Patricia Palomo-López

Foot disorders in the elderly: A mini-review

Ageing process is associated with changes to the aspect, biomechanics, structure and function of the foot, it may be related with a marked presence of foot conditions, pain, disability and other overall health problems that constitute a major public health concern. Also, the prevalence of epidemiologic research found an incidence of foot problems which is even higher as a consequence of increasing life expectation. Several studies have also suggested that such foot disorders currently affect between 71 and 87% of older patients and are a frequent cause of medical and foot care. Thus, these kind problems are extremely common conditions in the general population, especially in the elderly who are associated with poor quality of life, balance impairment, increase the risk of falls, dificulty on putting shoes, fractures, restrict mobility and performance of activities of daily living that turn can produce serious physical, mental and social consequences in the older people. The role of the physician in the assessment, evaluation, and examination of foot problems is very important, yet it is often an overlooked and undervalued component of geriatric health care. The purpose of this article is to review and to provide an overview of the most common foot deformities precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or deformities affecting the feet that may alter foot condition and general health amongst the elderly.

Footwear used by older people and a history of hyperkeratotic lesions on the foot: A prospective observational study

Abstract Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood. To discover footwear preferences of older people, pain tolerance may favor presence of HL for the use of inadequate footwear in old age. A sample of 100 participants with a mean age of 74.90 ± 7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants’ shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials. Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed. HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks.Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood. Todiscover footwearpreferencesof olderpeople,pain tolerancemay favorpresenceofHL for theuseof inadequate footwear inoldage. A sample of 100 participants with amean age of 74.90±7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants’ shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials. Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed. HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks. Abbreviations: BMI = body mass index, HL = hyperqueratosis lesions, SD = standard deviation.

Impact of Hallux Valgus related of quality of life in Women: Hallux valgus related to quality of life in women

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

Foot health-related quality of life among elderly with and without lesser toe deformities: a case–control study

Purpose The aim of this study was to compare the health-related quality of life impact related to foot health and health in general in older adults with lesser toe deformities (LTD) and without any foot conditions. Methods A case–control observational study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology criteria. A total of 100 older adults with a mean age of 74.39±6.02 years were recruited at an outpatient clinic; 50 of these subjects had LTD (case group) and 50 subjects were without any foot conditions (control group). Presence of LTD was determined in both feet using the Kelikian push-up test, and the Foot Health Status Questionnaire scores were self-reported. Results The case group showed lower scores in quality of life in relation to health in general and to foot health specifically. Statistically significant differences (p<0.05) between case and control groups were shown by means of the Wicoxon test. Conclusion A negative impact in quality of life in relation to foot health should be considered in older adults with LTD, regardless of gender.

Skin temperature in youth soccer players with functional equinus and non‐equinus condition after running

To check how a thermal IR camera can check skin temperature in gastrocnemius‐soleus equinus condition and non‐gastrocnemius‐soleus condition in youth soccer players and thus detect association between the extensibility of the triceps surae (with gastrocnemius‐soleus equinus and non‐gastrocnemius‐soleus equinus) and the muscle temperature pattern.

Impact of the mechanical hyperkeratotic lesions and its association with quality of life: An observational case–control study

Mechanical hyperkeratotic lesions (MHL) are common condition amongst population of all ages. Such problems may be associated with pain, reduction in mobility, changes of gait and risk of falls and is believed to affect the quality of life (QoL), general health and optimal foot health.

Clinical Aspects of Foot Health in Individuals with Alzheimer’s Disease

Alzheimer’s disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65–95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot.

Attitude and knowledge about foot health: a spanish view

Objetivo: explorar as atitudes em relacao aos dados auto-relatados dos pacientes sobre crencas relacionadas a saude do pe, desde uma perspectiva comportamental e atitudinal. Metodos: uma amostra de 282 participantes com idade media de 39,46 ± 16,026 chegaram a um centro de saude onde foram registradas caracteristicas demograficas, clinicas e crencas auto-relatadas referentes a dados de saude do pe, os quais completaram todas as fases do processo de pesquisa. Resultados: os resultados da analise revelaram uma estrutura fatorial de 8 fatores baseada em (1) comportamentos podiatricos, (2) a intencao de realizar comportamentos protetores, (3) crencas atitudinais, (4) crencas normativas, (6) apatia, (7) autocuidado, e (8) a percepcao geral da saude do pe. Todos eles explicaram 62,78% da variância e foram considerados como variaveis ​​independentes em uma analise de regressao para determinar quais forneceram as melhores explicacoes para a importância atribuida a saude do pe. Conclusoes: os participantes do estudo revelaram uma atitude positiva em relacao a saude do pe e comportamento responsavel.

Infrared thermography applied to lower limb muscles in elite soccer players with functional ankle equinus and non-equinus condition

Gastrocnemius-soleus equinus (GSE) is a foot-ankle complaint in which the extensibility of the gastrocnemius (G) and soleus muscles (triceps surae) and ankle are limited to a dorsiflexion beyond a neutral ankle position. The asymmetric forces of leg muscles and the associated asymmetric loading forces might promote major activation of the triceps surae, tibialis anterior, transverses abdominal and multifidus muscles. Here, we made infrared recordings of 21 sportsmen (elite professional soccer players) before activity and after 30 min of running. These recordings were used to assess temperature modifications on the gastrocnemius, tibialis anterior, and Achilles tendon in GSE and non-GSE participants. We identified significant temperature modifications among GSE and non-GSE participants for the tibialis anterior muscle (mean, minimum, and maximum temperature values). The cutaneous temperature increased as a direct consequence of muscle activity in GSE participants. IR imaging capture was reliable to muscle pattern activation for lower limb. Based on our findings, we propose that non-invasive IR evaluation is suitable for clinical evaluation of the status of these muscles.

Electromyography activity of triceps surae and tibialis anterior muscles related to various sports shoes

Triceps surae (TS) and tibialis anterior (TA) activation patterns have not yet been studied under different types of sport shoes. We hypothesized that sports shoes may reduce the activity patterns of these muscles in relation to barefoot condition. Thus, our main aim was to evaluate the activity patterns of TS and TA muscles in healthy people during all gait phases using five types of sport shoes with respect to barefoot condition. A total sample of thirty healthy participants, mean age 36.20 ± 8.50, was recruited in a podiatry laboratory following an observational research design. During walking and running, electromyography signals were recorded from TS and TA muscles using surface electrodes in the following experimental situations: 1.) barefoot, 2.) minimalist, 3.) pronated control, 4.) air chamber, 5.) ethyl-vinyl-acetate and 6.) boost. The TS and TA showed significant reductions (P < 0.05) in the peak amplitude of different sport shoes types with respect to the barefoot condition in different phases of the gait cycle during walking and running. Nevertheless, the boost sport shoe produced statistically significant increases in the peak amplitude of the gastrocnemius medialis muscle in comparison with the barefoot condition in the midstance phase of the gait cycle during running (P = 0.047). In addition, the pronation control and air chamber sport shoes produced statistically significant increases in the peak amplitude of the TA muscle with respect to the barefoot condition in the contact phase of the gait cycle (P = 0.021; P = 0.013), respectively, during running. Despite TS and TA muscles activity patterns seem to be reduced using different sport shoes types with respect to the barefoot condition in different phases of the gait cycle during walking and running, some sport shoes may increase this muscular activity in specific phases of the gait cycle during running.