Impact of foot functionality in patients with systemic sclerosis: Cross-sectional study.

BACKGROUND: Progressive systemic sclerosis or systemic scleroderma (SS) is a chronic and rare autoimmune disease that mainly affects the skin and various internal organs. Raynaud's phenomenon and digital ulcers are some of the symptoms that affect the foot, causing a decrease in the quality of life of patients. The objective of this study is to determine the functionality of the feet in patients with SS and determine the impact on their daily lives. METHODS: A sample of 165 patients (154 women, 11 men) diagnosed with SS with a mean age of 46.29 ± 11.36 years and a mean body mass index (BMI) of 24.90 ± 5.77 was recruited. Each participant completed the Foot Function Index (FFI) questionnaire and the Systemic Sclerosis Questionnaire (SySQ). A multivariate analysis was performed to determine which factors were related to a higher score in both questionnaires. RESULTS: 32.1% of the participants (n = 53) had claw toe deformities, 79.4% (n = 131) Raynaud's disease and 20% (n = 33) a history of foot ulcers. 51.5% of the participants (n = 85) presented symptoms in their nails, the most frequent sign being thickening, hardening and yellow coloration. The final score of the FFI questionnaire was 3.51 ± 2.41 (0-9.9), the pain subscale being the highest, with a score of 5.06 ± 2.75, followed by foot disability (3.26 ± 2.91) and difficulty performing activities (1.55 ± 2.22). The final score of the SySQ questionnaire was 0.95 ± 0.45 (0.18-2.45), and the subscales with the highest score were symptom frequency (1.30 ± 0.47), symptom intensity (1.11 ± 0.55), and general skill limitation (0.47 ± 0.51). A high correlation was observed between the final FFI score and the final SySQ score (r = 0.712; p=<0.001). Also, between foot activity limitation and general skill limitation (r = 0.658; p=<0.001). A moderate correlation was observed between foot pain score and overall symptom intensity (r = 0.482; p=<0.001). Also, between foot disability and overall symptom frequency (r = 0.556; p=<0.001). The multivariate analysis (R2 0.51) showed that the final FFI score had a significant relationship with the final SySQ score (p < 0.001). No significant correlation was found between age (p = 0.15), gender (p = 0.49), BMI (p = 0.74) or time of diagnosis (p = 0.57) and FFI. CONCLUSION: SS is a disease that affects foot functionality in patients, with a greater impact on the pain scale. There is a correlation between the final FFI score and the final SySQ score, so improving foot functionality could help to improve the overall functionality of the patient with sclerosis.

Childhood obesity and its impact on the characteristics of gait stance phases: a cross-sectional study.

This study aimed to investigate the variations in foot type, laxity, dynamic characteristics of gait, and the characteristics of the stance phase of gait, in relation to body mass index (BMI) and groups of children of different ages. Additionally, it aimed to explore the correlations between BMI and these variables across children groups of different ages. A cross-sectional study was conducted involving 196 infants aged between 5 and 10 years old. The variables assessed included BMI, foot type, laxity, dynamic variables, and characteristics of the stance phase of gait. Significant variations were observed in foot type, laxity, certain dynamic variables, and characteristics of the stance phase of gait between normoweight (NW) and overweight/obese (OW/OB) groups among children aged between 5 and 10 years old (p ranged between 0.019 and 0.050). Moreover, BMI was also positively associated with the initial forefoot contact, heel off, total duration of the step, and forefoot contact phase of children 7 to 10 years of age (p ranged between < 0.010 and 0.040).   Conclusion: Children who are OW/OB had alterations at different stages of gait. Being OW/OB is related to alterations of the phases of gait mainly from 7 to 10 years of age, and spending more time in each of the phases of walking. This could indicate that children who are OW/OB, in addition to walking slower, overload the musculoskeletal system, subjecting their joints and muscles to greater stress. What is Known: • Children who are overweight (OW) and obese (OB) can experience changes in their musculoskeletal systems, posture, and gait due to increased body mass index. • OW and OB children experience additional stress on their musculoskeletal systems, impacting posture, biomechanics, mobility, physical activity, and daily tasks. Excessive plantar loading is linked to foot pain in adults. What is New: • Body mass index was positively associated with initial forefoot contact, heel off, total duration of the step, and forefoot contact phase in children aged 7 to 10 years old. OW/OB children aged 5-6 exhibited less ankle dorsiflexion and smaller relaxed calcaneal stance position (RCSP) as compared to normal-weight children. • Obese children aged 5-6 showed less pronation excursion, suggesting altered frontal plane movement due to RCSP differences. Children aged 7-8 who are OW/OB spent more time in certain gait phases, particularly in the forefoot contact phase. Being OW/OB is linked to altered gait parameters such as initial forefoot, heel off, total step duration, and forefoot contact phase. Being OW/OB was associated with a longer forefoot contact phase, particularly in the right foot.

The resting calcaneal stance position (RCSP): an old dog, with new tricks.

The objective of this study was to establish the accuracy of the resting calcaneal stance position (RCSP) for the assessment of flat foot (FF) in children, aligned to the validity of the foot posture index (FPI). The RCSP cut-off point was explored, in context of both FF prevalence and the relationship between FF and body weight. A total of 205 healthy children, aged 5 to 10 years, participated in a cross-sectional study. Correlation was performed between RCSP and FPI. ROC curve technique was calculated to assess differentiation between groups. A score equal to or greater than 7 on the FPI was used as the 'gold standard' for analysis. The correlation between FPI and RCSP was significant (r = 0.63; p < 0.01). The discrimination score on the ROC curve (6 points/degrees) shows that the model can be used to identify FF through RCSP, with a sensitivity of 67% and specificity of 85% returned.  Conclusion: The results of this study indicate the role of RCSP for simple, accessible and quick screening of paediatric FF. This is especially pertinent for non-podiatric healthcare professional without specialised paediatric foot knowledge. What is Known: • Most children develop a normal arch quickly, and flat feet usually resolve on their own between 2 and 6 years of age. • The measurement used to diagnose flat foot in children must be accurate, consistent, and valid to characterize the standard foot position. The Resting Calcaneal Stance Position (RCSP) is another widely used measure to evaluate the position of the flat foot in children. What is New: • The RCSP cut-off point 6 shows a sensitivity of 67% and a specificity of 85% thanks to the FPI as the Gold standard. • The RCSP is useful for health professionals who are not specialised in pediatric foot health. The RCSP is useful to detect flat foot in children.

Effects of Low-Dye Tape on Arch Height and Its Impact on the Medial Gastrocnemius Electromyographic Activity in Structurally Differentiable Foot Types: A Cross-Sectional Observational Study.

BACKGROUND: Low-Dye tape (LDT) is a short-term treatment for plantar fasciitis, where external stabilization by means of the tape improves kinetics, kinematics, pain level, and electromyography (EMG). PURPOSE: The purpose of this study was to compare the EMG of the medial gastrocnemius (MG) and changes in arch height (AH) based on the type of foot. METHODS: A total of 30 subjects participated in this study; they walked on a treadmill barefoot and when taped, where the average activity and changes in AH were measured over a 30 s period. The statistical intraclass correlation coefficient (ICC) to test for reliability was calculated, and the Wilcoxon test was determined for measures of EMG and AH. RESULTS: The reliability of the values of EMG was almost perfect. The data show that there was an increase in height in the comparison of the moment pre-baseline walking and post-taped walking on neutral feet (5.61 ± 0.46 vs. 5.77 ± 0.39 cm, p < 0.05), on pronated feet (5.67 ± 0.57 vs. 6.01 ± 0.53 cm, p < 0.001) and on supinated feet (5.97 ± 0.36 vs. 6.28 ± 0.27 cm, p < 0.05). In the MG, EMG activity decreased significantly in the taped condition compared to the baseline condition in neutral subjects (0.0081 ± 0.016 vs. 0.076 ± 0.016 mV, p < 0.05) and in pronated subjects (0.081 ± 0.022 vs. 0.068 ± 0.025 mV, p < 0.05). CONCLUSIONS: It was demonstrated that with the use of LDT, there was an improvement in the average activity in the MG in pronated and neutral feet. All foot types improved in arch height with the use of tape.

Nursing Care Plan for Patients with Tay-Sachs-A Rare Paediatric Disease.

Tay-Sachs disease is classified as a rare paediatric disease of metabolic origin. It is an autosomal recessive inherited disease. The gene responsible for the disease is known as HEXA, and it is located on chromosome 15(15q23). There is currently no effective treatment for Tay-Sachs disease; hence, it is an incurable disease in which patients do not live for more than five years, meaning that nursing care takes on greater importance to maintain quality of life. The main objective of this work is to develop a specific standard nursing care plan by applying an inductive research method supported by nursing methodology using the NANDA-NIC-NOC taxonomy and validated by the Delphi method. This care plan will improve the knowledge of health professionals on this topic and support future studies on the disease. Following its implementation, the care plan proposed in this study aims to increase the quality of life of patients diagnosed with this disease.

Efficacy of Personalized Foot Orthoses in Children with Flexible Flat Foot: Protocol for a Randomized Controlled Trial.

Pediatric flat foot (PFF) is a very frequent entity and a common concern for parents and health professionals. There is no established definition, diagnostic method, or clear treatment approach. There are multiple conservative and surgical treatments, the implantation of foot orthoses (FO) being the most used treatment. The evidence supporting FO is very thin. It is not clearly known what the effect of these is, nor when it is convenient to recommend them. The main objective of this protocol is to design a randomized controlled trial to determine if personalized FO, together with a specific exercise regimen, produce the same or better results regarding the signs and symptoms of PFF, compared to only specific exercises. In order to respond to the stated objectives, we have proposed a randomized controlled clinical trial, in which we intend to evaluate the efficacy of FO together with strengthening exercises, compared to a control group in which placebos will be implanted as FO treatment along with the same exercises as the experimental group. For this, four measurements will be taken throughout 18 months (pre-treatment, two during treatment and finally another post-treatment measurement). The combination of FO plus exercise is expected to improve the signs and symptoms (if present) of PFF compared to exercise alone and the placebo FO group. In addition, it is expected that in both conditions the biomechanics of the foot will improve compared to the initial measurements.

A Qualitative Study Exploring the Experiences and Perceptions of Patients with Hemophilia Regarding Their Health-Related Well-Being, in Salamanca.

Hemophilia is a chronic, congenital/hereditary and X-linked disease, characterized by an insufficiency of factors VIII or IX, which are necessary for blood clotting. Those affected by hemophilia often suffer from particular psychosocial problems, both in the acceptance, coping, treatment and self-management of their disease and in their family and social relationships, which are often mediated by these circumstances. The aim of this study was to explore the experiences of people with hemophilia or their family members, of in a specific region of Spain, regarding the impact of having hemophilia. Structured interviews were conducted and developed, using the studies of the World Federation of Hemophilia and Osorio-Guzmán et al. as a guide, as well as a literature review of qualitative work on hemophilia. Data were analyzed using a six-step thematic analysis. A total of 34 interviews were thematically analyzed. The results showed that three key themes emerged from the data: (1) the daily impact of having hemophilia, (2) uncertainty about the disease, (3) the role of associations and (4) support from institutions. The results make it clear that the disease has a major impact on their lives (work, family, leisure and personal environment). The main conclusion is that hemophilia has a negative impact on the daily lives of patients, families and caregivers.

Follow-up of health-related quality of life and pain in a cohort of patients with rheumatoid arthritis before and after COVID-19.

BACKGROUND: The foot is one of the anatomical structures of the body most affected in rheumatoid arthritis (RA), associated with the disability of patients, even more during COVID-19. The aim of this study was to analyse whether the period of physical inactivity during COVID-19 is an influential factor on health-related quality of life and foot pain in patients with RA. METHODS: 162 patients with foot pain and RA, recruited from the Hospital Virgen de las Nieves, Granada (Spain) were included. Data was collected during two different periods: January - December 2018 in person and June - September 2021 by phone. Patients were asked to complete the Spanish adapted version of the 12-Item Short Form Survey (SF-12) and the Visual Analogue Scale (VAS). RESULTS: The results from the SF-12 questionnaires were divided between its two subscales (i.e., mental, and physical component). The physical component shows an improvement between 2018 and 2021, from 32.05 in 2018-35.18 in 2021 (p < 0.05). The opposite happened with the mental component, showing a deterioration, from 39.69 in 2018-34.48 in 2021 (p < 0.05). Regarding pain, VAS shows higher levels of pain with statistically significant differences, both in general pain (from 6 in 2018-7 in 2012) and in foot pain (from 5 to 7), (p < 0.05). CONCLUSION: Mental quality of life and pain, both general and foot pain, are influenced by the period of physical inactivity during COVID-19. LEVEL OF EVIDENCE: Level II.

Risk factors and associated factors for calcaneal apophysitis (Sever's disease): a systematic review.

OBJECTIVES: The aim of this review was to identify the potential intrinsic and extrinsic risk factors (RFs), associated factors (AFs) and consequences of developing calcaneal apophysitis (CA). DESIGN: Systematic review. DATA SOURCES: Cochrane Library, Embase, Medline Ovid, PubMed, Web of Science and Evidence, searched from inception to April 2021. ELIGIBILITY CRITERIA: We included cohort, case-control and cross-sectional studies that were conducted in patients younger than 18 years who were exposed to RFs or who presented with factors associated with developing CA. Studies in languages other than English or Spanish were excluded. DATA EXTRACTION AND SYNTHESIS: Two reviewers worked independently to evaluate the risk of bias of included studies. The Newcastle-Ottawa Scale (adapted version) was used. RESULTS: A total of 736 studies were identified and 11 observational studies fully met the inclusion criteria, including 1265 participants with a mean age of 10.72 years. Four studies identified extrinsic factors, 10 identified intrinsic factors and three identified both. The extrinsic and intrinsic RFs, AFs and consequences of CA include limitation of ankle dorsiflexion, foot alignment, stiffness and mobility of the midfoot, plantar pressures and ground reaction force, body mass index, age, gender, presence of other osteochondroses and practice of sport. The risk of bias varied, being either moderate or low. CONCLUSIONS: Regarding the factors and consequences associated with CA (Sever's disease), ankle dorsiflexion limitation is the most frequent intrinsic factor studied, followed by peak plantar pressures and foot malalignment. However, disagreements between the investigators of the included studies were found; in some cases, there is a lack of unanimity between different studies as to which factors are considered to be RFs, AFs and consequences. PROSPERO REGISTRATION NUMBER: CRD42021246366.

Overweight and Obesity: Its Impact on Foot Type, Flexibility, Foot Strength, Plantar Pressure and Stability in Children from 5 to 10 Years of Age: Descriptive Observational Study.

BACKGROUND: Overweight (OW) and childhood obesity (OB) may cause foot problems and affect one's ability to perform physical activities. The study aimed to analyze the differences in descriptive characteristics, foot type, laxity, foot strength, and baropodometric variables by body mass status and age groups in children and, secondly, to analyze the associations of the BMI with different physical variables by age groups in children. METHODS: A descriptive observational study involving 196 children aged 5-10 years was conducted. The variables used were: type of foot, flexibility, foot strength and baropodometric analysis of plantar pressures, and stability by pressure platform. RESULTS: Most of the foot strength variables showed significant differences between the normal weight (NW), OW and OB groups in children aged between 5 and 8. The OW and OB groups showed the highest level of foot strength. In addition, the linear regression analyses showed, in children aged 5 to 8 years, a positive association between BMI and foot strength (the higher the BMI, the greater the strength) and negative association between BMI and stability (lower BMI, greater instability). CONCLUSIONS: Children from 5 to 8 years of age with OW and OB show greater levels of foot strength, and OW and OB children from 7 to 8 years are more stable in terms of static stabilometrics. Furthermore, between 5 and 8 years, having OW and OB implies having more strength and static stability.

Efficacy of Plantar Orthoses in Paediatric Flexible Flatfoot: A Five-Year Systematic Review.

Paediatric flexible flatfoot (PFF) is a very common condition and a common concern among parents and various healthcare professionals. There is a multitude of conservative and surgical treatments, with foot orthoses (FO) being the first line of treatment due to their lack of contraindications and because the active participation of the child is not required, although the evidence supporting them is weak. It is not clear what the effect of FO is, nor when it is advisable to recommend them. PFF, if left untreated or uncorrected, could eventually cause problems in the foot itself or adjacent structures. It was necessary to update the existing information on the efficacy of FO as a conservative treatment for the reduction in signs and symptoms in patients with PFF, to know the best type of FO and the minimum time of use and to identify the diagnostic techniques most commonly used for PFF and the definition of PFF. A systematic review was carried out in the databases PubMed, EBSCO, Web of Science, Cochrane, SCOPUS and PEDro using the following strategy: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) on child patients with PFF, compared to those treated with FO or not being treated, assessing the improvement of signs and symptoms of PFF. Studies in which subjects had neurological or systemic disease or had undergone surgery were excluded. Two of the authors independently assessed study quality. PRISMA guidelines were followed, and the systematic review was registered in PROSPERO: CRD42021240163. Of the 237 initial studies considered, 7 RCTs and CCTs published between 2017 and 2022 met the inclusion criteria, representing 679 participants with PFF aged 3-14 years. The interventions of the included studies differed in diagnostic criteria, types of FO and duration of treatment, among others. All articles conclude that FO are beneficial, although the results must be taken with caution due to the risk of bias of the included articles. There is evidence for the efficacy of FO as a treatment for PFF signs and symptoms. There is no treatment algorithm. There is no clear definition for PFF. There is no ideal type of FO, although all have in common the incorporation of a large internal longitudinal arch.

Efficiency of virtual reality for cardiopulmonary resuscitation training of adult laypersons: A systematic review.

BACKGROUND: Virtual reality (VR) is an interesting and promising way to teach cardiopulmonary resuscitation (CPR) to adult laypersons as its high immersive characteristics could improve the level of skills and acquired knowledge in learning basic life support (BLS). METHODS: This systematic review assesses current literature about BLS training with VR and its possible effect on CPR-quality parameters, self-efficacy, perceived learning, and learners' satisfaction and short and long-term patients' outcome. We screened the Cochrane Library, PubMed, CINAHL, MEDLINE Ovid, Web of Science, and Scopus databases and included only clinical trials and quasi-experimental studies published from inception to October 1, 2021, which analyzed adult laypersons' BLS training with the use of VR. Primary outcomes were CPR parameters (chest compression rate and depth, Automated External Defibrillator use). Secondary outcomes were self-efficacy, perceived learning and learners satisfaction, and patients' outcomes (survival and good neurologic status). The risk of bias of included study was assessed using the Cochrane Handbook for Systematic Reviews of Interventions tool to evaluate randomized control trials and the transparent reporting of evaluations with nonrandomized designs checklist for nonrandomized studies. RESULTS: After full article screening, 6 studies were included in the systematic review (731 participants) published between 2017 and 2021. Because of the heterogeneity of the studies, we focused on describing the studies rather than meta-analysis. The assessment of the quality of evidence revealed overall a very low quality. Training with VR significantly improved the rate and depth of chest compressions in 4 out of 6 articles. VR was described as an efficient teaching method, exerting a positive effect on self-efficacy, perception of confidence, and competence in 2 articles. CONCLUSION: VR in BLS training improves manual skills and self-efficacy of adult laypersons and may be a good teaching method in a blended learning CPR training strategy. VR may add another way to divide complex parts of resuscitation training into easier individual skills. However, the conclusion of this review suggests that VR may improve the quality of the chest compressions as compared to instructor-led face-to-face BLS training.

Relationship between Kinesiophobia, Foot Pain and Foot Function, and Disease Activity in Patients with Rheumatoid Arthritis: A Cross-Sectional Study.

The main objective of the present study was to determine the relationship between kinesiophobia and pain (general and foot pain), foot function, and disease activity in patients with rheumatoid arthritis (RA). A total of 124 interviews were carried out with participants with RA. Participants were recruited from the Hospital Universitario Virgen de las Nieves de Granada in Spain. Interviews took place in January 2021. Participants completed the following questionnaires during an appointment with their rheumatologist: Foot Function Index (FFI), Tampa Scale for Kinesiophobia (TSK-11), and the Visual Analogue Scale Pain foot (VAS Pain). Furthermore, the Simplified Disease Activity Index (SDAI) was used to measure disease activity. Of the 124 participants, 73% were women, and their mean age was 59.44 years (SD 11.26 years). In the statistical analysis, positive linear correlations (p < 0.001) were obtained between the variables TSK-11 and VAS (related to general pain or foot pain) and FFI (in its three subscales). Additionally, a negative correlation between the TSK-11 and the educational background was shown. This study provided information about the relationship between foot function and pain with different levels of kinesiophobia in patients with RA. Additionally, the educational background of the patient was considered a predictor of whether or not a patient suffered from kinesiophobia.

Experiences of patients with rheumatoid arthritis during and after COVID-19-induced quarantine in terms of physical activity and health status: A qualitative study.

AIM: The aim of this study was to explore experiences of people with rheumatoid arthritis during and after COVID-19-induced quarantine in terms of physical activity and health status. BACKGROUND: Rheumatoid arthritis affects multiple facets of the person, both physically and psychologically. Physical activity is considered a safe and effective intervention to improve symptoms and systemic manifestations of rheumatoid arthritis. In the context of the COVID-19, countries like Spain were forced to impose restrictions on mobility, prohibiting outings even to perform physical activity. METHODS: Structured interviews were conducted and developed using the Tampa Scale for Kinesiophobia-11 questionnaire. Data were analysed using a six-step thematic analysis. RESULTS: The results make it clear that even though the patients declared that physical activity is essential for them to deal with their disease, most of the participants affirmed that they significatively reduced their levels of physical activity during the pandemic. CONCLUSIONS: Physical activity should be promoted in people, even in difficult times, to improve disease outcomes, well-being and mental health. IMPLICATIONS FOR NURSING MANAGEMENT: Knowing the experiences of these patients enables nursing managers to develop interventions that ensure the delivery of comprehensive nursing care regarding physical activity and health status, in future situations like this pandemic.

Evaluation of the Relationship between Lower Limb Hypermobility and Ankle Muscle Strength in a Paediatric Population: Protocol for a Cross Sectional Study.

The methodological heterogeneity in paediatric foot studies does not entail a stable foundation on which to focus the diagnosis and treatment of the various childhood foot problems. For this reason, the use of highly reliable tests is essential to find relationships and to establish a basis to guide the following studies. The main objective proposed in this cross-sectional observational study protocol is to examine the relationship between hypermobility (Lower Limb Assessment Score and Beighton score) and ankle muscle strength in different types of feet. The second objective is to describe the relationship between physical activity tests in children, and to compare with foot type and ankle muscle strength. The Strengthening Reporting of Observational Studies in Epidemiology (STROBE) criteria will be followed. The hypermobility, posture, strength and physical condition tests will be analyzed through three stations, each one directed by a single specialist in paediatric podiatry. The study has been approved by the Ethics Committee of the Universidad Católica San Antonio de Murcia CE112104. The results will be disseminated regardless of the magnitude or direction of effect. Intra-examiner and inter-examiner reliability will be analyzed.

Balance performance analysis after the COVID-19 quarantine in children aged between 8 and 12 years old: Longitudinal study.

BACKGROUND: Corona Virus Disease 2019 (COVID-19) has caused great changes in daily activities, especially in children. In Spain, to avoid infections, a home quarantine was declared, which caused a drastic reduction in daily or weekly physical activity in children. OBJECTIVE: to analyse the balance performance after the COVID-19-induced quarantine on children's balance, through the use of balance tests, considering the type of sport practiced. METHODS: an observational and longitudinal study was carried out with a sample size of 150 healthy children (69 boys and 81 girls) with a mean age of 10.02 ± 1.15 years. Postural control was evaluated under different equilibrium conditions before and after the quarantine period. Two data collections using the Gyko system were compared, with a difference of 8 months between them. In addition, the influence of foot type and physical activity was analysed. RESULTS: After the quarantine, statistically significant differences were found in terms of balance results, which were worse than before (p < 0.05). Postural control was not influenced by the type of sport practiced (i.e., individual, collective and / or not practicing sport), nor by the surface which the test was performed (p > 0.05). Physically active children (i.e., individual and / or collective sport) presented worse results than physically inactive children. A statistically significant impairment in terms of balance was demonstrated in children who performed high and moderate physical activity (p < 0.05). CONCLUSIONS: After the quarantine period, a significant reduction in balance performance was found in children. The findings suggest that regular physical activity benefits postural control. Loss of balance does not differ in postural stability by the type of sport practised. Postural stability is not influenced by the type of footprint after the period of physical inactivity. Postural control is influenced in children with a great level of physical activity.

Morpho-structural characteristics of feet in patients with rheumatoid arthritis: A cross sectional study.

Objective: The aim of this study was to evaluate and classify the types and incidences of foot deformities in patients with Rheumatoid Arthritis (RA). Methods: A cross-sectional study with convenience sample was obtained of 220 patients with foot pain and RA classification criteria (approved by the American College of Rheumatology and the European League against Rheumatism in 2010). A series of outcomes were assessed to measure the morphological characteristics of the feet. The Foot Posture Index (FPI), the Manchester Scale of Hallux Valgus and the Nijmegen classification of forefoot disorders were assessed. Results: The most common foot posture according to the FPI assessment are the pronated position in the left foot (32.7% of participants) and the neutral position in the right foot (34.1% of participants). The disease progression causes more developed and serious foot deformities. 1.82% of patients present a severe level of Hallux Valgus before 10 years of disease evolution whereas 4.09% of patients present a severe level of Hallux Valgus after 10 years of disease evolution. Conclusions: The most common foot type in patients with RA is the pronated foot type with deformities in the MTP joints without Hallux Valgus. However, a percentage of patients with RA presents supinated foot type. The evolution of the disease shows some morphological changes in terms of patient's feet. The presence of more developed foot deformities is increased, such us Hallux Valgus or MTP joints deformity (Grade 3 in the Nijmegen classification scale).

Effects of a 48-Day Home Quarantine during the Covid-19 Pandemic on the First Outdoor Running Session among Recreational Runners in Spain.

COVID-19-induced quarantine may lead to deleterious effects on health status as well as to impaired performance and increased injury risk when re-starting training after lockdown. We investigated the physical activity (PA) habits of recreational runners in Spain during a 48-day home quarantine during the COVID-19 pandemic and the characteristics of the first outdoor running session after confinement. A cross-sectional study, including a self-reported running questionnaire completed after the first outdoor running session after quarantine, was performed. Three hundred recreational runners (74% males; 60% 18-40 years old; most typical running experience >3 years, 10-30 km weekly running distance distributed in 3-4 sessions) were considered for analysis. Advanced runners ran, at least, 4 days/week and participated in running events. They performed significantly longer and more non-supervised weekly training sessions during confinement (p < 0.01 for both) than novice and amateur runners. Most runners performed their first outdoor running session on asphalt (65.3%) and ran 5 to 10 km (61%) at a pace above 5 min/km (60%), reporting no pain before (77%), during (64%), and 24 h after (76%) the session. Advanced runners performed a significantly longer running session, at a higher pace, and covered a greater distance (p < 0.01 for all) than novice and amateur runners, while enjoyment and motivation tended to be significantly higher when runners' level increased (p < 0.05). Higher training levels prior to and during confinement may lower the collateral effects (e.g., detraining, injury risk) of home quarantine when runners return to previous PA levels.

Symmetry Criterion for Patients with Rheumatoid Arthritis of the Foot: A Cross-Sectional Study.

OBJECTIVE: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients, to determine the degree to which both feet were affected, primarily analyzing the severity of RA in both feet looking at structure and morphology, and secondly looking at the symmetry in terms of the anthropometrics and posture. METHOD: This cross-sectional study was conducted from January to December 2018. The data from 229 patients with RA and with foot pain and no RA recruited (Granada, Spain) were analyzed. Two researchers independently interviewed the patients to obtain the study data. The clinical data were obtained using specific foot health and quality of life questionnaires and a validated platform for foot measurement. Anthropometric measurements were obtained by means of a foot measurement platform and the Foot Posture Index (FPI). The bivariate analysis was performed with the Student's t test and the non-parametric Wilcoxon test. The level of significance was established at p < 0.05. RESULTS: In the RA group, anthropometric measurements revealed significant differences between the left and right feet in 13 of the 23 parameters considered, as follows: (non-load-bearing) foot length, length of the first metatarsophalangeal joint, maximum height of the internal longitudinal arch, and width of the midfoot (p < 0.001, p = 0.038, p < 0.001, and p = 0.037 respectively); and Foot Posture Index (p = 0.001). CONCLUSIONS: In patients with RA, statistically significant differences were found in the Foot Posture Index and in several parameters related to foot structure and morphology. From this, we conclude that from a morphological, structural, and postural standpoint, a pattern of symmetric joint involvement should not be viewed as a specific criterion for RA in the foot.

A qualitative study exploring the experiences and perceptions of patients with rheumatoid arthritis before and after wearing foot orthoses for 6 months.

Foot pathology in people with rheumatoid arthritis (RA) can have a psychosocial impact, but interventions such as foot orthoses can reduce foot pain, improving physical activity and quality of life. A previous meta-analysis concluded that foot orthoses can relieve pain and disability and enhance patient's well-being. The aim of this study was to explore the experiences of people with RA, before and after wearing foot orthoses for 6 months. Data were collected through digital recordings of semi-structured interviews carried out before and after wearing foot orthoses for 6 months. A thematic analysis of the transcripts was used to identify themes. Six female participants with RA wore foot orthoses for 6 months in Spain. The mean disease duration was more than 10 years. The findings showed three key themes emerged from the data: (1) improvement in physical activity; (2) footwear… a tricky situation and (3) social implications of RA feet. It is concluded that patients reported that wearing foot orthoses can have a positive impact on physical activity and improve general wellness and quality of life. However, to achieve the potential positive benefits, people with RA also needed to wear suitable footwear (defined as footwear which accommodates both the foot and the insole while maintaining the fit and function of the shoe). Despite the positive impact of wearing orthoses, participants stated that complexities of finding suitable footwear acted as a blocker.