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Abstract Background The visual analogue scale (VAS) and the Foot Health Status Questionnaire (FHSQ) are patient‐reported outcome measures that are frequently used to evaluate the management of plantar heel pain. This study aimed to re‐calculate (i.e. revise) the minimal important differences (MIDs) of the VAS and the FHSQ when used for plantar heel pain to enhance the validity and precision of previous estimates. Methods This study used an anchor‐based method to calculate MIDs and incorporated best‐practice analyses to ensure credibility of the estimates. Data from 369 participants previously recruited from the community into four randomised controlled trials that evaluated interventions for plantar heel pain were used. VAS and FHSQ data from these participants at baseline and follow‐up were pooled to calculate the MIDs (95% confidence intervals). A 15‐point global rating of change Likert scale was used at follow‐up as the transition scale, which was anchored to baseline. For the VAS, MIDs for two distinct types of pain were calculated: average pain and first‐step pain. For the FHSQ, MIDs for two domains were calculated: foot pain and foot function. Results The revised MIDs for the 100 mm VAS were −8.5 mm (95% CI: −12.2 to −4.7) for average pain and −19.2 mm (95% CI: −24.7 to −13.8) for first‐step pain, which represent improvements in pain. The MIDs for the FHSQ were 12.4 points (95% CI: 6.9 to 18.0) for foot pain and 6.4 points (95% CI: 0.9 to 11.9) for foot function, which represent improvements in foot health status. Conclusions The revised MIDs from this study for the VAS and the FHSQ when used for plantar heel pain have enhanced validity and precision compared to previous estimates. This is important for clinicians and researchers as it provides a better understanding of how much improvement is required by an individual before an important change is experienced. The revised MIDs will also assist researchers with prospective sample size calculations, so future clinical trials are appropriately powered from a statistical standpoint.

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThis study aims to adapt and validate the Foot Health Status Questionnaire, developed by Bennett et al., in Portuguese patients with diabetic foot.A cross-sectional study was conducted with 143 patients with diabetic foot. A principal component analysis with oblique rotation and a confirmatory factor analysis using structural equation modeling were performed.The Portuguese version of the FHSQ (FHSQ-PT) in patients with diabetic foot remains equal to the original version, although with all factors correlated with each other. All scales presented high internal consistency values (pain: ω = 0.884; function: ω = 0.890; general foot health: ω = 0.910; and footwear: ω = 0.702), except for the footwear scale, although with a minimum acceptable coefficient. The FHSQ-PT scales showed good convergent validity and good discriminant validity. The FHSQ-PT scales were also able to discriminate between male and female patients as well as between patients with an active diabetic foot ulcer from those who did not.The results of the validated FHSQ-PT for Portuguese patients with diabetic foot showed good psychometric properties, being a useful, objective, and small instrument that may be used in clinical practice by health professionals without consuming too much time.Diabetic foot ulcer has been consistently reported to be associated to lower health-related quality of life, impairing the patient’s everyday function.Validated comprehensive measures that assess specific dimensions related to foot health in patients with diabetic foot are needed.The Portuguese version of the Foot Health Status Questionnaire (FHSQ-PT) showed good psychometric properties.FHSQ-PT is a useful short instrument that may be used to measure foot health status in clinical practice by health professionals who provide care to patients with diabetic foot.Diabetic foot ulcer has been consistently reported to be associated to lower health-related quality of life, impairing the patient’s everyday function.Validated comprehensive measures that assess specific dimensions related to foot health in patients with diabetic foot are needed.The Portuguese version of the Foot Health Status Questionnaire (FHSQ-PT) showed good psychometric properties.FHSQ-PT is a useful short instrument that may be used to measure foot health status in clinical practice by health professionals who provide care to patients with diabetic foot. [ABSTRACT FROM AUTHOR]

Objectives: Foot disorders, especially pain and deformities, are common patient complaints. Foot Health Status Questionnaire (FHSQ) was developed to assess general and foot health specifically in chronic foot disorders. The purpose of the current study was the cross-cultural adaptation of the FHSQ to Persian and evaluating the psychometric properties of the translated version. Methods: As per the International Quality of Life Assessment guideline, the forward and backward translations of the questionnaire were conducted by two independent translators. Accordingly, the final version was approved by a committee and confirmed by the developer. The psychometric properties of the Persian version of the FHSQ were tested in 101 participants (Mean±SD age: 42.98±15.03 y) with chronic foot disorders. Face validity by impact score calculation; criterion validity through correlation to the Manchester-Oxford Foot Questionnaire (MOXFQ) scores; internal consistency by Cronbach’s alpha coefficient, and test-retest reliability by calculating intra-class correlation were tested to describe the psychometric features of its Persian version. Results: Face validity was confirmed by impact scores of >1.5 for all items. The FHSQ was significantly correlated with the MOXFQ domains, supporting the criterion validity of the instrument, except for the shoe domain of the Persian FHSQ, i.e., not correlated with the pain domain of the MOXFQ (r=0.26). Cronbach’s alpha coefficients for pain, function, shoe, and general foot health were measured as 0.93, 0.92, 0.90, and 0.96 respectively. Thus, it suggested an excellent internal consistency for all domains. The intra-class correlation coefficient ranged from 0.73 to 0.93 for all domains, reflecting its good to excellent reliability. Discussion: The Persian version of the FHSQ is a valid and reliable patient satisfaction measurement instrument for evaluating foot conditions. Moreover, the current study results supported the potential of applying it as an appropriate instrument in research and clinical setting. Implementing this tool could help to evaluate the effects of an intervention or estimate the prevalence of a disorder in Persian-speaking populations.

Background: The visual analogue scale (VAS) and the Foot Health Status Questionnaire (FHSQ) are patient‐reported outcome measures that are frequently used to evaluate the management of plantar heel pain. This study aimed to re‐calculate (i.e. revise) the minimal important differences (MIDs) of the VAS and the FHSQ when used for plantar heel pain to enhance the validity and precision of previous estimates. Methods: This study used an anchor‐based method to calculate MIDs and incorporated best‐practice analyses to ensure credibility of the estimates. Data from 369 participants previously recruited from the community into four randomised controlled trials that evaluated interventions for plantar heel pain were used. VAS and FHSQ data from these participants at baseline and follow‐up were pooled to calculate the MIDs (95% confidence intervals). A 15‐point global rating of change Likert scale was used at follow‐up as the transition scale, which was anchored to baseline. For the VAS, MIDs for two distinct types of pain were calculated: average pain and first‐step pain. For the FHSQ, MIDs for two domains were calculated: foot pain and foot function. Results: The revised MIDs for the 100 mm VAS were −8.5 mm (95% CI: −12.2 to −4.7) for average pain and −19.2 mm (95% CI: −24.7 to −13.8) for first‐step pain, which represent improvements in pain. The MIDs for the FHSQ were 12.4 points (95% CI: 6.9 to 18.0) for foot pain and 6.4 points (95% CI: 0.9 to 11.9) for foot function, which represent improvements in foot health status. Conclusions: The revised MIDs from this study for the VAS and the FHSQ when used for plantar heel pain have enhanced validity and precision compared to previous estimates. This is important for clinicians and researchers as it provides a better understanding of how much improvement is required by an individual before an important change is experienced. The revised MIDs will also assist researchers with prospective sample size calculations, so future clinical trials are appropriately powered from a statistical standpoint. [ABSTRACT FROM AUTHOR]

Abstract Background Foot health of the Roma population is a challenge for the health professionals where this minority is significant, as is the case in Spain. At present, little is known about foot health of the Roma population and their knowledge would promote the training of these professionals at the community level. Foot pain is common and a reason for consulting podiatry services. The purpose of this study was to determine foot health among the Roma population according to the Foot Health Status Questionnaire. Method An observational, cross-sectional and quantitative study conducted at the Roma population living in Spain in 2018. Self-reported data and the Foot Health Status Questionnaire were recorded. Examining the general health and foot health (foot pain, foot function, footwear and general health) and general (general health, social capacity, physical activity and vigour). This questionnaire is recommended as a valid and reliable patient-reported outcome. The obtained scores were compared. Results A sample made up of 624 men and women from the Roma population took part in this study. 45% were Roma men and 55% Roma women. In the first section of the FHSQ, a lower score of values was recorded in the footwear domain (62.5) and in the general foot health domain (60). Gypsy women obtained lower scores in all the domains. In the second section, lower scores were obtained in the vigour (56) domain and in the general health (60) domain. A large effect size (r-Rosenthal) was found by gender in the footwear domain (0.334) and in the vigour domain (0.195). Roma women showed higher values in cardiac disorders, serious illnesses, doctor visits and foot problems. 67.8% reported that they had never been assisted by a podiatrist. Conclusions The studied Roma population has foot health problems, and these are more pronounced among women. They show lower values in the footwear and vigour domains. More professional training is required for health workers in this field to avoid cultural diversity stereotypes.

Background: Pregnancy is associated with physiological changes such as increased body mass index, postural changes, hormonal imbalance and changes in foot morphology. Due to an increased uterus and body mass, the centre of gravity is displaced anteriorly and superiorly as a means to produce and maintain stability and balance. An influx of relaxin mostly in the third trimester leads to ligament laxity which in turn causes the feet to become longer, flatter and broader. This structural change may remain permanent in some women. Structural changes, increased body weight and increased pressure in the lower limbs may also lead to lower limb oedema which makes it harder to find adequate fitting shoes and may be associated with causing or exacerbating foot pain in pregnant women. The purpose of this study was to determine the overall Foot Health Status (FHS) in pregnant women and also to compare the foot health status in the different trimesters., Methods: A quantitative approach, using a descriptive cross-sectional study design was utilized and a validated foot health status questionnaire was used. Data was analysed using a Statistical Package for Social Sciences (SPSS) version 1.04 program and presented in the form of tables., Results: All pregnant women had a poor foot health status in the area of vigour, particularly in the third trimester. In the third trimester, women's physical activity was diminished and they appeared to have greater footwear difficulties. However, it was found that despite having minimal foot pain, pregnant women maintained good foot function and good social capacity. The least amount of foot pain was felt in the second trimester., Conclusion: As a woman progresses in her pregnancy, her foot health status declined in the areas of footwear, physical activity and vigour., Competing Interests: Conflict of interest There were no conflict of interests in the undertaking of this research, in preparation of the manuscripts or the dissemination of this research and the knowledge gained., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

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., (© 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.)

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 of Health 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

AIM: The purpose of this study was to identify the individuals with symptomatic flat foot and find out a correlation between the foot pain and radiological parameters. Background: The talo-firstmetatarsal (TFM) angle, calcanealpitch (CP) angle, medial cuneiform-fifth metatarsal height on the lateral weight-bearing foot radiographs, and talar head uncoverage distance on the anteroposterior weight-bearing feet radiographs are the radiographic parameters used to assess the pes planus. The association of radiological parameters with symptomatic foot pain has always been a doubt. Assessment of superiority of one radiological parameter over the other is always controversial. Hence, we conducted a study to assess the correlation of symptomatic flat foot with CPangle and talo-1stmetatarsal angle. MATERIALS AND METHODS: We studied a total of 91 patients with symptomatic flat foot. The symptoms associated with flat foot were assessed using Foot Health Status Questionnaire. Based on the findings of this enquiry, they were objectively divided into mild, moderate, and severe which were then correlated with CP angle and TFM angles. Conclusion: In our study, we found that there is positive correlation between TFM angle and level of foot pain and negative correlation between CP angle and level of foot pain. Among the two, TFM angle showed higher correlation when compared to CP angle.

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 < 0.01 with a 99% confidence interval. Statistically significant differences (p < 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 > 0.01). Statistically significant correlations varied from week to strong (rs = 0.25−0.97). The strongest correlations (p < 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 and Objectives: Type 2 Diabetes Mellitus (T2DM) is a chronic disease characterized by hyperglycemia. T2DM affects millions of people, and has a lot of complications such as impaired sensation in the feet. Moreover, it is important to know the health of the feet of people with T2DM. The aim of this study is to know the preliminary values of the Foot Health Status Questionnaire (FHSQ) in people with T2DM., Materials and Methods: A total of 87 patients with T2DM with an average age of 65.56 years, divided in 54 men and 33 women, participated in this cross-sectional study. The main outcome was the health of the foot as measured by the FHSQ questionnaire. This questionnaire collects data on eight dimensions: Foot Pain, Foot Function, Shoe, General Foot Health, General Health, Physical Activity, Social Capacity, and Vigor., Results: Patients with T2DM have lower values in Foot Pain; median values in General Foot Health and high values in Foot Function, Shoe, Physical Activity and Social Capacity. Some of these dimensions are affected by age, diabetes control, Body Mass Index (BMI), and years of diagnosis. Females with T2DM have more problems than males in the Shoe, General Foot Health, Physical Activity and Vigor dimensions., Conclusions: this research gives us preliminary values of the FHSQ in Spanish patients with T2DM and divided by gender, age, diabetes control, BMI, and years of diagnosis in people with T2DM.

The aim of this study was to analyze the effects of an 8-week whole-body vibration (WBV) on the quality of life, physical fitness, body composition, glycosylate hemoglobin (HbA1c), lipid profile, and foot health status in people with type II diabetes mellitus (T2DM). It was performed as a double-blinded randomized controlled trial of 90 people with T2DM. Primary care facilities were used. The 8-week WBV training consisted of maintaining a knee flexion at 45° during five to nine series of 30-60 s in a vibration frequency that oscillated between 12.5-18.5 and 30 s of recovery between series. The placebo group had to perform the same protocol but without vibration. Participants performed the protocol three times per week. The WBV training significantly reduced the fat mass (%) of people with T2DM. However, significant effects of WBV training were not found in the quality of life, physical fitness, foot health status, lipid profile, blood pressure, fasting blood glucose, or HbA1c. Nevertheless, within groups enhances were found in HbA1c, blood pressure, fasting blood glucose, foot health status, health-related quality of life, timed-up and go test, and chair-stand test in both WBV and placebo groups. WBV was shown to be beneficial for reducing the fat mass and lipid profile of people with T2DM. The improvements of the placebo group could be due to both the social benefits of enrolling in an intervention and the physical fitness benefits of isometric contractions. Further studies are needed to clarify the effects of WBV and to establish a dose-response relationship in people with T2DM., Competing Interests: The authors declare no conflict of interest.