Influence of quality of life related to perceived foot health between in a rural an urban population: A case-control research.

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.

Dry needling of the flexor digitorum brevis muscle reduces postural control in standing: A pre-post stabilometric study.

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.

Effect of foot health-related quality of life in rural population: A case-control study.

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.

Repeatability and reliability of the footwear assessment tool in Spanish patients: A transcultural adaptation.

BACKGROUND: The footwear assessment tool was designed to advise an appropriate footwear for each situation and patient. Footwear alterations structures can influence in musculoskeletal disorders, developing foot ulcers, increase the peak plantar pressure, bacterial growth, low back pain. METHODS: To validate the study 101 subjects were recruited. The study was tested by two expert podiatrists using the tool for the assessment of footwear characteristics that is composed by five domains, fit, general features, general structure, motion control properties and cushioning system. Each domain analyzes different shoe items. RESULTS: An excellent agreement between the test-retest. A suitable Cronbach's α was suggested for the five domains of fit (α = 0.952), general features (α = 0.953), general structure (α = 0.947), motion control properties (α = 0.951), and cushioning system (α = 0.951). Test-retest reliability was excellent for all domains. There were no significant differences between any domain (p > 0.05). There was only statistically significant difference in the item forefoot height (p = 0.011). For all the domains items there were no statistically significant difference (p > 0.05). CONCLUSIONS: The tool for the assessment European footwear is a suitable repeatability and reliability footwear tool that can be used in Spanish language subjects.

"Translated and adaptation into Persian of the podiatric health questionnaire (PHQ)".

The Podiatric Health Questionnaire (PHQ) is a foot health psicometric tool consisting of six items for measuring foot health status. Currently, PHQ has been adapted into Spanish. Thus, this research focused on develop the Persian translation and adaptation of the PHQ. The translation into Persian and test-retest reliability methods were applied from english version questionnarie. As regards to the total mark for each sub-scale, internal consistency and reliability were determined by the Cronbach α and intraclass correlation coefficient (ICC) with a confidence interval (CI) of 95%. High internal consistency was shown for the six sub-scales: a) walk with a Cronbach α of 0.775; b) hygiene and c) nail care with 0.789 and 0.796 respectively; d) foot on pain with 0.779; e) concern domain with 0.788; and f) quality of life with 0.798; and g) visual analogic scale with 0.803. Excellent test-retest reliability (ICC = 0.912 [95% CI = 0.845-0.950]) was shown for the total score. Conclusions: The persian version of the PHQ was shown to be a valid and reliable tool for an acceptable use in the Iran population.

The implications of the foot health status in Parkinson patients: A case-control study.

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.

The implications of diabetic foot health-related with quality of life: A retrospective case control investigation.

BACKGROUND: The diabetes people show a significant presence of foot health problems are usually all over the world, causing in big economic effects for these persons, their families and world population OBJECTIVE: The purpose of this research is to evaluate and relate the impact of foot health associated with the quality of life (QoL) in a group of people with and without diabetes MATERIAL AND METHODS: A total of 150 persons of a mean age of 71.45 ± 11.93 years came to a foot and ankle specialist outpatient center. Self-reported data were medical records where persons'with and without diabetes was evaluated. All findings obtained was compared with scores quality of life using the tool Foot Health Status Questionnaire, spanish version RESULTS: The diabetes group revealed a reduction of QoL linked to overall health and to foot health in particular. Differences among both groups were analyzed by means of a independent Student's t-test samples, displaying a p-value lower than 0.05 statistically significant for the domains of foot pain, foot function footwear and social capacity CONCLUSIONS: Diabetes people recorded a negative influence on the QoL related with foot health, that seems to be linked with the presence of chronic disease in diabetes people.

Effect of foot health and quality of life in patients with Parkinson disease: A prospective case-control investigation.

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.

Repeatability and reliability of the diabetic foot self-care questionnaire in Arabic patients: A transcultural adaptation.

PURPOSE: The diabetic foot self-care questionnaire is considered a self-care evaluation tool with 16 questions for assessing diabetic foot health disorders. To date, the DFSQ has been validated in different languages, but an Arabic version was lacking. Consequently, the purpose of this study was to translate and validate the Arabic version of the DFSQ (DFSQ-AR). METHOD: A suitable method was developed for the translation protocol and cross-cultural validation from Spanish to Arabic. Regarding the total marks from each sub-scale, agreement degrees and confidence were analyzed using Cronbach's α and intraclass correlation coefficient (ICC), respectively. In addition, the mean ± standard deviation differences between pre and post-tests were calculated and completed using Bland-Altman distribution plots. RESULTS: Excellent agreement between the two versions was demonstrated based on Cronbach's α. Three sub-scales consisting of knowledge of foot hygiene, the appropriate use of footwear and socks, and podiatric self-care were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the self-care and shoe and socks sub-scales. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (P = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75-102.43] and 97.96 ± 13.88 [94.5-101.86] points, respectively). Bland-Altman plots or clinically pertinent variations were not statistically significantly different. CONCLUSIONS: The DFSQ-AR is considered a strong and valid questionnaire with adequate repeatability in the Arabic language population.

Psychometric evaluation of the Persian version of the diabetic foot self-care questionnaire in Iranian patients with diabetes.

BACKGROUND: Diabetic foot self-care refers to a group of self-management behaviors that can reduce the incidence of foot ulcers and amputations. It is necessary to have a valid and reliable standard tool to measure foot self-care in diabetic patients. This study aimed to evaluate the psychometric properties of the Persian version of the Diabetic Foot Self-Care Questionnaire of the University of Malaga, Spain (DFSQ-UMA) in Iran. METHODS: This cross-sectional study was conducted with 407 diabetic patients who were selected using a convenient sampling method. Construct validity was assessed by exploratory (with 207 patients) and confirmatory (with 200 patients) factor analyses. Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients. RESULTS: In the exploratory factor analysis, three factors with eigenvalues of 3.84, 2.41, and 2.26 were extracted that together explained 56.74% of the total variance of diabetic foot self-care. A Cronbach's alpha of 0.865 was found for the total instrument. CONCLUSIONS: The Persian version of the DFSQ-UMA has good validity and reliability, and given its good psychometric properties, it can be used in future studies.

Transcultural adaptation and validation of Italian Selfcare diabetic foot questionnaire.

The Italian Selfcare diabetic foot questionnaire, (SDFQ-IT) is considered a diabetic foot self-care evaluation tool with 16 questions for assessing diabetic foot health disorders. To date, SDFQ has been validated in different languages, but an Italian version was lacking. Consequently, the purpose of this study was to translate and validate the Italian version of the SDFQ-IT (SDFQ-IT). A suitable method was developed for the translation protocol and cross-cultural validation from Spanish to Italian. Regarding the total marks from each sub-scale, agreement degrees, and confidence were analysed using the Cronbach's α and intraclass correlation coefficient (ICC), respectively. In addition, the mean ± SD differences between pre and post-tests were calculated and completed using the Bland and Altman distribution plots. Excellent agreement between the two versions based on Cronbach's α was demonstrated. Three sub-scales consisting of knowledge of foot hygiene, the appropriate use of footwear and socks, and podiatric self-care were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the self-care domain, and shock and shoe sub-scales. There were no significant differences among any domain (P > .05). There were no statistically significant differences (P = .000) for the mean ± SDs differences between pre-and post-tests (92.9200 ± 12.914) [89.25-96.59] and 92.9200 ± 13.012 [89.22-96.62] points, respectively). Bland and Altman plots or clinically pertinent variations were not statistically significantly different. The SDFQ-IT is considered a strong and valid questionnaire with adequate repeatability in the Italian community.

Foot health-related quality of life in hemophiliacs: A case-control study.

Background: Haemophilia is considered as a chronic genetic disease related with alteration in coagulation mechanism which affects to health related quality of life (HQoL). Purpose: The goal compared marks of HQoL, in haemophiliacs with respect non haemophilic subjects. Methods: A population of 74 subjects, were recruited from association of haemophilic illness separated in haemophilic subjects (n = 37) and no haemophilic (n = 37). For subjects who suffered haemophilia were enlisted from the association of haemophilic illness after a seminar of 45 minutes to them and to their relatives about foot health. Control subjects, were recruited from their relatives who live with the patient. The marks of the Foot Health Status Questionnaire Spanish S_FHSQ sub-scales were recompiled. Results: All S_FHSQ domains as foot pain, foot function, tootwear, general foot health, general health, physical activity and social capacity showed lower scores in the haemophilic than non-haemophilic group (P <0.01) except for vigour (P = 0.173). Regarding the rest sub-scale marks of S_FHSQ, showed no significant difference P <0.01. Conclusion: Subjects with a haemophilia showed significant worse foot QoL in all S_FHSQ domains except vigour domain compared with non-haemophilic subjects.

Cross-cultural adaptation, translation, and validation of the Spanish Foot and Ankle Outcome Score questionnaire.

The Spanish Foot and Ankle Outcome Score questionnaire (FAOS-S) may be considered a health evaluation tool with 42 questions for assessing foot health disorders. To date, FAOS has been validated in different languages, but a Spanish version was lacking. Consequently, the purpose of this study was to translate and validate the Spanish version of the FAOS (FAOS es). A suitable method was developed for the translation protocol and cross-cultural validation from Swedish to Spanish. Regarding the total marks from each domain, agreement degrees and confidence were analysed using the Cronbach's α and intraclass correlation coefficient, respectively. In addition, the mean ± SD differences between pretest and posttests were calculated and completed using of the Bland and Altman distribution plots. Excellent agreement between the two versions based on Cronbach's α was demonstrated. Five domains consisting of pain, symptoms of foot disorders, activities of daily living, sports and recreation, and foot and ankle quality of life were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the pain, stiffness, other foot disorder-related symptoms, and quality of life domains. There were no significant differences among any domain (P > .05). There were no statistically significant differences (P = .000) for the mean ± SD differences between pretest and posttests (56.2524 ± 19.064 [51.98-60.52] and 57.45 ± 21.02 [52.74-62.16] points, respectively). Bland and Altman plots or clinically pertinent variations were not statistically significantly different. The FAOS is considered a strong and valid questionnaire with adequate repeatability in the Spanish community.

Predictive model to identify the risk of losing protective sensibility of the foot in patients with diabetes mellitus.

Diabetic neuropathy is defined as the presence of symptoms and signs of peripheral nerve dysfunction in diabetics. The aim of this study is to develop a predictive logistic model to identify the risk of losing protective sensitivity in the foot. This descriptive cross-sectional study included 111 patients diagnosed with diabetes mellitus. Participants completed a questionnaire designed to evaluate neuropathic symptoms, and multivariate analysis was subsequently performed to identify an optimal predictive model. The explanatory capacity was evaluated by calculating the R2 coefficient of Nagelkerke. Predictive capacity was evaluated by calculating sensitivity, specificity, and estimation of the area under the receiver operational curve. Protective sensitivity loss was detected in 19.1% of participants. Variables associated by multivariate analysis were: educational level (OR: 31.4, 95% CI: 2.5-383.3, P = .007) and two items from the questionnaire: one related to bleeding and wet socks (OR: 28.3, 95% CI: 3.7-215.9, P = .001) and the other related to electrical sensations (OR: 52.9, 95% CI: 4.3-643.9, P = .002), which were both statistically significant. The predictive model included the variables of age, sex, duration of diabetes, and educational level, and it had a sensitivity of 81.3% and a specificity of 95.5%. This model has a high predictive capacity to identify patients at risk of developing sensory neuropathy.

Comparison of Lateral Abdominal Musculature Activation during Expiration with an Expiratory Flow Control Device Versus the Abdominal Drawing-in Maneuver in Healthy Women: A Cross-Sectional Observational Pilot Study.

Background and Objectives: The purpose of the present study was to quantify and compare lateral abdominal musculature thickness, including the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles, via rehabilitative ultrasound imaging (RUSI) during the use of the expiratory flow control device (EFCD) versus the classic abdominal drawing-in maneuver (ADIM). Materials and Methods: A cross-sectional observational pilot study. Twenty-one women were recruited and assessed the thickness of each muscle (TrA, IO, and EO) by ultrasound imaging at rest, during the ADIM, and during expiration with the EFCD. Waist circumference was also measured under the same circumstances. Results: Statistically significant differences were observed between ADIM, EFCD, and at rest condition for the thickness of the TrA (p = 0.001) and IO (p = 0.039). Moreover, statistically significant differences for TrAb at rest compared with the ADIM (p = 0.001, Cohen's d = 2.183) and at rest and with the EFCD (p = 0.001, Cohen's d = 2.843). In addition, between ADIM and EFCD were not statistically significant, although a moderate effect size was found (p = 0.055, Cohen's d = 0.694). For the IO muscle thickness, significant differences were reported between the EFCD and at rest (p = 0.038), Cohen's d = 0.081). Conclusions: Significant differences in the increase of the thickness of the TrA and IO muscles during the use of the EFCD and the ADIM with respect to rest. In addition, for the TrA, statistically significant differences were found during expiration with the EFCD with respect to the ADIM. Expiration with EFCD can be a useful method for the activation of the TrA.

Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study.

Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality.

Development, validation and psychometric analysis of the diabetic foot self-care questionnaire of the University of Malaga, Spain (DFSQ-UMA).

This paper assessed the reliability and construct validity of a tool to evaluate the foot self-care of diabetic patients. The education of diabetic patients about their foot care is a major issue to avoid complications like amputations and ulcers. Specific tools aimed to assess patient's knowledge in this area are needed. The study had two phases: in Phase 1, item-generation was carried out through a literature review, expert review by a Delphi technique and cognitive interviews with diabetic patients for testing readability and comprehension. In Phase 2, diabetic patients participated in a cross-sectional study for a psychometric evaluation (reliability and construct validity) was carried out on a sample of type I and II diabetic patients. The study was conducted at the University of Malaga (Spain), podiatric clinics and a Diabetic Foot Unit between October 2012 and March 2013. After psychometric-test analyses on a sample of 209 diabetic patients, the questionnaire resulted in 16 questions. Cronbach's alpha was 0.89 after removing 4 items because of their low reliability. Inter-item correlations gave a mean value of 0.34 (range: 0.06-0.74). The rotated solution showed a 3-factor structure (self-care, foot care, and footwear and socks) that jointly accounted for 60.88% of the variance observed. The correlation between the questionnaire scores and HbA1c was significant and inverse, (r = -0.15; p < 0.01). The findings show that the questionnaire is a valid and reliable tool for evaluating foot self-care behavior in diabetic patients.

Ultrasound imaging assessment of the diaphragm and abdominal muscles in people with a recent history of moderate Covid-19 infection and healthy participants: A cross-sectional pilot study.

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 psychological 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.

Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life.

Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. This current study aimed to explore the relationships between peripheral sensory system decline and cognitive functions, the symptoms of depression, and quality of life (QoL) as metrics of central nervous system impairment in institutionalized older adults. A total of 95 individuals participated in this case-control study, which included diabetics and non-diabetics. The superficial sensory pathway was assessed in terms of thermal sensation, nociception, and non-discriminative touch, and the deep sensory pathway was evaluated by assessing vibration and light touch-pressure sensations. To assess function at the intellectual level, the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) cognitive functional tests were used, while the symptoms of depression and QoL were explored by employing the Yesavage Geriatric Depression Scale and EuroQol 5D questionnaire (EQ-5D), respectively. In the overall population analyses, altered thermal sensation was significantly associated with cognitive impairment (CI; p < 0.05). In turn, bivariate analyses and a binary logistic regression showed that the symptoms of depression and QoL were significantly related to altered vibratory sensation when assessed using a medical tuning fork (p < 0.05). In the group of diabetic patients, those with CI also had significantly lower thermal sensation (p < 0.05) and non-discriminative touch sensation, although this was only a trend (p = 0.055). Diabetics with depression had a significantly worse non-discriminative touch (p < 0.05) and vibratory sensation when tested with a tuning fork (p < 0.05). In addition, poorer QoL was associated with reduced sensitivity to heat (p < 0.05), light touch pressure (p < 0.05), and vibrations when assessed either with a tuning fork (p < 0.05) or a biothesiometer (p < 0.05). In contrast, no relationships were found between sensory functions and cognitive assessments in non-diabetic patients. These findings indicate that superficial sensitivity damage was related to CI, while deep sensation alterations were related to depression and poor QoL, with diabetes apparently further strengthening these relationships.

Validity and reliability of the English version of the Diabetic Foot Self-Care Questionnaire: a cross-cultural adaptation.

Introduction: The objective of this study was to carry out the cross-cultural adaptation and validation of the Diabetic Foot Self-Care Questionnaire into the English language, broadening the applicability of this patient-reported outcome measure and improving the monitoring of patients with diabetic foot disease. Methods: The validation study into English was conducted in two phases: cross-cultural adaptation and psychometric validation study. Short Form-12 Version 2, EuroQoL-5D and Foot Function Index were used to analyze the criterion validity. Item response, internal consistency, standard error of measurement, minimal detectable change and construct validity were calculated in the validation phase. Results: An English version of the questionnaire (DFSQ-UMA-En) was successfully obtained. A total of n = 193 participants were tested to confirm the validity and reliability of the questionnaire. Internal consistency values ranged from very good to excellent (Cronbach's α =0.889-0.981), and reliability was excellent (ICC = 0.854-0.959). Standard error measurement value was =2.543. Criterion validity ranged from r = 0.429 to r = 0.844. For construct validity, Kaiser-Meyer-Olkin test was =0.752. Conclusion: DFSQ-UMA-En is a valid and reliable tool with good readability and comprehension features. This questionnaire addresses foot self-care behaviors in patients with diabetic foot disease, standing out as essential for early diagnosis and prevention strategies in clinical and research settings.