiatrists of both sexes participated in the study, where 96 were women and 7 men, who underwent an assessment of sedentary behavior, level of physical activity and body composition. Statistical analysis: the data description was expressed as mean and standard deviation and the program used was the Statistical Package for the Social Sciences - version 20.0 (SPSS). Results: the professionals who participated in the research work an average of more than 9 hours a day, suggesting a long professional journey, in relation to the Physical Activity Level (NAF), the subjects evaluated were 80.39% insufficiently active and 19, 61% active and it was observed that the evaluated subjects spend 7.52 (± 3.50) hours sitting during the weekdays and 5.44 (± 3.24) hours of the day on the weekend. Conclusion: it was observed that podiatrists in Brazil do not comply with the recommendation of physical activity proposed by WHO and that the evaluated were exposed to excessive sedentary behavior.

BACKGROUND: This study determined if the body mass index, dynamic plantar-pressures, plantar surface contact-area, velocity of the centre of pressure (COP), gastrocnemius equinus, and gastrocnemius soleus equines are related to calcaneal apophysitis (Sever's disease) in athletic children. METHODS: This case-control study examined 106 boys enrolled in a soccer academy, including 53 with Sever's disease and 53 age-matched healthy controls. The dynamic average and maximum peak plantar-pressures, plantar surface contact-area, and velocity of the COP were evaluated with a digital pressure sensor platform. Goniometry was used to measure the ankle dorsiflexion range of motion and thereby identify gastrocnemius equinus and gastrocnemius soleus equinus. RESULTS: Participants with Sever's condition had significantly higher BMI and peak plantar-pressures (maximum and average) at the heel (Cohen's d > 3 for pressures) than the controls. Those with Sever's disease also had significantly slower velocity of the COP (Cohen's d > 3). Boys with Sever's disease were also 8 times more likely to have bilateral gastrocnemius equinus than disease controls. CONCLUSIONS: High heel plantar pressure and low velocity of COP are related to Sever's condition in boys, although it is not clear whether these factors predispose individuals to the disease or are consequences of the disease. Gastrocnemius ankle equinus could be a predisposing factor for Sever's condition. Sin financiación 1.983 JCR (2018) Q2, 56/125 Pediatrics 1.115 SJR (2018) Q1, 47/318 Pediatrics, Perinatology and Child Health No data IDR 2018 UEM

A dor e o sofrimento estão presentes em todos os sistemas de exploração de bovinos leiteiros e as podopatias, associadas ou não as claudicações, representam um dos mais importantes problemas de saúde que compromete o bem-estar desta categoria animal. Do ponto de vista médico a dor e o sofrimento são entidades nosológicas complexas e o seu diagnóstico, controle e tratamento envolve fatores que interagem não só com os animais, mas com o homem, o qual representa o problema central. Neste contexto, a sociedade vem se tornando cada vez mais sensível a dor e ao sofrimento animal, demonstrando sentimento que não se limita apenas a crueldade. Existem vários fatores pelos quais esta problemática persiste nos ambientes de criação de bovinos e, na maioria das vezes, têm sido ignorados. No entanto, alguns destes fatores são opressivamente subordinados a pecuária estritamente condicionada pelo valor econômico dos animais, fazendo da eutanásia, morte ou abate antecipado um refúgio para escapar da dor e do sofrimento desnecessários. Neste cenário, a bovinocultura leiteira tem características essencialmente extrativistas, não só do ponto de vista econômico, mas também científico. Esta revisão tem o objetivo de discutir os aspectos da dor e do sofrimento dos bovinos leiteiros afetados por podopatias e gerar um modelo conceitual de avaliação desta e outras patologias no contexto das questões de bem-estar, legislação pertinente, comissões de ética e sociedades protetoras dos animais.

El Objetivo fue determinar la frecuencia de trastornos pódales en bovinos doble propósito en el Departamento de Córdoba. Se hizo un estudio de corte transversal utilizando 170 vacas mayores de tres años escogidas al azar en diferentes fincas del departamento de Córdoba, Colombia, las cuales fueron evaluadas mediante la realización del examen clínico general y del sistema locomotor, con énfasis en la evaluación de las pezuñas, determinando la normalidad o anormalidad que presentaron estas y de acuerdo con la lesión encontrada se identifico dicho trastorno. La frecuencia de trastornos pódales en el Departamento de Córdoba fue del 64,70% del total de la muestra estudiada. El 30,59% de los animales estudiados presentaron alteración de la relación 2:1 muralla-talón y el 47,05% presentaron algún tipo de patología podal. Las patologías pódales encontradas fueron: Pezuña en tirabuzón (36,47%), Granuloma digital (17,06%), Pododermatitis séptica (4,71%) y Callo interdigital (2,35%). La incidencia de cojeras fue del 78,75% con respecto a los animales que presentaron patologías y de 37,05% con relación al total de la muestra. Además se encontró dependencia entre el tipo de terreno con relación al trastorno podal e independencia entre arreglos pódales y presencia de pediluvios con relación al trastorno podal.

E-learning platforms used in Higher Education Institutions store valuable information that can be analysed. Data mining is a multidisciplinary technique that integrates computer science, education, and statistics, and that could serve to interpret results and predict academic performance through the virtualized subjects. Objective: To identify the use of the interactive platform based on Moodle LMS (Learning Management System) in the Occupational Health compulsory subject in the curriculum of the podiatry degree and its relationship with academic success from 2017 to 2019 courses. Materials and methods: Logs (files of the interactions between a system and the students in the virtual system) for analyzing a variety of information from different activities carried out through the virtual campus on a Moodle platform were extracted, depurated and prepared for analysis. Finally, 33,776 (13,818 in 2017 and 19,958 in 2018) logs were used to perform the statistical analysis using the RStudio program and the SPSS v.22 software. A descriptive analysis, Pearson correlations and continuous variable decision trees diagrams were performed to determine the use of the Moodle classroom activities and resources and their relationship with academic results obtained in this subject. Results: 62 students enrolled in the academic course 2017-18 and 59 in the 2018-19 were studied. In the academic course of 2017-18, 62.9% were women, and mean and SD of academic results was 7.5±1.09. In 2018-19 academic course, 76.3% were women, and the mean results was 7.2±1.06. The highest peak of activity registered on the virtual subject was 200 visits in each academic course, with differences by months in relation to the distribution of tasks. The highest activity recorded was on Tuesdays and Sundays, in both years, but with more activity in the 2018-19 academic year. Lessons were the most used tools in both courses (40.3% in 2017 vs 46.2% in 2018) followed by the participation in forums (32.7% in 2017 vs 12.8% in 2018). Participation in the forums was 100% vs 93.1% and URLs entries 71.43% vs 87.93%; comparing both academic courses. In 2018, 3 new tools were introduced with high participation: Self-assessment Test 96.55%, glossary 87.93% and a wiki activity with a 48.28% of participation. Tools that significantly correlated with better test scores in year 2017 was the participation in the forums (p=0.016), while in 2018 test scores were significant correlated with the participation in the tasks (p=0.041) and self-assessment tests (p=0.044) carried out on the virtual classroom. Tree-like graphs identified two clusters of students related with forums and URLs entries, in the virtual classroom. Conclusion: This study reveals the importance of identifying and selecting tools with the capacity to improve and stimulate active and significant learning.

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 &lt, 0.01, &eta, 2 = 0.132&ndash, 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 &lt, 0.05, d = 0.85&ndash, 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 &lt, 0.05) for kinesiophobia (R2 = 0.300) and pain intensity (R2 = 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.

espanolObjetivo: El objetivo principal de este trabajo fue comprobar si el dolor y la funcionalidad del pie eran diferentes en pacientes con y sin diabetes mellitus. Pacientes y metodos: La muestra fue obtenida en el Area Clinica de Podologia de la Universidad de Sevilla, y estuvo compuesta por 101 pacientes divididos en dos grupos: 57 sujetos con diabetes mellitus y 44 personas sin diabetes mellitus. Se emplearon los cuestionarios Foot Function Index y el Cuestionario de Manchester sobre el dolor y la discapacidad del pie para medir el dolor y la funcionalidad del pie. Resultados: Existen diferencias significativas entre los dos grupos en el componente funcional del Cuestionario de Manchester sobre el dolor y la discapacidad del pie, donde la mejor puntuacion la obtiene el grupo sin diabetes mellitus. Para el resto de valores no existen diferencias significativas. Conclusiones: El grupo de pacientes con diabetes mellitus presento mayor limitacion funcional de acuerdo con los resultados obtenidos del Cuestionario de Manchester sobre el dolor y la discapacidad del pie. El dolor fue el mismo en presencia de diabetes mellitus o no. EnglishObjective: The main objective of this work was to verify if the pain and functionality of the foot were different in patients with and without diabetes mellitus. Method: The sample was obtained in the podiatric clinic area of the University of Seville, and consisted of 101 patients divided into two groups: 57 patients with diabetes mellitus and 44 persons without diabetes mellitus. The Foot function index and the Manchester foot pain and disability index were used to measure foot pain and functionality. Results: There are significant differences between the 2 groups in the functional component of the Manchester foot pain and disability index, where the best score is obtained by group B. For the rest of the values there were no significant differences. Conclusions: The group of patients with diabetes mellitus presented greater functional limitation according to the results obtained from the Manchester foot pain and disability index. The pain was the same in the presence of diabetes mellitus or not.

[Resumen] Objetivos. Se ha planteado como objetivo la mejora de la calidad de la docencia de la Microbiología mediante la actualización de la metodología docente, introduciendo como actividad el aprendizaje activo basado en la detección de portadores nasales de Staphylococcus aureus para conseguir mejorar las competencias que deberán adquirir los estudiantes como parte de su formación integral. Material y métodos. En este estudio han participado 56 y 72 alumnos (128 alumnos en total) del Grado de Podología de la Universidad Complutense de Madrid de los cursos 2018-2019 y 2019-2020, respectivamente. Los alumnos asistieron al laboratorio de Microbiología y completaron el estudio. Resultados. Un total de 29 alumnos (22,7%) fueron portadores nasales de S. aureus, uno de los cuales fue portador de S. aureus resistente a meticilina (SARM). La valoración de la actividad por parte de los alumnos fue muy positiva y se produjo una mejora general en la adquisición de conocimientos. Conclusión. El trabajo en el laboratorio de Microbiología unido a la actualización en la metodología docente puede mejorar el rendimiento académico de los estudiantes de Microbiología al relacionarlo con su futura práctica profesional y el diagnóstico microbiológico. [Abstract] Objectives: The objective has been to improve the quality of Microbiology teaching by updating the teaching methodology, introducing active learning as an activity based on the detection of nasal carriers of Staphylococcus aureus to improve the skills to be acquired by students as part of their integral formation. Methods: In this study, 56 and 72 students (total 128) of the Second Course of the Podiatry Degree of the Complutense University of Madrid from 2018-2019 and 2019-2020 academic years, respectively, participated. The students attended to the Microbiology laboratory. Results: A total of 29 students (22.7%) were nasal carriers of S. aureus of which one student was nasal carrier of methicillin-resistant S. aureus (MRSA). The assessment of the activity by the students was very positive and there was an improvement in knowledge acquisition. Conclusion: The work in the Microbiology laboratory together with the update in the teaching methodology can improve the academic performance of Microbiology students when related to their future professional practice and the microbiological diagnosis.

Fundamento: A incidência e a mortalidade por melanoma cutâneo vêm aumentando em todo o mundo. Os registros brasileiros de bases populacionais não refletem precisamente a real dimensão do problema.Objetivo: O objetivo deste trabalho foi descrever a importância da Podologia e do Podólogo na detecção do Melanoma e o relato de caso de um homem adulto de 69 anos.Método: Foi feita uma revisão bibliográfica para fundamentação teórica.Resultado: Ficou evidenciada a importância do exame de anatomia patológica no diagnóstico precoce da doença e a participação inicial do podólogo.Conclusão: É determinante a qualificação do profissional da podologia, sem o qual neste caso, o paciente poderia ficar sem a orientação inicial que o levou a diagnóstico precoce e cura.

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.

Background: Leukocyte and platelet-rich fibrin (L-PRF) may be considered a co-adjuvant intervention that may play a key role in blood coagulation and tissue repair after nail surgeries. The aim of this study was to determine the effectiveness of L-PRF versus nitrofurazone on the post-surgical bleeding and wound cicatrization period in patients with bilateral onychocryptosis during surgeries of chemical matrixectomies with 88% phenol solution. Methods: A randomized single-blind clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2016-002048-18. Twenty healthy participants with bilateral onychocryptosis (n = 40) were recruited and bilaterally received both protocols for both halluces. Patients with a mean age mean of 45.55 &plusmn, 12.19 years attended a specialized foot and ankle surgery clinic. Both halluces of each patient were randomized and allocated to receive L-PRF (experimental group, n = 20 halluces) or nitrofurazone (control group, n = 20 halluces) interventions in conjunction with surgery of chemical matrixectomies with 88% phenol solution for bilateral ingrown of toenail border (medial and lateral). Patients were blinded to their intervention in each hallux. The primary outcome measurement was post-surgical bleeding. The secondary outcome measurements were post-surgical pain intensity, inflammation, infection, analgesic intake, and wound cicatrization period. Results: Statistically significant differences (p &lt, 0.001) were found between both groups showing a reduction for wound cicatrization period and post-surgical bleeding for the L-PRF intervention with respect to nitrofurazone treatment. The rest of the outcome measurements did not show any statistically significant differences (p &gt, 0.05). Conclusions: L-PRF rather than nitrofurazone in conjunction with chemical matrixectomies performed with 88% phenol solution reduced the wound cicatrization period and bleeding after nail surgery. Thus, L-PRF may be considered a first-line co-adjuvant intervention for patients who suffer from nail problems, such as onychocryptosis, that require surgical procedures.

A exostose subungueal é o crescimento do tecido ósseo, mais comumente afetando o halux. Apresenta-se como edema solitário de coloração púrpura ou de cor de pele firme embaixo da unha que pode alcançar tamanho de 8 a 10 mm no diâmetro. Segundo autores o exame de raios-X confirma o diagnóstico. As lesões desenvolvem-se principalmente por trauma, em alguns casos ocorre evolução espontânea. Sendo o podólogo o profissional capacitado a aplicar terapias nos pés bem como atuar junto a uma equipe multiprofissional para melhorar a qualidade de vida dos indivíduos, essa pesquisa se fez necessária com objetivos de identificar esta patologia em atletas do gênero feminino e masculino que praticam futebol de campo. O trabalho foi realizado através de um estudo comparativo com base na incidência. Tratou-se de uma pesquisa qualitativa analítica e descritiva, fundamentada na pesquisa de campo. O cenário do estudo foi o Clube Atlético Juventus de São Paulo, Brasil. A população em estudo foi composta de jogadores de futebol de ambos os sexos com idade acima de 18 anos. Realizou-se coleta de dados através de entrevistas individuais, com roteiro previamente elaborado. Os dados obtidos foram analisados por meio da técnica de Análise de conteúdo temática, orientada por Minayo (2006). Os resultados revelaram que dos 22 participantes finais da pesquisa apenas dois do sexo feminino apresentaram exostose subungueal. Mostrou que a grande maioria possui peso adequado entre 60 a 70 quilos, e apresentaram idade entre 18 a 20 anos. Constatou-se que 90% fazem uso de calçado fechado e que 36,36% já sofreram traumas nos pés. Através da pesquisa foi possível verificar que nos atletas do gênero masculino, não foi identificado exostose subungueal, nas atletas do gênero feminino foi identificado um baixo índice de exostose subungueal.

Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (P &lt, 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P &gt, 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.

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

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 &plusmn, 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&deg, Shore D), (2) selective aluminum (60 HB Brinell hardness) in metatarsal and first hallux areas and polypropylene elsewhere (58&deg, Shore D), (3) ethylene vinyl acetate (EVA) (52&deg, Shore A), and (4) standard EVA (25&deg, 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&deg, Shore D, EVA 52&deg, Shore A, and standard EVA 25&deg, Shore A), except for the fibularis longus in right curves that is increased when the knee touches the road increasing the stability.

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 &plusmn, 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 &plusmn, 0.10&deg, to 3.46 &plusmn, 0.05&deg, (p &lt, 0.05) and from 1.35 &plusmn, 0.28&deg, to 1.69 &plusmn, 0.30&deg, 0.001), respectively. In addition, a PPH abduction increase from 1.01 &plusmn, 0.36&deg, to 1.31 &plusmn, 0.46&deg, 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.

Background: Postural balance and fall efficacy (self-perceived confidence in performing daily physical activities) have been found to be risk factors associated with falls in older adults. Stretching is one intervention that has been investigated to improve balance and therefore reduce fall risk. Various forms of stretching have been evaluated with different outcomes, but there is a lack of knowledge about the effect of stretching (continuous and intermittent) on plantar pressures and balance. Therefore, the aim of the present study was to analyze the effects of stretching (continuous and intermittent) of the bilateral ankle plantar flexors on plantar pressures and static balance. Methods: A randomized clinical trial was carried out. Forty-eight healthy subjects (42 females and 6 males) were recruited in an outpatient clinic. Subjects were randomly assigned to an intermittent stretching group (five sets of 1 min, 15 s of rest) or a continuous stretching group (2 min of continuous stretching) of the plantar flexors. Plantar pressures and balance using stabilometry were measured before and after stretching. Results: There were significant differences between intermittent and continuous stretching in rearfoot maximum pressure, forefoot surface area, and center of pressure surface area with eyes open. Conclusions: Bilateral intermittent stretching of the ankle plantar flexors was found to be more effective than continuous stretching for the reduction of rearfoot maximum pressure and improved balance.

Purpose: To compare and quantify with ultrasound imaging (USI) the inter-recti distance (IRD), rectus abdominis (RA), external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and multifidus thickness and the RA and multifidus cross-sectional area (CSA) between individuals with and without chronic mid-portion Achilles tendinopathy (AT). Methods: A cross-sectional study. A sample of 143 patients were recruited and divided into two groups: A group comprised of chronic mid-portion AT (n = 71) and B group composed of healthy subjects (n = 72). The IRD, RA, EO, IO, TrAb, and multifidus thickness, as well as RA and multifidus CSA, were measured by USI. Results: USI measurements for the EO (p = 0.001), IO (p = 0.001), TrAb (p = 0.041) and RA (p = 0.001) thickness were decreased as well as IRD (p = 0.001) and multifidus thickness (p = 0.001) and CSA (p = 0.001) were increased for the tendinopathy group with respect the healthy group. Linear regression prediction models (R2 = 0.260 − 0.494; p < 0.05) for the IRD, RA, EO, and IO thickness (R2 = 0.494), as well as multifidus CSA and thickness were determined by weight, height, BMI and AT presence. Conclusions: EO, IO, TrAb, and RA thickness was reduced and IRD, multifidus thickness and CSA were increased in patients with AT. Sin financiación 3.706 JCR (2020) Q2, 45/169 Medicine, General & Internal 0.622 SJR (2020) Q3, 70/121 Clinical Biochemistry No data IDR 2019 UEM

Some studies suggest that gender is related to gait. Females show significantly higher ankle motion and vertical ground reaction forces. Males have significantly larger plantar contact surface areas in all regions of the foot than females in most, but not all, prior studies. However, there is no research on sex differences in a functional equinus condition. In this study, 119 individuals, including 59 females (29.7 &plusmn, 5.15 years, 58.74 &plusmn, 6.66 kg, 163.65 &plusmn, 5.58 cm) and 60 males (31.22 &plusmn, 6.06 years, 75.67 &plusmn, 9.81 kg, 177.10 &plusmn, 6.16 cm), with a functional equinus condition walked onto a pressure platform. In two separate testing sessions, five trials of each foot were conducted for the first, second, and third steps. We measured the contact surface areas for each of the three phases of the stance phase. We computed the intraclass correlation coefficient and standard error of the mean to assess the reliability. We found significantly greater contact surface areas in males than females in the first, second, and third steps in all phases of the stance phase: heel strike, mid-stance, and take-off. This is important information for the design of footwear and orthotics and gender knowledge. In a functional equinus condition, males have registered greater contact surface areas than females in all phases of the dynamic footprint of the stance phase.

Heel pain is one of the most frequent complaints in medical clinical practice for conditions affecting the feet during weight-bearing tasks. OBJECTIVE: The goal of this study was to measure and compare the thickness of the fat pad in a sample of patients with current unilateral heel pain and patients without unilateral heel pain with normalized reference parameters. STUDY DESIGN: This was an observational case-control study. SETTINGS: The research took place in the podiatry department within a medical health care center. METHODS: A total of 375 patients were randomly selected from a pool of patients attending a medical health care center between the years 2008 and 2015 and diagnosed by a single medical podiatrist without having previous treatment. Patients were categorized in 2 groups: a heel pain group (n = 185) and a control group (asymptomatic; n = 190). The thickness of the plantar fat pad was measured with an ultrasonic probe (BodyMetrix® BX 2000; IntelaMetrix, Inc, Livermore, CA). RESULTS: Initial examination of both groups indicated no significant differences in age, height, weight, or body mass index (P > 0.01). There were, however, significant differences in the thickness of the fat pad between those in the heel pain group and those in the control group, when analyzed by group and by gender (P < 0.01; Cohen´s d = 0.465-1.959). LIMITATIONS: The study was not a randomized controlled trial. Although primary outcome data were self-reported, the assessor was not blinded. CONCLUSION: This study provides further evidence that people with unilateral heel pain showed a significantly decreased thickness of the subcalcaneal fat pad, regardless of gender. Sin financiación 3.251 JCR (2019) Q2, 11/32 Anesthesiology, 70/204 Clinical Neurology 1.099 SJR (2019) Q1, 19/126 Anesthesiology and Pain Medicine No data IDR 2019 UEM

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&reg, Gym Step&reg, and Milan-SCL Liso&reg, ) were evaluated with respect to barefoot condition for stability measures on the Podoprint&reg, 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 &lt, 0.05). Milan-SCL Liso&reg, sanitary shoes improved podobarometric data of forefoot force and distribution with respect to barefoot condition. Eva Plus Ultralight&reg, and Gym Step&reg, 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&ndash, 0.995). Conclusions: Sanitary shoes improved podobarometric and stabilometry stability with respect to barefoot condition.

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.

Background: Based on changes in lung function and musculoskeletal disorders in patients with asthma, this study aimed to compare the tarsal tunnel and fibular bone pressure pain thresholds (PPTs) of patients with asthma and healthy matched-paired controls. Methods: A case-control study was performed. One hundred participants were recruited: 50 asthma patients and 50 healthy matched-paired controls. Bilaterally, tarsal tunnel and fibula bone PPTs were registered. Results: Statistically significant differences (p &lt, 0.01) were shown bilaterally for tarsal tunnel PPT. With the exception of fibula PPT (p &gt, 0.05), asthma patients presented less tarsal tunnel PPT than healthy participants. Statistically significant differences (p &lt, 0.05) were shown for two linear regression prediction models of the right (R2 = 0.279) and left (R2 = 0.249) tarsal tunnels PPTs as dependent variables, and based on sex, group, contralateral tarsal tunnel PPT and ipsilateral fibula PPT as independent variables. Conclusions: The study findings showed that a bilateral tarsal tunnel mechanosensitivity increase is exhibited in patients diagnosed with asthma. The presence of asthma may bilaterally predict the PPT of tarsal tunnel. These findings may suggest the presence of central sensitization in asthma patients, which could clinically predispose them to musculoskeletal disorders, such as tarsal tunnel syndrome.

ObjectiveFoot problems (FP) may be considered to be a prevalent conditions in people but there is limited evidence of their effect on the quality of life (QoL) related to foot health in men and women. The aim of this study was to assess the impact of FPs on both overall foot health and QoL, stratified by gender.DesignA cross sectional study.SettingClinic of Podiatric Medicine and Surgery at University of A Coruña in the city of Ferrol (Spain).SubjectsThe sample consisted of 1647 participants with FP; the total population of the sample had a mean age of 43.24±19.89 years, with mean ages 44.09±21.36 years and 42.94±19.34 years for men and women, respectively.MethodsMeasurement of sociodemographic characteristics include age, sex and body mass index. The Foot Health Status Questionnaire (FHSQ) was used to evaluate the general health and foot health. Differences between groups were evaluated by means of a t-test for independent samples.ResultsWomen with FP showed significantly lower scores in the domains of Foot Pain, Foot Function, Footwear, General Foot Health, Physical Activity and Vigour, and there was no difference compared with men in the domains of Overall Health and Social Capacity.ConclusionsWomen with FP present a negative impact on QoL related to foot health as compared with men except in the domains of Overall Health and Social Capacity, which appears to be associated with the presence of foot conditions.

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 &gt, 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 Sin financiación 2.468 JCR (2018) Q2, 112/251 Environmental Sciences, 67/186 Public, Environmental & Occupational Health 0.818 SJR (2018) Q2, 37/137 Health, Toxicology and Mutagenesis, 157/562 Public Health, Environmental and Occupational Health No data IDR 2018 UEM

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

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. Sin financiación 2.468 JCR (2018) Q2, 67/186 Public, Environmental & Occupational Health, 112/251 Environmental Sciences 0.818 SJR (2018) Q2, 37/137 Health, Toxicology and Mutagenesis, 157/562 Public Health, Environmental and Occupational Health No data IDR 2018 UEM

ResumenEste trabajo presenta un resumen de lo realizado en los últimos 12 años de colaboración entre la comunidad escolar de varios centros de enseñanza primaria y secundaria y los/las responsables de las prácticas de la asignatura Podología Preventiva y Comunitaria del Grado en Podología, que se imparte en la Universidad de Sevilla. Se muestran diferentes estrategias llevadas a cabo desde las líneas de investigación Salud Podológica para Todos y Podología Preventiva y Comunitaria, integradas en el Grupo de Investigación Hermes (CTS-601), dirigidas a promocionar la salud podológica en general. Se ha explorado un total de 4630 escolares y se han confirmado alteraciones podológicas en 677. También se han beneficiado 7145 miembros de la comunidad escolar a quienes se ha llegado a través de actividades educativas sobre el cuidado de los pies. Su desarrollo trata de impedir que se generen lesiones, en la edad adulta, que perjudiquen la calidad de vida.AbstractThis article presents an overview of the work done over the past 12 years in a collaboration between the school communities at various primary and secondary schools and the practical experience managers working in the Preventive and Community Podiatry area of the Podiatry degree at the University of Seville (Spain). The article presents several strategies, which were carried out in the fields of Foot Health for All and Preventive and Community Podiatry as part of the Hermes Research Group (CTS-601) aimed at promoting general foot health. Foot examinations were conducted in a total of 4,630 school pupils, with foot problems being confirmed in 677 of them. Some 7,145 members of the school community were also helped, with these people being reached through educational activities around foot care. The aim of the initiative was to prevent foot damage among children, which could have a harmful impact on their quality of life as adults.

espanolIntroduccion: El presente estudio evaluo la frecuencia de onicocriptosis recurrente en pacientes con diabetes mellitus (DM). Pacientes y metodos: Estudio transversal observacional de prevalencia. 146 individuos, diagnosticados de cualquier tipo de DM, excepto DM gestacional, del area basica de salud de los centros de atencion primaria de Bufala y Dr. Robert de Badalona, atendidos en un centro de podologia a traves del programa de pie diabetico del sistema publico de salud en Cataluna. Dos individuos se descartaron por presentar criterios de exclusion. Se valoro la incidencia de onicocriptosis y el tipo de curas de los pies realizadas habitualmente, a traves de un cuestionario respondido por el paciente. Presencia de signos de neuropatia y o isquemia en extremidades inferiores a traves de exploracion clinica. Resultados: Se encontro una frecuencia de onicocriptosis del 33 %. No se encontro relacion entre presencia de onicocriptosis con la edad, anos evolucion de la DM, presencia de signos de polineuropatia o de isquemia, o el tipo de curas. De los pacientes con onicocriptosis, un 29 % y un 33 % presentaban signos de isquemia y polineuropatia, respectivamente. Conclusiones: Un tercio de los pacientes con DM remitidos presentaba o ha presentado onicocriptosis. Cerca de un tercio de estos pacientes presentan ademas factores de riesgo de pie diabetico: polineuropatia e isquemia. Dos tercios de los pacientes con onicocriptosis se realizan medidas de autocuidado en los pies sin control profesional sanitario EnglishIntroduction: The present study evaluated the frequency of recurrent onychocryptosis in patients with DM mellitus. Patients and methods: Prevalence observational transversal study. 146 individuals, diagnosed of any type of DM, except gestational DM, from the basic health area of the primary care office of Bufala and Dr. Robert de Badalona, attended at a podiatry clinic through the diabetic foot program of the public health system in Catalonia. 2 individuals were ruled out by presenting exclusion criteria.The incidence of onychocryptosis and the type of commonly used foot cures was assessed, through a questionnaire answered by the patient. Presence of signs of neuropathy and or ischemia in lower limbs through clinical examination. Results: A 33 % onychocryptosis frequency was found. No relationship was found between the presence of onychocryptosis with the age, evolution of DM, the presence of signs of polyneuropathy or ischemia, or the type of cure. Of the patients with onychocryptosis 29 % and 33 % presented signs of ischemia and polyneuropathy respectively. Conclusions: One-third of the patients with DM submitted presented or presented onychocryptosis. Many of these patients also have diabetic foot risk factors: polyneuropathy and ischemia. Most patients with onychocryptosis carry out self-care measures at the feet without professional health control.

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&ndash, retest procedures of the PHQ (PHQ-S). Method: The forward/backward translation and test&ndash, 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 &alpha, 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 &alpha, 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&ndash, retest reliability (ICC = 0.99 (95% CI = 0.96&ndash, 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.