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[Abstract]: Foot problems are very common in the community. Studies indicate that between 18% and 63% of people have foot pain or stiffness and that foot problems have a large impact on people's functional decline and a significant detrimental impact on measures of quality of life related to health. The general objective of this research was to compare foot health in people from the rural population compared to people from the urban population and its relationship with quality of life. A case–control descriptive study was developed with a sample of 304 patients, 152 patients from the rural population and 152 patients from the urban population. Quality of life was measured through the SF-36 Health Questionnaire in its Spanish version. The rural population group had a mean age of 46.67 ± 13.69 and the urban population group 49.02 ± 18.29. Regarding the score of the lowest levels of quality of life related to foot problems, the rural population group compared to the urban population group showed: for body pain (52.21 ± 30.71 vs. 67.80 ± 25.28, p < 0.001); and for mental health (69.58 ± 18.98 vs. 64.60 ± 14.88, p < 0.006). Differences between groups were analysed using Student's t-test for independent samples, which showed statistical significance (p < 0.05). This research offers evidence that the rural population presents better levels of mental health and lower levels of bodily pain in the domains of the SF-36 Health Questionnaire comparing with the urban population.

There are studies that show the better balance after dry needling in lumbar pain. However, the postural control effects after foot dry needling are unknown. Our objective was to check if dry needling reduces postural control. Eighteen subjects with flexor digitorum brevis (FDB) muscle Myofascial trigger point were evaluated pre- and post-deep dry needling. We measured stabilometric variables in a pre-post study. We have found significant differences in three stabilometric variables: surface with eyes closed (29.36–53.21 mm2) (p = 0.000), medium speed of the laterolateral displacement with eyes closed (1.42–1.64 mm/s) (p = 0.004), and medium speed of the anteroposterior displacement with eyes closed (1.30–1.53 mm/s) (p = 0.025). Dry needling therapy application in FDB muscle reduces standing postural control with eyes closed., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

[Abstract] Background: Functional Hallux Limitus (FHL) is a dynamic foot dysfunction characterized by a limitation of hallux dorsiflexion when the first metatarsal head is under load. FHL plays a role in the development of osteoarthrosis in the first metatarsophalangeal joint (IMTPJ). Forefoot disorders can significantly impact an individual’s quality of life, leading to dysfunction and pain. The aim of this project was to evaluate the quality of life of school-aged individuals with and without FHL using the Foot Health Status Questionnaire (FHSQ). Methods: A case-control study was conducted to evaluate the outcomes in paediatric age. A total sample of 116 children between 6 and 12 years old was used to conduct this research. The sample was divided into two groups: (i) the healthy group (n = 58) and the FHL group (n = 58). The FHSQ was completed and the FHL test was performed in a seated position to classify the patients into the selected group. Results: Non-significant changes were observed when the mean values of the FHSQ domains were compared between the groups with and without FHL, except for the “general foot health” domain (p = 0,024) associated with the specific foot health section (section 1) of the Questionnaire. For the domains linked with the general well-being section (section 2), there was not a statistically difference in the mean of the scores obtained between the two school-aged groups with and without FHL, being slightly lower in the group with the presence of FHL for the overall health and physical function domains. Both the healthy and case groups obtained and identical range of scores (10– 100) for the “foot pain” domain. Nevertheless, the mean of the score was lower for the participants with FHL. Conclusions: The perception of the quality of general foot health was poorer in the school-aged group with FHL. Variables such as foot pain and footwear are likely contributors influencing the perception of foot health quality. The schoolaged population

´[Abstract] Background: Hallux limitus is a common foot disorder whose incidence has increased in the school-age population. Hallux limitus is characterized by musculoskeletal alteration that involves the metatarsophalangeal joint causing structural disorders in different anatomical areas of the locomotor system, affecting gait patterns. The aim of this study was to analyze dynamic plantar pressures in a school-aged population both with functional hallux and without. Methods: A full sample of 100 subjects (50 male and 50 female) 7 to 12 years old was included. The subjects were identified in two groups: the case group (50 subjects characterized as having hallux limitus, 22 male and 28 female) and control group (50 subjects characterized as not having hallux limitus, 28 male and 22 female). Measurements were obtained while subjects walked barefoot in a relaxed manner along a baropodometric platform. The hallux limitus test was realized in a seated position to sort subjects out into an established study group. The variables checked in the research were the surface area supported by each lower limb, the maximum peak pressure of each lower limb, the maximum mean pressure of each lower limb, the body weight on the hallux of each foot, the body weight on the first metatarsal head of each foot, the body weight at the second metatarsal head of each foot, the body weight at the third and fourth metatarsal head of each foot, the body weight at the head of the fifth metatarsal of each foot, the body weight at the midfoot of each foot, and the body weight at the heel of each foot. Results: Non-significant results were obtained in the variable of pressure peaks between both study groups; the highest pressures were found in the hallux with a p-value of 0.127 and in the first metatarsal head with a p-value 0.354 in subjects with hallux limitus. A non-significant result with a p-value of 0.156 was obtained at the second metatarsal head in healthy subjects. However, significant resu

[Abstract] Background: Hard insoles have been proposed to decrease plantar pressure and prevent foot pain and paresthesia due to repetitive loading. The aim of this research was to analyze the effect of three different hard insoles in cycling on healthy subjects. Methods: A crossover randomized trial was carried out. The mean age of the subjects was 35 3.19 years, and all of them were men. While the subjects were cycling on a stationary bicycle, their plantar pressure was recorded with nine in-shoe sensors placed in nine specific foot areas to test a standard ethylene-vinyl-acetate 52 Shore A hardness insole, a polypropylene 58 Shore D insole, and a polypropylene 580 Shore D insole with selective aluminum 60 HB Brinell hardness in the metatarsal head and hallux. Results: The maximum plantar pressure decreased significantly with the polypropylene insole containing selective aluminum in the metatarsal head and hallux areas. The maximum plantar data of the polypropylene aluminum insole in the M2 area (5.56 kgF/cm2), fifth metatarsal styloid process (6.48 kgF/cm2), M3–M4 area (4.97 kgF/cm2), and hallux (8.91 kgF/cm2) were of particular interest compared to the other insoles. Conclusions: The use of insoles made of polypropylene with aluminum in the metatarsal head and hallux areas decreases the maximum plantar pressure in cycling compared to standard EVA and polypropylene insoles.

[Abstract] There are studies that show the better balance after dry needling in lumbar pain. However, the postural control effects after foot dry needling are unknown. Our objective was to check if dry needling reduces postural control. Eighteen subjects with flexor digitorum brevis (FDB) muscle Myofascial trigger point were evaluated pre-and post-deep dry needling. We measured stabilometric variables in a pre-post study. We have found significant differences in three stabilometric variables: surface with eyes closed (29.36–53.21 mm2) (p = 0.000), medium speed of the laterolateral displacement with eyes closed (1.42–1.64 mm/s) (p = 0.004), and medium speed of the anteroposterior displacement with eyes closed (1.30–1.53 mm/s) (p = 0.025). Dry needling therapy application in FDB muscle reduces standing postural control with eyes closed.

[Resumen] Introducción: Los pies son un pilar esencial de la salud de las personas, y por sus complejas características anatómicas, desempeñan un papel clave en la postura y en la deambulación ya que son los responsables de la autonomía, la independencia y el bienestar del individuo. Actualmente, existe un incremento en la prevalencia de las patologías del pie, por lo que constituyen un importante problema de salud pública. Además, existen otros factores, como la dificultad en el manejo de los problemas del pie, en parte debido a su etiología multifactorial y la cronicidad de los mismos. Por esta razón, el objetivo de esta tesis porcompendio de artículos publicados es analizar la influencia de los pies, como factor predictor en el proceso de salud vs enfermedad, donde los sujetos a estudio pertenecen a diferentes grupos de pacientes que presentan Dolor Crónico (DC), Enfermedad de Parkinson (EP) y Diabetes Mellitus (DM). Material y Métodos: Se llevaron a cabo tres estudios cuantitativos, descriptivos, observacionales, transversales y analíticos bajo los criterios que recogen las guías clínicas Strengthening the Reporting of Observational Studies in Epidemiology. Con los tres estudios de casos y controles se ha podido valorar mediante herramientas validadas, factores predictores de la salud del pie. Resultados: Los pacientes con DC, EP y DM presentan una reducción significativa en la calidad de vida y de la salud en general en comparación con una muestra de personas sanas. Conclusiones: La patología del pie tiene un gran impacto en la reducción de la calidad de vida. La presente tesis por compendio de publicaciones viene a mostrar las necesidades reales de la asistencia podológica en una muestra de población. En los tres grupos poblacionales estudiados: DC, EP y DM, muestran todos ellos, un deterioro considerable de la salud del pie, con factores más significativos en pacientes con DM y donde los pacientes con DC muestran el indicador más elevado de salud., [Resumo] Introdución: Os pés son un piar esencial da saúde das persoas, e polas súas complexas características anatómicas, desempeñan un papel fundamental na postura e na deambulación xa que son responsables da autonomía, independencia e benestar do individuo. Na actualidade, está a aumentar a prevalencia de patoloxías do pé, polo que constitúen un importante problema de saúde pública. Ademais, hai outros factores, como a dificultade para xestionar os problemas dos pés, en parte pola súa etioloxía multifactorial e a súa cronicidade. Por este motivo, o obxectivo desta tese por compendio de artigos publicados é analizar a influencia dos pés, como factor predictor no proceso de saúde vs enfermidade, onde os suxeitos de estudo pertencen a distintos grupos de pacientes que presentan Dor Crónica (DC), enfermidade de Parkinson (EP) e diabetes mellitus (DM). Material e Métodos: Realizáronse tres estudos cuantitativos, descritivos, observacionais, transversais e analíticos, baixo os criterios incluídos nas directrices clínicas “Fortalecemento do Informe de Estudos Observacionais en Epidemioloxía”. Cos tres estudos de casos e controis, púidose avaliar, mediante ferramentas validadas, factores preditivos da saúde do pé. Resultados: Os doentes con DC, EP e DM mostran unha redución significativa da calidade de vida e da saúde xeral en comparación cunha mostra de persoas sans. Conclusións: A patoloxía do pé ten un gran impacto na redución da calidade de vida. Esta tese por compendio de publicacións, vén a amosar as necesidades reais de atención podolóxica nunha mostra poboacional. Nos tres grupos de poboación estudados: DC, EP e DM, todos eles presentan un deterioro considerable da saúde do pé, con factores máis significativos nos pacientes con DM e onde os pacientes con DC presentan o indicador de saúde máis alto., [Abstract] Introduction: The feet are an essential pillar of people's health, and due to their complex anatomical characteristics, they play a key role in posture and ambulation, since they are responsible for the autonomy, independence and wellbeing of the individual. Currently, there is an increase in the prevalence of foot pathologies, which is why they constitute an important public health problem. In addition, there are other factors, such as the difficulty in managing foot problems, partly due to their multifactorial etiology and their chronicity. For this reason, the objective of this thesis by compendium of published articles is to analyze the influence of the feet, as a predictor factor in the process of health vs disease, where the study subjects belong to different groups of patients who present Chronic Pain (CD), Parkinson's disease (PD) and Diabetes Mellitus (DM). Methods: Three quantitative, descriptive, observational, cross-sectional, and analytical studies were carried out under the criteria included in the Strengthening the Reporting of Observational Studies in Epidemiology clinical guidelines. With the three case-control studies, it has been possible to assess, using validated tools, predictive factors of foot health. Results: Patients with CD, PD and DM show a significant reduction in quality of life and general health compared to a sample of healthy people. Conclusions: Foot pathology has a great impact on reducing the quality of life. This thesis by compendium of publications comes to show the real needs of podiatric care in a population sample. In the three population groups studied: DC, PD and DM, all of them show a considerable deterioration in foot health, with more significant factors in patients with DM and where patients with DC show the highest health indicator.

[Abstract] Background: Foot health problems can affect quality of life and general health producing a source of discomfort and pain. Low levels of foot health-related quality of life (HRQoL) are present in patients with foot disabilities, such as hallux valgus, plantar fasciitis, or minor toe deformities. Objective: The objective was to analyze the foot health status in patients with and without foot problems in a rural population and its relationship with quality of life. Material and methods: A prospective case-control study was developed with a sample of 152 patients, 76 subjects with podiatric pathologies and 76 without, in a rural population. HRQoL was measured through the SF-36 Health Questionnaire in the Spanish version. Results: The case group had a mean age of 49.18 ± 14.96 and the control group 44.16 ± 11.79. Regarding the score of the lowest levels of quality of life related to foot problems, the case group compared to the controls showed: for physical function (79.86 ± 26.38 vs. 92.63 ± 11 0.17, p < 0.001); for the physical role (73.68 ± 41.00 vs. 88.48 ± 27.51, p < 0.0022); for body pain (45.81 ± 27.18 vs. 73.68 ± 41.00, p < 0.035); and for general health (60.36 ± 30.58 vs. 68.71 ± 18.52, p < 0.047). The differences between groups were analyzed using the Mann-Whitney U test, which showed statistical significance (P < 0.05). Conclusions: In the rural population, people with foot pathologies present a worse quality of life compared to those who do not present foot pathology, especially for the health domains: physical function, physical role, body pain and health general.

[Abstract] Coronavirus disease (Covid-19) is a highly infectious disease caused by the SARS-CoV-2 virus and is associated with a decrease of respiratory, physical, and sychological function, subsequently affecting quality of life. The aim of the present pilot study was to use ultrasound imaging (USI) to evaluate and compare the thickness of the diaphragm and abdominal muscles between individuals recently diagnosed with moderate Covid-19 infection and healthy individuals. Methods: A cross-sectional observational pilot study was performed. A total sample of 24 participants were recruited from a private medical center (Madrid, Spain): Covid-19 (n = 12) and healthy controls (n = 12). The external oblique (EO), internal oblique (IO), transversus abdominis (TrA), rectus abdominis (RA), interrecti distance (IRD) and diaphragm thickness were assessed using USI during inspiration, expiration and during contraction. Results: USI measurements of the thickness of EO, IO, TrA, RA, IRD and the diaphragm did not differ significantly between groups during inspiration, expiration or during contraction (all P > 0.05). Conclusions: These preliminary results suggest that the morphology of the abdominal muscles and diaphragm is not altered in people with a recent history of moderate Covid-19 infection.

[Abstract] Parkinson's disease (PD) is a neurodegenerative disorder that affects bothhealth of the feet, as to gait patterns. This study aimed to find out about footproblems and their impact on self-perceived quality of life and related to foothealth in Parkinson's patients compared to a group of healthy subjects and tomeasure it with Spanish Podiatry Health Questionnaire (PHQ-S). It is about acase–control study in a sample of Parkinson's patients n=62, healthy controlsn=62. The PHQ-S was reported, it describes perception the subject has ineach of podiatric 6 dimensions consulted, assessing appreciation of health sta-tus of interviewee's feet and a self-rated the foot health score on the visual ana-log scale (VAS). There were statistically significant differences (P< 0.05) inthe dimensions that assessed problems with walking and moving, nail trim-ming, concern feet state, and affectation of quality of life related foot health.Regarding the self-perception of state of their feet, Parkinson's patientsperceive a worse state of health of their feet than healthy subjects. The meanvalue was 4.8 (SD 2.2) for Parkinson's patients and 3.8 (SD 2.3) for healthysubjects. In conclusion, patients with PD have problems in walking or moving,foot pain, difficulties in foot hygiene and in cutting for their nails, as well asthe concern they suffer from deterioration in state of their feet affect them anddecrease their quality of life. Podiatric problems in Parkinson's patients have agreat impact in reducing quality of life related to foot health

Cancer is a condition that can increase the risk of frailty. In addition, palliative oncological patients in home hospitalization can find their activities of daily living affected. The main objective was to measure the degree of frailty in the oncological population in home hospitalization comparing Barthel and Frail-VIG Indexes. This is a descriptive cross-sectional study. A sample of oncological patients in home hospitalization (n = 50) that included 27 men and 23 women were recruited, and disability due to frailty was measured using the VIG frailty index and the Barthel scale for Activities of Daily Living (ADLs). Spearman’s correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69) or robust (0.70 ≤ rs ≥ 1.00), with a strong indirect correlation between the domains using the toilet, transferring and wandering on the Frail-VIG scale with an r (s) value −0.810 (p < 0.001), −0.831 (p < 0.001) and −0.805 (p < 0.001), respectively, and a moderate indirect correlation for the domains of eating −0.718 (p < 0.001), dressing −0.770 (p < 0.001) and urination −0.704 (<0.001). The Frail-VIG index above 0.35 points, that is, from moderate to severe, does not affect ADLs except in the nutritional dimension in a palliative oncological population in home hospitalization. The preliminary outcomes obtained should be considered to determine the impact of nutritional status with regard to ADLs in palliative oncological patients in a home hospitalization unit., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

[Abstract] Background: Chronic foot pain (CFP) is a widespread condition worldwide; however, few studies that relate CFP and foot health-related quality of life have been reported. Objective: The aim of this study was to describe the impact of foot health and health in general in a sample of adult people with CFP compared with a control group. Study design: This study was designed as a retrospective case-control study. Setting: Podiatric section of a care center. Methods: Two hundred adults were included in the study. Patients were divided into CFP patient (n = 100) and control groups (n = 100). All of them regularly attended a private podiatric clinic to take care of their foot health. Self-reported data and medical histories for people with and without CFP were evaluated. All findings were compared with quality of life (QoL) scores based on the Foot Health Status Questionnaire, Spanish version. Results: Adults with CFP (compared to the control group) showed reductions in QoL linked to overall health and foot health in particular and were statistically significant with respect to several domains: (1) foot pain, (2) foot function, (3) general health, and (4) physical activity. These differ-ences were evaluated with a t-test for independent samples, and statistical significance was consid-ered a P value of P < 0.05. Limitations: The study was not a randomized controlled trial. Although primary outcome data were self-reported, the assessor was not blinded. Conclusions: CFP patients, regardless of gender, recorded a negative influence on QoL-related foot health that seems to be linked with the presence of this chronic condition.

[Abstract] Background: Hemophilia is an inherited recessive hemorrhagic disorder of the X-linked type, suffered by the male sex. Adults with hemophilia are coping with numerous diagnostics, associated comorbidities, pain, and difficult gait by arthropathy in ankles and feet. Physical pains contribute to depression in patients with hemophilia. Purpose: The study aimed to assess the impact of depression in adult patient with hemophilia and to compare it with healthy matched-paired controls. Methods: The sample consisted of 100 participants (median age 42.50 ± 30). Patients with hemophilia were recruited from Spanish Hemophiliac Associations (n = 50) and healthy subjects (n = 50) from a Clinic Podiatry Practices (University of Malaga, Spain). Results: Results and categories of the Spanish-translated version of the Beck Depression Inventory (BDI) were gathered. A clear statistically significant difference (p < 0.001) was presented in the variation of the BDI scores between both groups. Patients with hemophilia presented worse results with a BDI = 7.50 ± 11.25 points compared to healthy subjects with BDI = 2.50 ± 5 points. In the BDI categories, statistically significant differences (p = 0.004) were found in greater BDI categories in the Hemophilia group compared with healthy subjects. Moderate and severe depression categories were only shown in patients with hemophilia. Conclusions: Greater depression scores and range status were observed in patients with hemophilia compared to non-patients with hemophilia. Patients with hemophilia are at increased risk of depressiveness.

[Abstract] Parkinson's disease (PD) is a neurodegenerative disorder that affects both health of the feet, as to gait patterns. This study aimed to find out about foot problems and their impact on self-perceived quality of life and related to foot health in Parkinson's patients compared to a group of healthy subjects and to measure it with Spanish Podiatry Health Questionnaire (PHQ-S). It is about a case-control study in a sample of Parkinson's patients n = 62, healthy controls n = 62. The PHQ-S was reported, it describes perception the subject has in each of podiatric 6 dimensions consulted, assessing appreciation of health status of interviewee's feet and a self-rated the foot health score on the visual analog scale (VAS). There were statistically significant differences (P < 0.05) in the dimensions that assessed problems with walking and moving, nail trimming, concern feet state, and affectation of quality of life related foot health. Regarding the self-perception of state of their feet, Parkinson's patients perceive a worse state of health of their feet than healthy subjects. The mean value was 4.8 (SD 2.2) for Parkinson's patients and 3.8 (SD 2.3) for healthy subjects. In conclusion, patients with PD have problems in walking or moving, foot pain, difficulties in foot hygiene and in cutting for their nails, as well as the concern they suffer from deterioration in state of their feet affect them and decrease their quality of life. Podiatric problems in Parkinson's patients have a great impact in reducing quality of life related to foot health.

[Abstract] Cancer is a condition that can increase the risk of frailty. In addition, palliative oncological patients in home hospitalization can find their activities of daily living affected. The main objective was to measure the degree of frailty in the oncological population in home hospitalization comparing Barthel and Frail-VIG Indexes. This is a descriptive cross-sectional study. A sample of oncological patients in home hospitalization (n = 50) that included 27 men and 23 women were recruited, and disability due to frailty was measured using the VIG frailty index and the Barthel scale for Activities of Daily Living (ADLs). Spearman’s correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69) or robust (0.70 ≤ rs ≥ 1.00), with a strong indirect correlation between the domains using the toilet, transferring and wandering on the Frail-VIG scale with an r (s) value −0.810 (p < 0.001), −0.831 (p < 0.001) and −0.805 (p < 0.001), respectively, and a moderate indirect correlation for the domains of eating −0.718 (p < 0.001), dressing −0.770 (p < 0.001) and urination −0.704 (<0.001). The Frail-VIG index above 0.35 points, that is, from moderate to severe, does not affect ADLs except in the nutritional dimension in a palliative oncological population in home hospitalization. The preliminary outcomes obtained should be considered to determine the impact of nutritional status with regard to ADLs in palliative oncological patients in a home hospitalization unit

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