Orthopaedic Simulation of a Morton's Extension to Test the Effect on Plantar Pressures of Each Metatarsal Head in Patients without Deformity: A Pre-Post-Test Study.

BACKGROUND: the area beneath the metatarsal heads is a common location of foot pain, which is often associated with high plantar pressures. The aim of this study was to determine the effect of the application of a Morton's extension on the pressure in the metatarsal bones of the foot using a pressure platform. METHODS: twenty-five subjects without musculoskeletal pathology were selected for this study, and an experiment was conducted with them as the subjects, before and after application of a Morton's extension. The foot regions were divided into the forefoot (transversely subdivided into six areas corresponding to the first, second, third, fourth, and fifth metatarsal heads, and the hallux), midfoot, and rearfoot, and then the maximum and average pressures exerted at each region were measured before and after placing a Morton's extension. MAIN FINDINGS: we found a pressure reduction, with a p-value less than (p < 0.05), in the head of the second and third metatarsals in statics and dynamics. CONCLUSIONS: we can conclude that the Morton's extension produces a variation in plantar pressures on the lesser metatarsals. The application of a Morton's extension may be beneficial for the management of forefoot pathology. This study will help clinicians consider various tools to treat forefoot disorders. NCT05879094 (ClinicalTrial.gov (accessed on 18 May 2023)).

The Effectiveness of Hard Insoles for Plantar Pressure in Cycling: A Crossover Study.

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.

Development and Validation of the Overall Foot Pain Questionnaire in Motorcycle Riders.

Objectives: Our primary aim was to develop a transcultural adaptation of a cycling questionnaire using the Borg CR-10 scale as a tool to describe the discomfort among motorcyclists during the riding process in two trial sessions. Design: A transcultural adaptation and descriptive cross-sectional study. Settings: Jarama motorcycling circuit (Madrid, Spain). Participants: The participants were riders recorded across in a final motorcycling race. Interventions: The study design is based in two tools, the adapted Motorcyclist Questionnaire (MQ-21) with 21 items and Borg CR10 Scale® was used to determine discomfort level during motorcycling performance. The translation procedure, reliability, and reproducibility were performed. Results: All items showed an almost perfect intraclass correlation coefficient (ICC) (ICC = 0.909-1.00), except for item 9 (ICC = 0.881). Almost perfect internal consistency was shown for the total score (Cronbach α = 0.899). No systematic differences existed among test and retest in all items (p > 0.05) according to Bland-Altman plots. Respondents experienced slight discomfort on their body parts during the test-retest 1 h riding process. Foot discomfort was scored as 1.20, being the eighth of the 12 studied body parts. Conclusions: Internal consistency and test-retest reliability of the MQ-21 questionnaire were excellent and this questionnaire may be recommended to be used in motorcycling sports and clinical settings to evaluate the discomfort.

Quality of life improvement in aged patients after toenail surgery.

BACKGROUND: Patients of all ages can develop nail disorders, such as onychocryptosis, which are recurrent and painful conditions. OBJECTIVE: The aim of the study was to compare the quality of life in a group of aged patients with recurrent and painful ingrown toenails before and after chemical nail surgery to treat onychocryptosis. MATERIAL AND METHODS: The study design utilized a presurgery and a postsurgery questionnaire and examined prospective serial cases. The participants were drawn from an outpatient podiatric clinic from 1 January 2015 to 29 August 2016. The final sample of patients (>65 years old) underwent nail surgery with chemical matricectomy using phenol. In addition to the chemical nail surgical procedure, the patients completed the Manchester-Oxford Foot Questionnaire (MOXFQ) and the Borg CR-10 scale category ratio (CR) within 4 weeks prior to surgery. The patients completed both questionnaires again through mailing 3 months postsurgery. RESULTS: Lower MOXFQ scores were noted after surgery, demonstrating an improvement in quality of life after chemical nail surgery. Men and women exhibited similar results (p > 0.05), with the exception of the Borg CR-10 scale where women reported more residual pain compared with men, with scores of 1.26 ± 1.65 and 0.09 ± 0.20, respectively (p = 0.011). CONCLUSION: After a chemical nail surgery procedure, the quality of life improved in aged patients with recurrent and painful ingrown toenails.

Relationship Between Decreased Subcalcaneal Fat Pad Thickness and Plantar Heel Pain. A Case Control Study.

BACKGROUND: Heel pain is one of the most frequent complaints in medical clinical practice for conditions affecting the feet during weight-bearing tasks. OBJECTIVE: The goal of this study was to measure and compare the thickness of the fat pad in a sample of patients with current unilateral heel pain and patients without unilateral heel pain with normalized reference parameters. STUDY DESIGN: This was an observational case-control study. SETTINGS: The research took place in the podiatry department within a medical health care center. METHODS: A total of 375 patients were randomly selected from a pool of patients attending a medical health care center between the years 2008 and 2015 and diagnosed by a single medical podiatrist without having previous treatment. Patients were categorized in 2 groups: a heel pain group (n = 185) and a control group (asymptomatic; n = 190). The thickness of the plantar fat pad was measured with an ultrasonic probe (BodyMetrix® BX 2000; IntelaMetrix, Inc, Livermore, CA). RESULTS: Initial examination of both groups indicated no significant differences in age, height, weight, or body mass index (P > 0.01). There were, however, significant differences in the thickness of the fat pad between those in the heel pain group and those in the control group, when analyzed by group and by gender (P < 0.01; Cohen´s d = 0.465-1.959). LIMITATIONS: The study was not a randomized controlled trial. Although primary outcome data were self-reported, the assessor was not blinded. CONCLUSION: This study provides further evidence that people with unilateral heel pain showed a significantly decreased thickness of the subcalcaneal fat pad, regardless of gender. KEY WORDS: Heel pain, subcalcaneal fat, pain.

Sinovitis de la segunda articulación metatarsofalángica: actualización / Second Metatarsophalangeal joint Synovitis: Update

En las consultas de podología es común la existencia de numerosos procesos patológicos que desarrollan episodios inflamatorios en la cápsula articular de las articulaciones metatarsofalángicas (AMTF) y de sus estructuras vecinas como el plato glenoideo o los ligamentos colaterales, pero no son reconocidas claramente. Diferentes autores lo han explicado como el compromiso articular generado por un proceso de inestabilidad de etiología diversa y que evoluciona en diferentes estadíos, cada uno de los cuales posee diferentes grados de afectación a nivel de esa articulación. Esta patología se localiza en la articulación metatarsofalángica del segundo dedo con mayor prevalencia sobre el tercero en la mayoría de los casos de la bibliografía consultada, siendo reconocida como una de las causas potenciales de metatarsalgias. Los procesos biomecánicos anómalos que sobrecargan las estructuras de antepie pueden provocar una inflamación de la cápsula sinovial que delimita la articulación, disminuyendo progresivamente la movilidad del dedo y agravando la progresión de la patología (AU)

In podiatric clinics is very common to find inflamatory process in metatarsophalangeal joint capsule, plantar plate and collateral ligaments damage, but it is not clearly recognized. Many authors hipotetized with joint instability of multiple aetiology and his concomitant evolution in different stages with own joint disease. This pathology has more incidence in second metatarsophalangeal joint than third and others and it is a common etiology of metatarsal pain. Bad biomechanics alters forefoot function and can produce overload in capsular joint, decreasing mobility and getting worse the pathology (AU)

Optimal choice of footwear in the elderly population.

To discover whether changes in foot morphology and pain tolerance may favor the use of inadequate footwear in old age. 100 participants, mean age 81.60 ± 8.26 years attended an outpatient clinic where self-reported demographic data, frequency checked their feet, measurements of foot sensitivity, foot size and shoe size. Only 19% checked their feet every day, 73% revealed symptoms of neuropathy and 83% used inadequate footwear on at least one foot. In a bivariate analysis, no significant differences were observed. Distinct physical changes affect the feet in the elderly population. Decreased sensitivity and absence of regular foot checks can contribute to use of inadequate footwear. Often, it is necessary to use a different shoe size to ensure that the footwear matches the actual dimensions and true needs of each foot in order to improve functionality and prevent the onset of severe medical conditions and/or foot deformities.

Aproximación al manejo de la patología micótica en el pie / Approach to the management of fungal infection in the foot

El término micosis engloba a las patologías causadas por hongos en el ser humano. Por su prevalencia, en la actualidad, se puede afirmar, que se ha llegado a comparar, a la caries dental y a los resfriados, debido sin duda alguna al alto porcentaje de pacientes que la padecen. Además, de que estudios epidemiológicos recientes, han demostrado que a parte de alterar per se la calidad de vida, (relaciones personales, nivel psicológico, deambulación...) También, pueden dar lugar a complicaciones poco deseables, provocando cuadros infecciosos y bacterianos, que suponen un alto gasto sociosanitario al ocasionar perturbación ocupacional, deterioro psicológico y físico, y una potencial estigmatización social. La carencia de consenso en relación a la etiología multifactorial que presenta esta afección y la prevalencia de esta enfermedad a nivel del pie, sobre todo en los jóvenes y en los deportistas, nos lleva a mejorar los conocimientos existentes en lo que se refiere a su clasificación, diagnóstico y tratamiento en la búsqueda de actualizar los conceptos relacionados con esta patología del pie (AU)

The term encompasses fungal fungal diseases in humans. Because of its prevalence, today, we can say, that has been compared to dental caries and colds due undoubtedly to the high percentage of patients with the disease. Moreover, that recent epidemiological studies have shown that part per se alter the quality of life (personal, psychological level, walking...) also may result in undesirable complications, causing infectious diseases, and bacterial, involving high expenditure by causing disruption socio occupational psychological and physical deterioration, and potential social stigmatization. The lack of consensus regarding the multifactorial etiology has this condition and the prevalence of this disease at foot level, especially in the young and in athletes, leads us to improve existing knowledge in regard to classification diagnosis and treatment in the quest to update the concepts related to this foot disorders (AU)

Lesión muscular en podología. Actualización en patofisiología y terapéutica / Muscle injury in podiatry. Update on pathophysiology and therapeutic

El tejido muscular es de elevado interés científico en podología debido a su influencia en el mantenimiento de la postura y la deambulación, siendo necesario su perfecto funcionamiento para poder desarrollar dichas actividades con la eficacia y eficiencia esperadas. Además se encuentra fuertemente asociada al desarrollo de actividades deportivas. Son muy frecuentes las lesiones en su estructura muscular que pueden alterar dichas actividades funcionales. A continuación realizaremos un trabajo de actualización en las lesiones musculares y profundizaremos más en el DOMS (Delayed Onset Muscle Soreness) de elevado interés biológico por su información en la reparación biológica de los tejidos dañados (AU)

Muscle tissue is of high scientific interest in podiatry due to its influence on the maintenance of posture and gait, perfect operation being necessary to develop such activities expected effectiveness and efficiency. Besides is strongly associated with the development of sports. They are very frecuents lesions in muscular structures that can alter these functional activities. Then do a major upgrade in muscle strains and delve more into the DOMS (Delayed Onset Muscle Soreness) of high biological interest for its information on the biological repair of damaged tissue (AU)