The education of diabetic patients about their foot self-care : Our experiences in the Unit of Diabetic foot in the University of Malaga.

Diabetes Mellitus (DM) is currently one of the most prevalent chronic diseases, with rising figures that reflect a pandemic scenario. .The International Diabetes Federation (IDF) estimated that 366 million people worldwide have DM. The foot is in the core of the problem in patients with DM Furthermore, patients qualified as low-risk can develop complications relatively fast in the absence of good glycemia monitoring and adequate self-care practices. 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 was conducted at the University of Malaga (Spain), podiatric clinics and a Diabetic Foot Unit A total of 209 diabetic patients responded to the questionnaire. Of the sample, 108 (51.7%) were females and 101 (48.3%) were males. The average age was 61.33 years (±16.74 year), the average duration of the diabetes was 13.44 years (±10.90), the mean glycemia was 134.43 (±40.16), and the mean glycosylated hemoglobin was 7.1 (±1.20) The results of the foot health questionnaire showed the educational level is important in the self-care of the diabetic patientsUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Systematic review of flexible flatfoot treatments. Retrospective analysis (1977-2011)

Objetivo: Con esta búsqueda sistemática pretendíamos en un principio contrastar los diferentes tratamientos ortopodológicos utilizados en el pie plano flexible (PPF). Material y métodos: Se ha realizado una revisión de la literatura científica para identificar los posibles estudios de los diferentes tratamientos para el pie plano flexible. Se han consultado los principales buscadores y bases de datos biomédicas: Medline-pubmed, Enfispo, Scopus y Cochrane Library®. El periodo de búsqueda estuvo comprendido entre febrero-junio de 2011. Resultados: En nuestra búsqueda hallamos 150 resúmenes de artículos con las palabras clave seleccionadas. 106 artículos de los anteriormente mencionados fueron excluidos tras leerlos por no cumplir los criterios de selección del estudio. Por lo tanto, obtuvimos 44 potencialmente relevantes. De estos, 4 eran estudios sobre tratamientos conservadores para el PPF, 17 sobre tratamientos quirúrgicos, 22 eran análisis descriptivos de la materia y 1 revisión sistemática. Conclusiones: Con esta búsqueda, destacamos la falta de estudios con tratamientos ortoprotésicos y conservadores en general, existiendo, por el contrario, una amplia bibliografía sobre estudios en multitud de técnicas quirúrgicas aplicadas al PPF. Por lo cual, en investigaciones futuras se deberían obtener métodos de clasificación del PPF válidos y fiables que faciliten el estudio y nos aporten medidas de resultados adecuadamente valoradas para la intervención que se está llevando a cabo. La investigación debería dirigirse en el futuro a realizar ensayos clínicos que incluyan a mayor número de pacientes, que comparen diferentes combinaciones y algoritmos de formas de tratamiento conservadores, para analizar su coste-efectividad a medio-largo plazo.Background: At first, with this systematic search we intended to contrast the different orthopedictreatments used for flexible flatfoot. Material and methods: We have performed a literature review to identify potential studies of different treatments for flexible flat foot. We have consulted the main search enginesand biomedical databases: Medline, PubMed, Enfispo, Results: In our search, we found 147 abstracts with our selected keywords. 106 articles of the previously mentioned were excluded afterreading them, because theydid not meetthe study criteria for selection. Therefore, we obtained 44 potentially relevant. 4 of these were conservative treatment studies for the PPF, 17 about surgical treatments and 23 were descriptive analysis of the subject. Conclusions:With this search, we point out the lack of studies with orthopedicand conservative treatments, being, however, a wide bibliography about studies in diverse surgical techniques for flexible flatfoot. Whereby, the future researches should get valid and reliable methods for the classification of flexible flatfoot, that facilitate the adequately valued measures for the intervention that we are carring out. In the future, the investigation should run to do clinical trials that include a greater number of patients that compare different combinations and algorithms of conservative treatments to analyze its cost-effectiveness in a medium-long term

The level of competencies in the Podiatry Degrees around Europe: Can we harmonize the basic level?

Las competencias en podología a lo largo de Europa genera muchas dudas, cada país con legislaciones diferentes trabaja en mejorar las suyas sin tener un foco común que pueda ser defendido. ENPODHE como la red de Educación Superior a nivel europeo, pretende mejorar esa problemática creando nuevas líneas de trabajo y proyectos ERASMUS +Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Effectiveness of foot orthosis in patients with rheumatoid arthritis related to quality of life and pain. A systematic review and meta-analysis

Foot pain and deformity is almost ubiquitous in RA and results in considerable physical and psychosocial impairment. Epidemiological studies consistently suggest a 90% prevalence of foot pain despite advances in pharmacological therapy. Mechanical and other non-pharmacological interventions such as orthoses and footwear, have an important role in managing foot pathology in patients with their systemic disease controlled. The effectiveness of treatment with insoles, especially in early periods, was studied in a randomized controlled trial, which results suggested an immediate clinical improvement, reducing foot pain, disability and limited functionality.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

The custom-made foot orthosis using the Central Stabilizer Element: nex concept of element

Foot orthoses have been applied for the management of lower limb disorders, mainly for those who develop foot pain. The Central Stabilizer Element (CSE) is a new element that contains the midfoot laterally when a plantar insole is manufactured. OBJECTIVES: - To determine the effect on foot pain of adding the Central Stabilizer Element during the manufacturing process of foot orthosis, -- - To describe the proportions of Central Stabilizer Element in terms of width and length of this element. METHODS: A sample comprising 130 patients (57 males and 73 females) with foot pain was recruited for this study, with the patients having supinated, neutral, pronated and overpronated feet. All the patients received a custom-made foot orthosis with the Central Stabilizer Element. The Central Stabilizer Element was made of resins of polyvinyl chloride, and is a device insert in foot orthosis that contains the midfoot laterally to control pronation and supination movements. Conclusion •The students know how to design the insole. •They know how to match different foot posture with the different types of insoles •We make our decisions based on the scientific evidence foundUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Systematic review of the psychometric properties of patient-reported outcome measures for foot and ankle in rheumatoid arthritis

Background Foot problems and pain are common in patients with rheumatoid arthritis. Patient-reported outcome measures provide a standardized method of capturing patients’ perspectives of their functional status and wellbeing. There are many instruments specific to people with feet affected by rheumatoid arthritis but knowledge of their psychometric validation or methodological quality is lacking Objectives To identify patient-reported outcome measures specific to the foot and ankle and rheumatoid arthritis and investigate their methodological quality and psychometric properties Design Systematic review. Data source : A search was conducted for psychometric or validation studies on patient-reported outcomes in Rheumatoid Arthritis published in different languages, by examining the Pubmed; Scopus, CINAHL; PEDro and Google Scholar databases. Review methods . The systematic review performed was based on the following inclusion criteria: psychometric or clinimetric validation studies on patient-reported outcomes specific to the foot and ankle that included patients with Rheumatoid arthritis. Two authors independently assessed the quality of the studies and extracted datas Results Of the initial 431 studies, fourteen instruments met the inclusion criteria. Significant methodological flaws were detected in most with only SEFAS met the COSMIN quality criteria. Conclusion SEFAS had the best quality and was ranked most appropriate for use with patients living with Rheumatoid Arthriti

Impact of in shoe and barefoot placed frontal wedges on plantar loading: A systematic review

Eleven papers were included in the final review. Four were cross-over studies, other four were quasi-experimental studies and three were RCTs. These eleven studies included 320 patients, with ages ranging from 20 to 60 years. Regarding the risk of bias, most of the observational studies and RCTs had a moderate level of quality. Conclusions: The results suggest that lateral wedges are more effective, producing a lateral shift of the centre of pressure and increasing the pressure. Regarding the impact on the peak impact force there seems to be less consensus among the published data.Funding for open access charge is provided by Universidad de Malaga/CBUA

PSYCHOMETRIC CHARACTERISTICS OF A SPANISH TRANSLATION OF THE MANCHESTER FOOT PAIN AND DISABILITY INDEX: VALIDATION AND RASCH ANALYSIS

Background: The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment questionnaire developed in the UK to measure foot pain and disability in the general population1. It has been translated and validated in several languages 2,3 Objectives: The aim of this study was to conduct cross-cultural adaptation and validation of the MFPDI into Spanish Methods: The cross-cultural adaptation process was undertaken using International Society for Pharmacoeconomics and Outcomes Research (ISPOR)4 recommendations. This involved 8 stages: i) Forward translation, ii) Reconciliation, iii) Back translation, iv) Back translation review, v) Harmonisation, vi) Pilot, vii) Pilot review, and viii) Proofreading. In the validation phase, the MFPDI datasets from the UK (original) and Spain (adapted) were pooled and subjected to Rasch analysis. Fit to the Rasch model, unidimensionality, reliability and cross-cultural invariance is reported Results: The pooled dataset comprised 1015 patients (Spain n=333 and UK n=682) with characteristics summarised in Table 1. Rasch analysis confirmed three subscales for both the Spanish and UK datasets and fit to the Rasch model X2 (df) = 15.945 (12), p = 0.194 and 31.024 (21), p = 0.073, for Spain and UK . The reliability (Person Separation Index - PSI) was .85 and .82 for Spain and UK respectively. Significant cross-cultural non-invariance was present on the Functional and Personal appearance subscales. Adjustment for the bias was achieved by ‘splitting’ the affected subscales and creation of cultural-specific subscales for each country and cultural-general subscale. Fit to the Rasch model was satisfied following cross-cultural adjustment (Table 1). The MFPDI was calibrated into interval-level scales for Spain and UK to enable future data pooling or comparisons. Sampl e size Gender Age Item Fit Residual Person Fit Residual Chi Square Interaction PSI Analysis N Female (%) Mean (SD) Mean SD Mean SD Value (df) p Spain 333 248 (74.4) 51.6 (15.2) -0.164 3.07 - 0.364 0.93 15.95 (12) 0.19 0.85 UK 682 416 (61.0) 55.2 (16.7) -0.366 2.80 - 0.429 0.99 31.02 (21) 0.07 0.82 Pooled 1015 663 (65.4) 52.8 (15.8) -0.766 4.40 - 0.441 1.06 49.17 (27) 0.01 0.84 DIFAdjusted -0.420 2.98 - 0.415 0.98 57.94 (45) 0.09 0.84 Table 1: P = Χ2 interaction probability, (non-significant P = Fit to the model), PSI = Person separation index Conclusions: A gold standard translation process (ISPOR) has been used to develop a Spanish (for Spain) version of the MFPDI, a widely used foot-specific patient-reported outcome measure. Rasch analysis has confirmed that the MFPDI is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions. Future work can make cross-cultural comparisons using the calibrated scale

How susceptible are our Achilles Tendons? Sonoanatomical assessment. A cross-sectional study

Objective: the aim of this study is to observe whether there are ultrasound changes between men and women in the Achilles tendon at rest, at maximum passive force is applied and during walking. Material and methods: it was a cross-sectional study involving 27 healthy young participants recruited as vol-unteers between April to July 2022. A variety of data was recorded: (age, Body Mass Index, sex, smoking, current injury status, allergies, medications, previous surgeries, type of sport, and number of weekly workouts) and ultrasound measurements at rest and at passive force (Cross Sectional Area Achilles Tendon length, tendon thickness, Cross Sectional Area and pennation angle of the soleus muscle to the Achilles Tendon). Results: women demonstrated a statistically significant lower proximal and median thickness both at rest (4.5 vs 5.1 mm with p < 0.001 for proximal thickness; 4.4 vs 5.3 mm with p < 0.001 for median thickness) as well as during maximum eccentric contraction (4.3 vs 4.8 mm with p=<0.001 for proximal thickness; 4.1 vs 4.8 mm with p < 0.001 for median thickness). Conclusion: there are significant sonoanatomical differences in vivo Achilles tendon between men and women.Funding for opoen access charge: Universidad de Málaga / CBU

Diccionario Podológico Español-Ingles Términos podológicos de uso común en el Grado de Podología (Cuaderno de ayuda para el alumno)

Diccionario con terminos utilizados en el ambito de la podologia tanto en ingles como en español, y su definicion en ambos idiomas.Se pretende sea un documento de uso dentro de las asignaturas del Grado de Podologia para facilitar uso de terminos en ambos idiomasUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech .Incluido en el Proyecto de Inovacion Docente (PIE15/77