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Foot care is a common problem for homeless adults in cities, who often receive fragmented foot care services, resulting in increased foot problems, health complications, hospitalisation, limb removal and disabilities. Among the health factors that negatively affect the homeless, foot health is essential, but often neglected. This study employed a descriptive, cross-sectional research design to assess the foot care of homeless people and develop recommendations for clinical practice. Using Inlow's 60-s foot screening method, the foot conditions of a purposive sample of 65 homeless adults were examined in British Columbia, Canada, in 2019-2020. Descriptive and inferential statistics were used to analyse the data. Determinants, such as sex and years of homelessness significantly contributed to homeless individuals' risk of developing foot problems. Differences in perceived and observed foot problems were influenced by equitable access to social health and healthcare services. Foot assessment is not well-covered by homeless health services and should be implemented as part of the standard medical review of homeless patients. Furthermore, foot assessment should be conducted by healthcare professionals, rather than relying on the standard practice of service users' self-report. Finally, foot care should be based on tailoring assessments and interventions for the individualised needs of homeless service users. Future research must seek ways to integrate homeless individuals' voices in the development, implementation and evaluation of foot care services.

Objective Hallux valgus, the lateral deviation of the great toe, can result in poor balance, impaired mobility and is an independent risk factor for falls. This research aims to compare the prevalence of hallux valgus in subpopulations of medieval Cambridge, England, and to examine the relationship between hallux valgus and fractures to examine the impact of impaired mobility and poor balance caused by this condition. Materials 177 adult individuals from four cemeteries located in Cambridge, England. Methods Human remains were macroscopically and radiographically assessed. Results Hallux valgus was identified in 18 % of individuals and was significantly more common during the 14th–15th centuries than the 11th–13th centuries. The highest prevalence was observed in the friary (43 %), followed by the Hospital (23 %), the rurban parish cemetery (10 %), and the rural parish cemetery (3%). Fractures from falls were significantly more common in those with hallux valgus than those without. Conclusion The increased prevalence of hallux valgus identified in individuals from the 14th to 15th centuries coincided with the adoption of new footwear with pointed toes. Those that adopted this fashion trend appear to have been more likely to develop balance and mobility problems that resulted in an increased risk of falls. Significance This is the first study to explore the relationship between foot problems and functional ability by studying hallux valgus in archaeological assemblages. Limitations Falls are complex and determining the mechanism of injury in human skeletal remains is not always possible. Further research Fracture prevalence rates may have been affected by biological factors and underlying pathological conditions.

According to WHO, about 422 million people are affected with diabetics and among them 15% of diabetic patients are associated with foot problems. Due to peripheral neuropathy, the patients are unable to sense pressure pain which eventually creates calluses. Thus the aim of this study is to effectively find the risk areas which may form ulcers in the foot. The physical components required for this study are a camera which captures high-quality images of foot and a laptop capable of processing image by using MATLAB (The Mathworks Inc., USA). The algorithm which we developed extracts the high-intensity areas in the foot which are actually the areas where the patient exert high pressure compared to other areas in the foot. This method was evaluated by assessing the foot for 5 normal patients and 5 diabetic patients. It is found that this method is capable of giving the riskier areas of the foot and thereby further prevention of foot ulcer can be done. Our method is time-efficient, cost-efficient, and space-efficient and thus can be easily installed in any hospital for diabetic foot analysis. In most of the cases, the metatarsal head region and plantar medial tubercle region are mainly affected by calluses. By proper diagnosis and daily care of the foot can reduce the risk of ulcer in diabetic patients.

As the number of people being diagnosed with diabetes continues to increase, practice nurses need to understand the associated conditions. Linda Nazarko explains diabetic foot care, the development of ulcers, and methods to support people with diabetes Around 1.4 million people in the UK had diabetes mellitus (DM) in 1996 ( Diabetes UK, 2010 ). There are now 3.59 million people who have been diagnosed ( Diabetes UK, 2017 ). In the past, diabetic foot care was managed by podiatrists; however, in recent years practice nurses have begun to undertake diabetic foot assessments ( Lakha and Lee, 2018 ). DM increases the risk of foot problems and the person with diabetes is vulnerable to major complications, including ulcers and amputations. A person with DM is 30 times more likely to require an amputation than a person without diabetes ( Khanolkar et al, 2008 ). Every day, 20 people with diabetes have a lower limb amputation in England ( Diabetes UK, 2016 ). Routine foot care assessments and risk ratings can enable the nurse to determine the patient's level of risk and know when to refer; they can also determine the frequency of monitoring. The practice nurse can also educate and support the person with diabetes to manage their health to reduce the risks of foot problems. Simple interventions such as smoking cessation, inspecting feet daily, seeking help if there are any concerns, and wearing suitable footwear can reduce the risk of ulcers and amputations and improve quality of life. This article aims to enable the practice nurse to understand the components of diabetic foot care, the reasons why people with diabetes develop foot ulcers, and to enable the practice nurse to provide appropriate care and support to people with diabetes.

The foot changes with age. Foot disorders in older adults are associated with falls, lower limb ulcers, and pain. Physical examination of the feet as part of the routine assessment of older adults is imperative to detect foot problems. Foot pain and pathologies are common in older adults. Regular foot care is important to prevent these issues. However, some older adults may find it difficult to complete foot care, including cutting toenails. Regular foot examination can detect common foot problems, functional decline, and is recommended for preventing falls. We describe a technique for performing a focused examination of the feet for older adults. This review addresses current podiatric issues in older patient populations and describes a method for foot examination to address the needs of older adults that can be incorporated into patient assessments in any clinical setting.

Footwear plays a crucial role in several activities to realize aesthetic and cultural needs of urban society. The increasing popularity of high-heeled shoes (HHS) can be attributed to modern fashion, job requirement, and common belief in enhancing aesthetic appeal. Although most women like wearing HHS, it has been reported to be associated with foot problems, i.e., changing the body alignment and muscle activities, knee joint osteoarthritis, lower back pains, redistribute the plantar pressure and ground reaction forces as well as forefoot diseases, which finally can trigger clinical problems of lower extremity. However, wearing a flat-heeled shoe (FHS) would not be accompanied with such problems in the foot. This is why women would be pleased if they could have an adjustable HHS with fast, easy switching ability to a FHS one according to their needs. Therefore, this study was aimed at proposing a newly designed adjustable HHS/FHS to be worn by women for the sake of comfort. To do that, a 3-dimensional computational finite element (FE) model of our own proposed adjustable HHS/FHS was established and the amounts of stress and deformation in the foot and footwear during a simple standing were calculated and compared. The results revealed a lower von Mises stress in the soft tissue and bony structures of the foot when wearing a FHS compared to that of the HHS. The results have implication not only for proposing a newly designed adjustable HHS/FHS to the market, but also for deep understanding of foot and footwear biomechanics and proving women with an innovative flexible design which both keeps their fashion and comfort.

Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.

Objectives: People with type 2 diabetes (T2DM) should check their feet and\ud protect them against harm, but few do. Living with a spouse contributes to\ud good foot care behaviour. This study explores awareness, perceived susceptibility\ud of, and concern about, foot problems, and reported foot care behaviour,\ud and ways in which a spouse may or may not contribute to foot care in\ud T2DM.\ud Methods: 1:1 interviews were conducted with 6 individuals with T2DM. Half\ud had a spouse half did not. There was one person at low, medium and high\ud risk in each sample. Each spouse participated in a separate interview, and the\ud dyads were interviewed together. Interviews were analysed using Applied\ud Thematic Analysis.\ud Results: All participants knew that diabetes was associated with foot problems.\ud Not all people with T2DM thought that they were susceptible; spouses\ud perceived greater susceptibility for the patient. This was unrelated to risk\ud level. Most people with T2DM and all spouses engaged in behaviour to identify\ud problems or protect feet, but rarely both. Spouses’ attitude and behaviour\ud did influence the patients’ own behaviour. At times spouse support was perceived\ud positively, and at times negatively.\ud Conclusion: Engaging spouses in foot care education may improve foot care\ud behaviour.

Background A high percentage of the population report footwear related foot pain, yet there is limited research on the effect footwear has on the development of this pain. The aim of this study was to establish whether footwear purchased by patients have an association with foot pain and what choices determined a purchase decision. Methods Shape and size measurements of the dominant foot and footwear (length and width) were taken from 67 female participants who routinely received podiatric treatment. Participants were also asked to complete a short questionnaire to rate the shoe characteristics, emotions whilst wearing and reasons for the purchase. Results Results highlighted a high prevalence of structural foot pathology for those over 61 who preferred slip on shoes. This group also wore shoes that were significantly narrower than their feet with width difference correlating to the presence of Hallux Abductovarus (HAV). In addition, results indicate that individual footwear advice is more important than previously thought, as it is clear that choice of footwear worn to podiatry appointments are not always worn on a daily basis. Conclusions This study emphasises that the width of the shoe is an important part of fit, highlighting the need for patient specific footwear assessment and education for behaviour changes.

Heel height elevation is correlated with the prevalence of hallux valgus (Dawson et al., 2002; Menz & Morris, 2005), forefoot pain, hallux valgus and calluses are among the common foot problems enc...

Diabetic foot ulcer (DFU) is a common complication observed in diabetic patients and affects diabetic patients in multiple ways. Severe DFU even leads to amputation in many cases. Early detection and intervention of DFU in diabetic patients can significantly relieve the pain caused by the ulcer and also keep patients from losing limbs in severe cases. In this study, the risks of diabetic patients getting DFU were estimated through a hospital-based survey. This survey collected information from hospitalized diabetic patients in Wuhan City, Hubei Province, China, using a questionnaire. This investigation includes studies from two stages with 502 diabetic patients from 20 hospitals in Wuhan City. The results suggested that patients with a long history of diabetes are often associated with a high risk of DFU (χ2=11.428, p=0.0007), smoking (χ2=8.386, p=0.0007), diabetic complications (χ2=13.484, p

Background: Pediatric flatfoot has been reported as the highest clinical complains for foot problems in pediatric department. Nutritional status has showed great influence on the occurrence of flat foot. There are many debates regarding whether underweight or overweight children are more prone to flatfoot. The aim of this study was to analyze the relationship between nutritional status and flatfoot in children. Methods: A cross sectional study was conducted from July to October 2015 in 3 primary schools in Kecamatan Jatinangor. There were 259 children of grade 4 to 5 included in this study. Flatfoot screening was based on measurement of footprint and calculation using Chippaux-smirak index (CSI). The height and weight of children were measured to obtain their Body Mass Index (BMI). Nutritional status was classified based on CDC BMI-for-age growth charts. Analysis was done using chi-square test. Results: There was significant association between nutritional status and flatfoot with p value

Epidermolysis bullosa (EB) is a complex rare condition that affects the skin and many parts of the body. Those born with EB have skin so fragile they are called 'butterfly children', their skin is quite simply as fragile as the wing of a butterfly. In the UK it is estimated that there are more than 5,000 people living with EB and 500,000 worldwide. Little clinical guidance for care existed until DEBRA International started a programme to develop clinical practice guidelines (CPGs). There were no previous guidelines and few published studies on foot care in EB so treatment decisions were largely based on individual opinion and experience. The panel - made up of clinical experts and people living with EB representing Australia, the UK, and the USA - aimed to describe foot problems in people of all ages with EB, and summarise current evidence and management. The authors used a logical podiatric (foot) care literature review focussed on patients with EB. The authors found that the evidence in this area was limited but several interventions (treatments) currently practised by podiatrists show positive outcomes. The study allowed the group to make recommendations on how to treat foot and nail disorders in patients with EB. Furthermore, the authors concluded that further research is needed. This is a summary of the study: Foot care in epidermolysis bullosa: evidence-based guideline.

Wereldwijd heeft 10% van de bevolking te maken met een vorm van diabetes. Een ziekte die, als gevolg van minder gevoel in de voet, kan leiden tot ernstige gezondheidsklachten. In het meest ernstige geval kan dit zelfs leiden tot (gedeeltelijke) amputatie van de voet. Shoe-TIMeS is een tweejarig SIA-RAAK project waarin onderwijs, zorgpartners en bedrijfsleven op zoek zijn gegaan naar mogelijkheden om druk- en schuifkrachten van de voet in beeld te brengen. Het doel? Een meetapparaat ontwikkelen dat voortdurend krachten en druk kan meten tijdens iemands activiteiten in het dagelijks leven. Orthopedisch schoentechnologen en podotherapeuten kunnen zo’n apparaat gebruiken om de effectiviteit van de schoenen en inlegzolen die ze gemaakt hebben, te onderbouwen. Als dit lukt, kunnen zorgprofessionals een probleem als diabetisch ulcus tijdig herkennen of zelfs zien aankomen. En tijdig acties inzetten om dergelijke voetproblemen te voorkomen.

Wereldwijd heeft 10% van de bevolking te maken met een vorm van diabetes. Een ziekte die, als gevolg van minder gevoel in de voet, kan leiden tot ernstige gezondheidsklachten. In het meest ernstige geval kan dit zelfs leiden tot (gedeeltelijke) amputatie van de voet. Shoe-TIMeS is een tweejarig SIA-RAAK project waarin onderwijs, zorgpartners en bedrijfsleven op zoek zijn gegaan naar mogelijkheden om druk- en schuifkrachten van de voet in beeld te brengen. Het doel? Een meetapparaat ontwikkelen dat voortdurend krachten en druk kan meten tijdens iemands activiteiten in het dagelijks leven. Orthopedisch schoentechnologen en podotherapeuten kunnen zo’n apparaat gebruiken om de effectiviteit van de schoenen en inlegzolen die ze gemaakt hebben, te onderbouwen. Als dit lukt, kunnen zorgprofessionals een probleem als diabetisch ulcus tijdig herkennen of zelfs zien aankomen. En tijdig acties inzetten om dergelijke voetproblemen te voorkomen.

Foot problems can cause pain and discomfort, limiting the activities of many individuals. Infrared thermography may be useful for early detection of abnormal temperatures using various ways of calculating the mean foot temperature (MFT) to analyze asymmetries and differences between different groups. The aim of this study was to compare two protocols for calculating the MFT, identifying the magnitude of asymmetries in several regions and their correlations with the forehead temperature and brain temperature tunnel(BTT).Nineteen healthy volunteers of both genders aged between 18 and 55 years participated in the study.Data collection included anamnesis, body mass measurement, stature, glycaemia, body core temperature and acquisition of thermal images of the feet and face. The Wilcoxon test revealed that the mean foot temperature calculated using hallux, 2nd, 3rd, 4th and 5th toes, 1st, 3rd and 5th metatarsal heads and heel, was lower than that calculated without the four lesser toes (Z = -2.636, p = 0.008).However, the asymmetry between the two feet was the same in both cases (medianof 0.4 °C). The correlations of the MFT with the forehead temperature and BTT were positive and significant for the two forms of calculation, and the correlation was stronger when all toes were used to calculate the mean (forehead: ρ = 0.654, p = 0.002, BTT: ρ = 0.617, p = 0.005). The study showed the relevance of the toes in the analysis of the MFT, and it may be important to evaluate asymmetries in the toes to detect abnormal thermal patterns. This finding suggests that it is preferable to use MFT calculated with all toes.

Aim: To develop a multi-dimensional Patient Reported Outcomes (PRO) questionnaire to improve person-centered care for type 1 and 2 diabetes across sectors in Denmark. Methodology: A stepwise cross-regional multi-stakeholder multi-disciplinary co-development process was undertaken: 1) Patient-important PRO domains for value based diabetes care defined (ADA 2018), 2) Multi-sector strategy for active use of PRO to benefit People With Diabetes (PWD) and care quality 3) Conceptual measurement model and psychometric methodological foundation, 4) Literature review and mapping of PRO items/scales 5) Iterative item selection/testing and design of PRO dialogue tool 7) Qualitative, clinical and psychometric evaluation. Results: The final e-PRO questionnaire (53-78 items) consisted of pre-existing/adapted items (from e.g., WHO-5, PROMIS-10, MDI, DSC-R) and newly developed global essence domain and single items covering: General health, social support, life stress, psychological well-being, symptom distress (neuropathic pain, heart, gastro-intestinal, sexual, sleep, fatigue, foot problems), diabetes well-being, worries, limitations and support, self-care, lifestyle and technology confidence, wishes for support, confidence in care access, medicine burden and satisfaction, blood sugar regulation (stability, moderate/severe hypoglycemia), preferred topics for next visit. Workshops and selective item testing (n=85) supported item acceptability and content coverage. A novel web dialogue tool with algorithms/resources to enable PWD and providers to interpret and follow-up on each PRO output was designed as part of the project. Conclusions: A systematic collaborative process led to a new PRO questionnaire and dialogue tool for use in routine diabetes care. Research is now ongoing to validate scoring and evaluate benefits of real-world use of intervention for PWD, clinicians and payers. Disclosure S.E. Skovlund: Stock/Shareholder; Self; Novo Nordisk A/S. L. Nørgaard: None. S. Stefansen: None. T. Honnens de Lichtenberg: None. L. Troelsen: None. A. Pietraszek: None. P.H. Kjær: None. H. Ravn Larsen: None. P.O. Jakobsen: None. N. Ejskjaer: None. Funding Danish Health Care System

Objectives To determine the prevalence of foot problems and its related associations in different regions across India among people with Intellectual Disabilities (ID) stratified by age and gender. Method A survey was done among a randomly chosen sample of 1517 Indian inhabitants (8–50 years of age) residing in different regions of the country under the drive named Healthy Athlete (HA) Fit Feet Screening Program of Special Olympics Bharat. Chi-Square test is used to draw an inference of prevalence of different foot conditions among the population from different age groups and from different genders. Results The percentage of Healthy Athletes with the normal foot in Bhiwadi, Warangal, Ajmer, Bhopal, Guwahati, and Jodhpur was 48.14%, 53.92%, 55.82%, 27.31%, 54.47%, and 76.34%. The percentage of athletes with foot problems from these areas was 53.08%, 46.07%, 44.1%, 72.69%, 45.53%, and 26.35%. Moreover, on analyzing the athletes with foot problems on the basis of the age group, it was found that the middle age group athletes from Bhopal had the highest incidence of more frequent foot problems. Furthermore, on comparing the prevalence of foot problem on basis of gender it was found that female athletes have more prevalence than men. Conclusion The numerical results indicate the middle age group subjects have statistically significant higher tendencies towards the foot problems in contrast to the lower and the higher age group subjects Also, the prevalence of the foot problems and their related associations in women are higher compared to men.

Background Active foot disease persists in a high proportion of people with psoriatic arthritis despite the availability of pharmacological and non-pharmacological interventions to modify the course of the disease. Limited information exists on the provision of health care for foot disease in psoriatic arthritis. The objective of this study was to explore the views of health professionals on the assessment and management of people with psoriatic arthritis-related foot involvement. Methods Convenience sampling was used to recruit health professionals working in rheumatology outpatient clinics in Sydney, Australia and Auckland, New Zealand. Three focus groups were undertaken to explore the views and experiences of health professionals on the assessment and management of foot problems in people with psoriatic arthritis. All interviews were audio-recorded and transcribed verbatim. Qualitative data was analysed using a constant comparative analytic approach to identify themes. Results A total of seventeen health professionals participated including rheumatologists, podiatrists and a physiotherapist. Key themes derived from the focus groups suggest that health professionals perceived that people with psoriatic arthritis-related foot problems experience suboptimal management from symptom onset, to diagnosis and treatment. Frustration was expressed throughout discussions relating to lack of appropriate training and expertise required for the specialised management of foot problems typically encountered with psoriatic arthritis and poor access for patients to specialist podiatry services. Conclusions This study provides new insight into the perspectives of health professionals on the management of foot problems related to psoriatic arthritis. Deficiencies in the diagnosis, assessment and treatment of foot problems were revealed. To meet the foot health needs of people with psoriatic arthritis, reducing diagnostic delay, improving knowledge and awareness about the disease among people with psoriatic arthritis and health professionals, and increasing specialist podiatry service provision may be required.

Background - Every year, an estimated 4 million diabetic patients all over the world develop a foot ulcer. These ulcers often become non-healing, gangrenous, or infected - and are both caused and complicated by underlying neuropathy and peripheral arterial disease which further impairs wound healing. Peripheral arterial disease is a major risk factor in lower extremity amputation - one of the most dreaded complications of diabetes - as it results in impaired quality of life and huge personal costs. Objective - This study aims to determine the prevalence of foot problems among patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease and identify the risk factors that predispose these patients to foot problems. Design and Methods - We implemented an analytical cross-sectional study of consecutive patients with type 2 Diabetes and Chronic Kidney Disease (stage I-V) consulting at the emergency room and out-patient department of the National Kidney and Transplant Institute from November 2017 to August 2018. Foot problems were assessed by inspection, palpation, the Michigan Neuropathy Screening Instrument, and measuring the ankle brachial index. Risk factors for foot problems were analyzed by univariate and multivariate logistic regression. Results - We analyzed 104 patients with type 2 diabetes and chronic kidney disease (mean age 47 years; 48% male; 88% CKD stage V; 73% on dialysis). We found a prevalence of 49% of foot problems (73% neuropathy; 69% neuro-ischemia; 45% peripheral arterial disease, 8% amputation, 6% active foot ulcerations and 4% foot deformities). In univariate statistical analysis, independent risk factors for foot problems were: history of coronary artery disease (odds ratio 4.1 [95% CI 1.2-13.9]), history of stroke (9.6 [1.2-80.4]), dialytic therapy (3.3 [1.3-8.3]), HbA1c (p=0.008), cholesterol (p=0.048), triglycerides (p=0.018), and stage of CKD (p=0.041). In multivariate logistic analysis risk factors for foot problems were history of coronary artery disease (OR 16.3), dialytic therapy (OR 7.6), cholesterol (OR 1.08) and triglycerides (OR 1.04). Conclusions - The high prevalence of foot problems (but at an earlier stage of the disease continuum compared to reports internationally) strongly favors the establishment of preventive foot strategies within the context of a multidisciplinary team. Patients on dialytic therapy with coronary artery disease and hyperlipidemia should be prioritized for these preventive programs.

Patellar subluxation is common in adolescents, and a variety of factors are related to this condition, with valgus of the knee joint an important factor. The results of many studies suggest that flatfoot can cause an abnormality of the lower limb power line. Structural abnormalities of the foot caused by the high stresses exerted by body weight can lead to structural deformity of the knee and can also cause knee valgus. Screening for foot problems can help determine the risk of patellar subluxation, and early intervention can lessen the incidence of this condition. The purpose of the present study was to investigate the effects of flatfoot on the structure and function of the knees and, especially, the risk of patellar subluxation. A total of 72 participants were recruited for this cross-sectional study. The mean age at examination was 15.4 ± 4.0 (range 9 to 22) years. The measured parameters were heel valgus angle, arch index, and quadriceps angle (Q-angle). Overall, the mean values of the heel valgus angle, arch index, and Q-angle were 5.9° ± 2.4° (range 1° to 11°), 0.33 ± 0.07 (range 0.23 to 0.46), and 19.1° ± 3.5° (range 9° to 26°), respectively. The Q-angle was directly associated with the heel valgus angle (r = 0.818, p < .001) and arch index (r = 0.655, p < .001). We found that flatfoot can affect the morphology of the knee joint and increase the risk of patellar subluxation.

Background Foot problems may limit physical activity in children with Down syndrome. This prospective cohort study investigated the association of foot posture, deformity, and footwear fit with activity.Method Foot posture of 50 children with Down syndrome (22 girls, 28 boys; M age = 10.5 years) was assessed using the arch index and deformities were documented. Footwear fit compared the difference in length and width of shoes with participants’ feet. Physical activity was measured using accelerometers.Results Mean arch index (0.29 ± 0.08) was indicative of flat feet. Footwear fit was too short for five participants, too long for 26 participants, and too narrow for 29 participants. Regression analysis for the 20 participants adherent with wearing an accelerometer found no association of foot posture or deformity with activity. Footwear fit was negatively associated with activity (p = .03).Conclusion Preliminary data suggest poor footwear fit is associated with reduced physical activity in children ...

9th Textile Bioengineering and Informatics Symposium, TBIS 2016, in conjunction with the 6th Asian Protective Clothing Conference, APCC 2016, Melbourne, 12-15 July 2016

Introduction An increasing number of older people with frailty in Japan use geriatric day care centers. Older people who have been certified as requiring long-term care attend centers during the day and receive nursing care help with bathing, excretion, meals, and functional training services. Many older people have foot problems with need foot care by nurses and care workers (NCWs) at geriatric day care centers. Objective This study explored the effects of NCWs’ foot-care programs on the foot conditions of older people attending daytime services. Methods A before-after intervention study was conducted at geriatric day care centers for older people, where the foot-care program was presented by NCWs for two months. The foot conditions of 23 clients (8 men, 15 women, mean age = 78.6 years, standard deviation = 9.2) were assessed before and after the program. Changes in foot condition and clients’ perceptions after the study were analyzed through descriptive statistics, McNemar, and paired t-tests. Results Although dramatic changes in foot conditions were not observed, some conditions were improved or maintained. Changes were observed in mean dry skin scores ( p Conclusion The NCWs’ foot-care program was effective in maintaining and improving foot health in older people and positively affected their perception of foot care.

Introduction: Diabetes is a major public health concern in Qatar. This study examined diabetes knowledge and perception of available services for diabetes control among diabetic patients in Qatar.Methods: Data from 300 diabetic patients were collected through face-to-face interviews using a semi-structured questionnaire between February and May 2015 at Hamad Medical Corporation healthcare facilities in Qatar. Survey responses were represented as frequencies, and Chi-square tests were used to compare proportions across gender. A p-value of 0.05 was considered statistically significant.Results: 31% of patients had Type 1 Diabetes (T1D) (females 36.6%, males 26.5%) and 54% had Type 2 Diabetes (T2D) (males 56.6%, females 50%). Knowledge about diabetes types did not differ by sex (P=0.16). 32.3% of patients were treated for diabetes-related complications including: high cholesterol (39.2%), vision problems (33.1%), hypertension (30.0%), and foot problems (25.1 %). Most patients were diagnosed at primary care clinics (41.7%). During visits, 78.3% of patients reported that they were fully advised about different diabetes tests. 57.0% of patients had ≥4 visits for diabetes checkups in the past 12 months. 66.7% of patients reported that they were confident or very confident in managing their diabetes as a result of their healthcare visits in the past year. The majority of patients reported receiving diabetes-related guidance from physicians (89.7%).Conclusions: Study participants had variable knowledge of diabetes, its complications and risk factors, and services available to diabetics. More comprehensive education and awareness about diabetes is recommended for both patients and family members. At the provider level, further improvement in patient counseling and promotion of available services can be beneficial.

Purpose: Foot problems and suboptimal footwear are risk factors for falls among the elderly. Footwear choice may, therefore, be important for people with balance impairment following stroke, but li...

Background The purpose of this study is to develop a Dutch version of the Oxford Ankle and Foot Questionnaire for Children (OxAFQ-c) to allow evaluation of pediatric foot care. Methods The OxAFQ-c was translated into Dutch, according to the ISPOR-guidelines. Children with different foot and ankle complaints completed the OxAFQ-c at baseline, after two weeks, and after 4–6 months. Measurement properties were assessed in terms of reliability, responsiveness, and construct validity. Results Test–retest reliability showed moderate intraclass correlation coefficients. Bland–Altman plots showed wide limits of agreement. After 4–6 months, the group that experienced improvement also showed improved questionnaire outcomes, indicating responsiveness. Moderate correlation between the OxAFQ-c and the Kidscreen and foot-specific VAS-scores were observed, indicating moderate construct validity. Conclusions The Dutch OxAFQ-c showed moderate to good measurement properties. However, because we observed limited sensitivity to changes and wide limits of agreement in individual patients, we think the questionnaire should only be used in groups.

Ergonomic footwear is a type of shoe specifically designed for consumers to treat foot problems. In accelerating concern on foot health nowadays, ergonomic footwear is introduced to fill the gap in the context of Malaysia. This study applied the Theory of Planned Behaviour and Expectancy-Value Theory to explore the consumers’ purchase intention toward ergonomic footwear. Targeted respondents were adults in Klang Valley, Malaysia aged from 21 years and above through judgmental sampling. A total of 221 responses were collected using a survey questionnaire from June to July 2018. This study found that utilitarian consumption, consumer perceived value and perceived trust have a significant positive relationship with the purchase intention. Meanwhile, the word-of-mouth shows the insignificant relationship between purchase intention. Word-of-mouth is unimportant might be due to contrary word-of-mouth spread by experienced customers, and perhaps the less tendency the consumers rely on word-of-mouth.

This paper describes the design and development of an In-sole Plantar Pressure Device (IPPD) to measure underfoot pressure. Knowledge on underfoot pressure is important for different purposes. It is essential for doctors and clinicians to have information about underfoot pressure to enable them to diagnose foot problems. Currently, underfoot pressure ranges have not been effectively established, and there is insufficient information about the minimum and maximum values of underfoot pressure. Likewise, constraints with regard to the implementation of insole systems still persist and are represented by the need to put a spacer on the sensor during measurements, and the problem of sensor parameters changing after the calibration. These challenges are addressed in this work and preliminary results or performance of the proposed device are then presented.

Diabetic foot is one of the main complications experienced by diabetic patients. An early diagnosis and an appropriated treatment can prevent serious foot problems. This paper presents a criterion to identify thermal changes in the plantar temperature distribution. This criterion is based on the comparison of plantar temperature distribution with a reference distribution obtained from control subjects. A characteristic distribution in one and two dimensions are proposed. To measure the similarity degree, four similarity measures are used: Kullback-Leibler divergence, Jensen-Shannon divergence, Quadratic distance and Earth Movers distance. A 85.9% of 220 samples of diabetic patients presented a change in the plantar temperature distribution which can be a precursor of some complications.

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.

Frailty syndrome is a state of decreased body function, thereby increasing susceptibility to poor clinical outcomes. The risks of developing frailty syndrome increase in the elderly at Nursing Home. This study is expected to provide characteristic data of frailty syndrome as the basis for the prevention and management for the elderly. This study is conducted by using a descriptive quantitative design. The data is taken by using FI-40 questionnaire consisting of 40 questions in the elderly at Bandung done by using total sampling. There are 42(58.3%) of pre-frail and 7(9.7%) of frail elderly out of 72 data. Pre-frail prevails mostly in women (29 subjects; 69.1%) and at age of 60-69 years in 18 subjects (42.8%). Frail elderly is found mostly in women (3 subjects; 42.8%) and aged 70-79 years (3 subjects ; (42.8). The most common cause of frailty is eye and foot problems in 7(100%). The most common cause of pre-frail is the assumption of health level in 35(83.3%). This study concludes that frailty syndrome is common among the elderly and special attention must be paid to eye and foot problems.Keywords: elderly, frailty syndrome, FI-40 questionnaire, nursing home

This study aimed to determine whether thermal imaging can detect temperature differences between healthy feet, nonulcerated neuroischemic feet, and neuroischemic feet with toe ulcers in patients with type 2 diabetes mellitus (T2DM). Participants were prospectively divided into 3 groups: T2DM without foot problems; a healthy, nonulcerated neuroischemic group, and an ulcerated neuroischemic group. Thermal images of the feet were obtained with automated segmentation of regions of interest. Thermographic images from 43 neuroischemic feet, 21 healthy feet, and 12 neuroischemic feet with active ulcer in one of the toes were analyzed. There was a significant difference in toe temperatures between the 3 groups ( P = .001), that is, nonulcerated neuroischemic (n = 181; mean temperature = 27.7°C [±2.16 SD]) versus neuroischemic ulcerated (n = 12; mean temperature = 28.7°C [±3.23 SD]), and healthy T2DM group (n = 104; mean temperature = 24.9°C [±5.04 SD]). A post hoc analysis showed a significant difference in toe temperatures between neuroischemic nonulcerated and healthy T2DM groups ( P = .001), neuroischemic ulcerated and healthy groups ( P = .001). However, no significant differences in toe temperatures were identified between the ulcerated neuroischemic and nonulcerated neuroischemic groups ( P = .626). There were no significant differences between the ulcerated toes (n = 12) and the nonulcerated toes (n = 57) of the same foot in the ulcerated neuroischemic group ( P = .331). Toe temperatures were significantly higher in neuroischemic feet with or without ulceration compared with healthy feet in patients with T2DM. There were no significant differences in temperatures of ulcerated toes and the nonulcerated toes of the same foot, implying that all the toes of the same foot could potentially be at risk of developing complications, which can be potentially detected by infrared thermography.

Greater one-horned rhinoceros Rhinoceros unicornis have been successfully maintained by and bred at zoological gardens in the past half century. Despite this success, decades ago it was recognized that this species frequently develops foot lesions. Such damage can impair the health and well-being of an individual, and contribute to a reduction of its lifespan. The death of a breeding bull or cow will have an effect upon the success of the breeding programme. Various studies have been carried out to determine the types and causes of foot problems in Greater one-horned rhinoceros with the aim of identifying long-term solutions to this health concern. The most effective method for preventing lesions and improving the health of the feet in rhinoceros is to utilize an appropriate substrate (e.g. 50 cm-deep untreated wood chips) in both outdoor enclosures and indoor stables.