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Smith JT, Parker EB, Bluman EM, Martin EA, Chiodo CP. Differences in Baseline Physical Function and Mental Health PROM Scores in Patients With Foot and Ankle Conditions. Foot Ankle Int 2024; 45:621-631. [PMID: 38433427 DOI: 10.1177/10711007241231974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
BACKGROUND This study sought to establish normative values for baseline physical and mental health by foot and ankle diagnosis using validated PROMIS scores and to compare the correlation between these 2 outcomes across common diagnoses. Additionally, it investigated the effects associated with chronic vs acute conditions and specific diagnoses on mental health. METHODS We reviewed baseline PROMIS Physical Function 10a (PF10a) and PROMIS Global-Mental (PGM) scores of 14,245 patients with one of the 10 most common foot and ankle diagnoses seen at our institution between 2016 and 2021. Pearson correlation coefficients were calculated to assess the relationship between PF10a and PGM by diagnosis. A multivariable regression model including age, sex, language, race, ethnicity, education level, income, and Charlson Comorbidity Index was used to determine the associated effect of diagnosis on PGM score. RESULTS On unadjusted analysis, patients diagnosed with an ankle fracture had the lowest mean physical function, whereas patients with hallux valgus had the highest (PF10a = 33.9 vs 46.7, P < .001). Patients with foot/ankle osteoarthritis had the lowest mean self-reported mental health, whereas patients with hallux rigidus had the highest (PGM = 49.9 vs 53.4, P < .001). PF10a and PGM scores were significantly positively correlated for all diagnoses; the correlation was strongest in patients diagnosed with foot/ankle osteoarthritis or hammertoes (r = 0.511) and weakest in patients with ankle fractures (r = 0.232) or sprains (r = 0.280). Chronic conditions, including hammertoes (β = -5.1, 95% CI [-5.8, -4.3], P < .001), foot/ankle osteoarthritis (β = -5.0, 95% CI [-5.7, -4.3], P < .001), and hallux valgus (β = -4.8, 95% CI [-5.5, -4.1], P < .001) were associated with the largest negative effects on patients' mental health. CONCLUSION Self-reported physical function and mental health varied across common foot and ankle diagnoses and were more tightly correlated in chronic conditions. The associations between diagnosis and mental health scores appear larger for more chronic diagnoses, including those that are generally associated with relatively unimpaired physical function.
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Affiliation(s)
- Jeremy T Smith
- Harvard Medical School, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Emily B Parker
- Harvard Medical School, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Eric M Bluman
- Harvard Medical School, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Elizabeth A Martin
- Harvard Medical School, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher P Chiodo
- Harvard Medical School, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Foot and Ankle Division, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
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2
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Gates LS, Cherry L, Grønne DT, Roos EM, Skou ST. The prevalence of foot pain and association with baseline characteristics in people participating in education and supervised exercise for knee or hip osteoarthritis: a cross-sectional study of 26,003 participants from the GLA:D® registry. J Foot Ankle Res 2023; 16:83. [PMID: 37993923 PMCID: PMC10666392 DOI: 10.1186/s13047-023-00673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/15/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) affecting the knee or hip is highly prevalent in the general population and has associated high disease burden. Early identification of modifiable risk factors that prevent, limit, or resolve disease symptoms is critical. Foot pain may represent a potentially modifiable factor however little is known about the prevalence of foot pain in people with knee or hip OA nor whether foot pain is associated with clinical characteristics. The main aim of this study was therefore to determine the prevalence of foot pain in people with knee or hip OA attending an education and supervised exercise-based intervention in Denmark (GLA:D®) and determine if baseline demographic or clinical characteristics are associated with foot pain. METHODS Analysis was conducted on baseline data of 26,003 people with symptomatic knee or hip OA completing a pain mannequin as part of the Good Life with osteoArthritis in Denmark (GLA:D®) primary care programme. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the strength of association between baseline clinical characteristics (including pain severity in worst knee/hip joint, number of painful knee/hip joints, pain medication use and physical activity level) and the presence of baseline foot pain. RESULTS Twelve percent of participants (n = 3,049) reported foot pain. In those people with index knee OA (n = 19,391), knee pain severity (OR 1.01 CI 1.00, 1.01), number of painful knee/hip joints (OR 1.67 CI 1.58, 1.79), and use of pain medication (OR 1.23 CI 1.12, 1.36) were statistically associated with foot pain. Excluding use of pain medication, similar associations were seen in those with index hip OA. CONCLUSION Twelve percent of people with knee or hip OA participating in GLA:D® had foot pain. Those with worse knee/hip pain, and greater number of painful joints were more likely to report foot pain. This study is the first to demonstrate a significant relationship between clinical characteristics and foot pain in people with knee or hip OA participating in education and supervised exercise. Future investigation should consider the role that foot pain may play on knee and hip related outcomes following therapeutic intervention.
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Affiliation(s)
- Lucy S Gates
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Lindsey Cherry
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK.
- Solent NHS Trust, Southampton, UK.
| | - Dorte T Grønne
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Næstved, Denmark
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3
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Harmon S, Alvarez C, Hannan MT, Callahan LF, Gates LS, Bowen CJ, Menz HB, Nelson AE, Golightly YM. Association of Foot Symptoms With Decreased Time to All-Cause Mortality: The Johnston County Osteoarthritis Project. Arthritis Care Res (Hoboken) 2023:10.1002/acr.25186. [PMID: 37386686 PMCID: PMC10755075 DOI: 10.1002/acr.25186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Adults with foot symptoms (ie, pain, aching, or stiffness) may be at increased risk of reduced time to all-cause mortality. The purpose of this study was to evaluate whether foot symptoms are independently associated with all-cause mortality in older adults. METHODS We analyzed longitudinal data from 2613 participants from the Johnston County Osteoarthritis Project, a longitudinal population-based cohort of adults 45 years of age and older. Participants completed questionnaires at baseline to determine presence of foot symptoms and covariable status. Baseline walking speed was measured via an 8-foot walk test. To examine the association of foot symptoms with time to mortality, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression models, adjusted for potential confounders. RESULTS We observed 813 deaths over 4 to 14.5 years of follow-up. At baseline, 37% of participants had foot symptoms, mean age was 63 years, mean body mass index was approximately 31 kg/m2 , 65% were women, and 33% were Black. Moderate to severe foot symptoms were associated with reduced time to mortality after adjustment for demographics, comorbidities, physical activity, and knee and hip symptoms (HR = 1.30, 95% CI 1.09-1.54). Importantly, this association was not modified by walking speed or diabetes. CONCLUSION Individuals with foot symptoms had an increased hazard of all-cause mortality compared with those with no foot symptoms. These effects were independent of key confounders and were not moderated by walking speed. Effective interventions to identify and manage at least moderate foot symptoms may reduce the risk of decreased time to mortality.
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Affiliation(s)
- Skylar Harmon
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Nova Southeastern University- Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL USA
| | - Carolina Alvarez
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Marian T. Hannan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA
- Hinda and Arthur Marcus Institute of Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Leigh F. Callahan
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Lucy S. Gates
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Catherine J. Bowen
- School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Southampton, Southampton, SO17 1BJ, UK
| | - Hylton B. Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, AUS
| | - Amanda E. Nelson
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Yvonne M. Golightly
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE USA
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4
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Holt M, Swalwell CL, Silveira GH, Tippett V, Walsh TP, Platt SR. Pain catastrophising, body mass index and depressive symptoms are associated with pain severity in tertiary referral orthopaedic foot/ankle patients. J Foot Ankle Res 2022; 15:32. [PMID: 35524334 PMCID: PMC9074220 DOI: 10.1186/s13047-022-00536-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Patients with chronic foot/ankle pain are often referred for orthopaedic assessment. Psychological vulnerabilities influence pain states (including foot and ankle), therefore this study aimed to establish the prevalence and relative importance of compromised psychological health to perceived foot/ankle pain severity in people referred to an orthopaedic foot and ankle clinic with non-urgent presentations. Methods Patients with triaged non-urgent foot/ankle referrals to the Department of Orthopaedics at Gold Coast University Hospital were recruited over a 12-month period and completed the Manchester-Oxford Foot and Ankle Questionnaire which was the primary measure. Participants also completed questionnaires assessing their anthropometric, demographic and health characteristics (Self-Administered Comorbidity Questionnaire) as well as measures of health-related quality of life (EuroQol-5-Dimensions-5-Level Questionnaire and EQ Visual Analogue Scale) and psychological health (Center for Epidemiological Studies-Depression scale, Pain Catastrophizing Scale and Central Sensitization Inventory). Descriptive statistics were used to summarise participant characteristics and a hierarchical multiple linear regression was employed to establish the extent to which psychological variables explain additional variance in foot/ankle pain severity beyond the effects of participant characteristics (age, sex, body mass index (BMI)). Results One hundred and seventy-two adults were recruited ((64.0% female), median (IQR) age 60.9 (17.7) years and BMI 27.6 (7.5) kg/m2). Specific psychological comorbidities were prevalent including depressive symptoms (48%), central sensitisation (38%) and pain catastrophising (24%). Age, sex and BMI accounted for 11.7% of the variance in MOXFQ-index and psychological variables accounted for an additional 28.2%. Pain catastrophising was the most significant independent predictor of foot/ankle pain severity (accounting for 14.4% of variance), followed by BMI (10.7%) and depressive symptoms (2.3%). Conclusions This study demonstrated that specific psychological comorbidities and increased BMI are common in this cohort and that these factors are associated with the symptoms for which patients are seeking orthopaedic assessment. This knowledge should prompt clinicians to routinely consider the psychosocial components of patient presentations and develop non-operative and pre-operative treatment strategies which consider these factors with the goal of improving overall patient outcomes.
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Affiliation(s)
- Matthew Holt
- Department of Orthopaedics, Gold Coast University Hospital, Southport, Queensland, 4215, Australia.,Griffith University, School of Medicine, Southport, Queensland, 4215, Australia
| | - Caitlin L Swalwell
- Department of Orthopaedics, Gold Coast University Hospital, Southport, Queensland, 4215, Australia.,Queensland University of Technology (QUT), Faculty of Health, School of Clinical Sciences, Kelvin Grove, Queensland, 4059, Australia
| | - Gayle H Silveira
- Department of Orthopaedics & Trauma, Northern Adelaide Local Health Network, South Australia, 5112, Australia
| | - Vivienne Tippett
- Queensland University of Technology (QUT), Faculty of Health, School of Clinical Sciences, Kelvin Grove, Queensland, 4059, Australia
| | - Tom P Walsh
- Department of Orthopaedics, Gold Coast University Hospital, Southport, Queensland, 4215, Australia. .,Queensland University of Technology (QUT), Faculty of Health, School of Clinical Sciences, Kelvin Grove, Queensland, 4059, Australia.
| | - Simon R Platt
- Department of Orthopaedics, Gold Coast University Hospital, Southport, Queensland, 4215, Australia.,Griffith University, School of Medicine, Southport, Queensland, 4215, Australia
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Dueñas L, Arnal-Gómez A, Aparicio I, Balasch-Bernat M, López-Bueno L, González JC, Solves-Camallonga C, Alcántara E. Influence of age, gender and obesity on pressure discomfort threshold of the foot: A cross-sectional study. Clin Biomech (Bristol, Avon) 2021; 82:105252. [PMID: 33497989 DOI: 10.1016/j.clinbiomech.2020.105252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Foot pain is a highly prevalent health problem for which measures such as a pattern of Pressure Discomfort Threshold of the foot plantar surface can provide valuable information for orthosis design. This study aimed to describe such pattern as a tool for the assessment of painful conditions of the feet and to analyse how it modifies according to age, gender and obesity. METHODS A cross-sectional study was performed with participants allocated in: Group 1 people aged 20 to 35 years, Group 2 aged 50 to 65 years and Group 3 aged over 65. Pressure Discomfort Threshold on twelve points of the foot plantar surface was measured with an adapted manual dynamometer. Inferential analyses of the data were performed using one-way analysis of variance (ANOVA) considering foot areas, age group, gender and obesity. FINDINGS 36 participants were analysed. The pattern of Pressure Discomfort Threshold for all individuals showed a significantly higher threshold on the heel and external foot (P < 0.001, η2 = 0.124) and was statistical significantly influenced by age (P < 0.001, η2 = 0.17), especially in participants aged over 65; by gender, with women having higher values (P < 0.001, η2 = 0.13), and by obesity (P < 0.001, η2 = 0.19). INTERPRETATION A Pressure Discomfort Threshold pattern exists in the foot plantar surface. The characteristics of the discomfort pattern of the foot and its association with aging, gender and obesity may have considerable implications for orthosis and footwear design.
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Affiliation(s)
- L Dueñas
- Department of Physiotherapy, University of Valencia, Valencia, Spain; "Physiotherapy in Motion, Multi-specialty Research Group" (PTinMOTION), University of Valencia, Valencia, Spain.
| | - A Arnal-Gómez
- Department of Physiotherapy, University of Valencia, Valencia, Spain; Research Unit in Clinical Biomechanics (UBIC Research Group), University of Valencia, Valencia, Spain.
| | - I Aparicio
- Department of Physical Education, Research Group of Sports Biomechanic (GIBD) University of Valencia, Spain.
| | - M Balasch-Bernat
- Department of Physiotherapy, University of Valencia, Valencia, Spain; "Physiotherapy in Motion, Multi-specialty Research Group" (PTinMOTION), University of Valencia, Valencia, Spain.
| | - L López-Bueno
- Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | - J C González
- Instituto de Biomécanica de Valencia, Valencia, Spain.
| | | | - E Alcántara
- Instituto de Biomécanica de Valencia, Valencia, Spain.
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6
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Fujii K, Stolt M, Komoda T, Nishikawa M. Effects of Nurse and Care Worker-led Foot-Care Program on Older People's Foot Conditions: Before and After Intervention Study. SAGE Open Nurs 2021; 7:23779608211058492. [PMID: 35155772 PMCID: PMC8832336 DOI: 10.1177/23779608211058492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 10/02/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction An increasing number of older people with frailty in Japan use geriatric day
care centers. Older people who have been certified as requiring long-term
care attend centers during the day and receive nursing care help with
bathing, excretion, meals, and functional training services. Many older
people have foot problems with need foot care by nurses and care workers
(NCWs) at geriatric day care centers. Objective This study explored the effects of NCWs’ foot-care programs on the foot
conditions of older people attending daytime services. Methods A before-after intervention study was conducted at geriatric day care centers
for older people, where the foot-care program was presented by NCWs for two
months. The foot conditions of 23 clients (8 men, 15 women, mean age = 78.6
years, standard deviation = 9.2) were assessed before and after the program.
Changes in foot condition and clients’ perceptions after the study were
analyzed through descriptive statistics, McNemar, and paired
t-tests. Results Although dramatic changes in foot conditions were not observed, some
conditions were improved or maintained. Changes were observed in mean dry
skin scores (p < .01; right foot: 1.6→1.1, left foot:
1.6→1.1), skin lesions and long nails (skin lesions R: 0.2→0.1; long nail R:
1.4→1.0, L: 1.1→0.8), and edema (R: 43.5%→39.1%, L: 52.2%→47.8%). Further,
clients started perceiving that foot health is important and discussed their
feet with staff more often. Conclusion The NCWs’ foot-care program was effective in maintaining and improving foot
health in older people and positively affected their perception of foot
care.
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Affiliation(s)
- Kashiko Fujii
- Department of Nursing, Tokyo University of Information Sciences, Chiba City, Chiba Prefecture, Japan
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Takuyuki Komoda
- Department of Plastic and Reconstructive Surgery, Toyohashi Heart Center, Toyohashi City, Aichi Prefecture, Japan
| | - Mariko Nishikawa
- Department of Nursing, University of Human Environments, Obu City, Aichi Prefecture Japan
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7
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Nixon DC, Zhang C, Weinberg MW, Presson AP, Nickisch F. Relationship of Press Ganey Satisfaction and PROMIS Function and Pain in Foot and Ankle Patients. Foot Ankle Int 2020; 41:1206-1211. [PMID: 32660263 DOI: 10.1177/1071100720937013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patient satisfaction has garnered interest as a tool to measure health care quality. However, orthopedic studies in total joint arthroplasty, spine, and hand patients have offered conflicting relationships between Press Ganey (PG) satisfaction metrics and patient-reported outcome (PRO) measures. No prior study has assessed the relationship between PG and PROs in foot and ankle patients. Whether satisfaction and outcomes instruments, though, measure similar or differing aspects of the patient experience is unclear. Here, we tested if there was an association between Patient-Reported Outcomes Measurement Information System (PROMIS) outcomes and PG satisfaction scores. METHODS PG and PROMIS outcomes data for new patient visits to an orthopedic foot and ankle clinic between 2015 and 2017 were retrospectively analyzed. Patients that completed PG satisfaction surveys were included for study. All patients who completed PG surveys and completed one or both PROMIS physical function (PF) or pain interference (PI) metrics administered by computerized adaptive testing were included. Negative binomial regressions were used to compare PRO scores to PG overall satisfaction and PG satisfaction with care provider, adjusting for patient characteristics. Results were reported as dissatisfaction score ratios, which represented the amount of PG dissatisfaction associated with a 10-point increase in PROMIS PF or PI. Of the 3984 new patient visits, only 441 completed the PG survey (11.3% response rate). RESULTS Ceiling effects were seen with PG data: 64% of patients reported perfect satisfaction with care provider and 27% had perfect overall satisfaction. Higher function on the PROMIS PF was weakly associated with increased overall satisfaction (ratio = 0.82, 95% CI: 0.68-0.99, P = .039) and increased satisfaction with care provider (ratio = 0.60, 95% CI: 0.40-0.92, P = .019). However, pain (PROMIS PI) was not associated with overall satisfaction or with satisfaction with care provider. CONCLUSIONS Based on our data here, patient satisfaction was weakly related to patient-reported function but not pain interference among this subset of new patients presenting to a foot and ankle clinic. Given our essentially negative findings, further study is needed to determine which aspects of the PG satisfaction and PROMIS scores track similarly. Further, our findings add to the growing literature showcasing limitations of the PG tool, including low response rates and notable ceiling effects. If satisfaction metrics and patient-reported outcomes capture differing aspects of the patient experience, we need to better understand how that influences the measurement of health care quality and value. LEVEL OF EVIDENCE Level III, comparative study.
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Affiliation(s)
- Devon C Nixon
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Chong Zhang
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Maxwell W Weinberg
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Angela P Presson
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Florian Nickisch
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
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8
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Chean CS, Lingham A, Rathod-Mistry T, Thomas MJ, Marshall M, Menz HB, Roddy E. Identification of patterns of foot and ankle pain in the community: Cross-sectional findings from the clinical assessment study of the foot. Musculoskeletal Care 2020; 19:9-19. [PMID: 32996230 DOI: 10.1002/msc.1502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/12/2020] [Accepted: 08/15/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To investigate patterns of foot and ankle pain locations and symptoms, socio-demographic and comorbid characteristics to examine whether there are distinct foot and ankle pain phenotypes. METHODS Adults aged ≥50 years registered with four general practices in North Staffordshire were mailed a Health Survey questionnaire. Participants reporting foot pain in the last month indicated foot pain location on a foot manikin. Foot and ankle pain patterns were investigated by latent class analysis. Associations between the classes with foot pain symptoms, socio-demographic and comorbid characteristics were assessed. RESULTS Four thousand four hundred fifty-five participants with complete foot pain and manikin data were included in this analysis (mean age 65 years [SD 9.8], 49% male). Of those with foot and ankle pain (n = 1356), 90% had pain in more than one region. Six distinct classes of foot and ankle pain were identified: no pain (71%), bilateral forefoot/midfoot pain (4%), bilateral hindfoot pain (5%), left forefoot/midfoot pain (8%), right forefoot/midfoot pain (5%) and bilateral widespread foot and ankle pain (6%). People with bilateral widespread foot and ankle pain were more likely to be female, obese, depressed, anxious, have/had a manual occupation, have comorbidities, lower SF-12 scores and greater foot-specific disability. Age did not differ between classes. CONCLUSIONS Six distinct classes of foot and ankle pain locations were identified, and those with bilateral widespread foot and ankle pain had distinct characteristics. Further investigation of these individuals is required to determine if they have poorer outcomes over time and whether they would benefit from earlier identification and treatment.
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Affiliation(s)
- Chung Shen Chean
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Aranghan Lingham
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK.,East Kent Hospitals NHS Trust, William Harvey Hospital, Ashford, UK
| | - Trishna Rathod-Mistry
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Martin J Thomas
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Burslem, UK
| | - Michelle Marshall
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Hylton B Menz
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK.,School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood Hospital, Burslem, UK
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9
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Bovonsunthonchai S, Thong-On S, Vachalathiti R, Intiravoranont W, Suwannarat S, Smith R. Thai version of the foot function index: a cross-cultural adaptation with reliability and validity evaluation. BMC Sports Sci Med Rehabil 2020; 12:56. [PMID: 32944253 PMCID: PMC7488097 DOI: 10.1186/s13102-020-00206-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 09/01/2020] [Indexed: 11/11/2022]
Abstract
Background The study aimed to translate the foot function index (FFI) questionnaire to Thai and to determine psychometric properties of the questionnaire among individuals with plantar foot complaints. Methods The Thai version of the FFI (FFI-Th) was adapted according to a forward and backward translation protocol by two independent translators and analyzed by a linguist and a committee. The FFI-Th was administered among 49 individuals with plantar foot complaints to determine internal consistency, reliability, and validity. Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC3,1) were used to test the internal consistency and test-retest reliability. The Principal Component Analysis with varimax rotation method was used to test the factor structure and construct validity. Furthermore, the criterion validity was tested using Pearson’s correlation coefficient (rp) between the FFI-Th and the visual analogue pain scale (pain-VAS) as well as the EuroQol five-dimensional questionnaire (EQ-5D-5L). Results The FFI-Th showed good to excellent internal consistency and test-retest reliability in the total score, pain, disability, and activity limitation subscales. The Principal Component Analysis produced 4 principal factors from the FFI-Th items. Criterion validity of the FFI-Th total score showed moderate to strong correlations with pain-VAS and EQ-5D-5L, and EQ-VAS scores. Conclusion The FFI-Th was a reliable and valid questionnaire to assess the foot function in a Thai population. Trial registration NCT03161314 (08/05/2017).
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Affiliation(s)
- Sunee Bovonsunthonchai
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Rd., Salaya, Phuttamonthon, Nakhon Pathom, 73170 Thailand
| | - Suthasinee Thong-On
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Rd., Salaya, Phuttamonthon, Nakhon Pathom, 73170 Thailand
| | - Roongtiwa Vachalathiti
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Rd., Salaya, Phuttamonthon, Nakhon Pathom, 73170 Thailand
| | - Warinda Intiravoranont
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, 10700 Thailand
| | - Sarawut Suwannarat
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, 10700 Thailand
| | - Richard Smith
- Discipline of Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health Science, The University of Sydney, Sydney, NSW 2006 Australia
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10
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Fujii K, Komoda T, Maekawa A, Nishikawa M. Foot care knowledge and practices among Japanese nurses and care workers in home care and adult service center: a cross- sectional study. BMC Nurs 2020; 19:75. [PMID: 32782433 PMCID: PMC7412637 DOI: 10.1186/s12912-020-00467-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background Foot care knowledge and practices among nurses and care workers in the community greatly impact foot health maintenance and prevention of foot-related problems among older people. This study aimed to explore and examine the current foot care knowledge, practices, and perceptions among nurses and care workers at home care and adult day service center, along with their demographic characteristics and daily care for clients. Methods This study analyzed 232 randomly selected front-line nurses and care workers working at home care or adult day service center in one of the selected cities, Aichi Prefecture, Japan. Data were obtained using questionnaires and subsequently analyzed using descriptive statistics, t-tests, Chi-square tests, Wilcoxon rank-sum tests, and Spearman's rank correlation tests. Results Among the 305 surveyed, 232 (62 nurses; 170 care workers) provided data. Although 57 nurses (91.9%) and 142 care workers (83.5%) showed interest in foot care, 33 nurses (53.2%) and 133 care workers (78.2%) stated that foot care education was insufficient. Knowledge and practice scores were associated with working status.Higher accuracy differences in the early detection of foot problems and skin tears on lower limbs in knowledge category were observed between nurses and care workers. The nurses as well as the care workers had low accuracy rates of knowledge questions regarding the use of shoes and socks subscale.For practice, both nurses and care workers had low mean scores for checking client's shoes (2.0/5.0 and 2.1/5.0, respectively), method for reducing ingrown nail pain (2.6/5.0 and 1.9/5.0, respectively), and opportunity for discussing foot care with others (2.7/5.0 and 2.2/5.0, respectively). A significant correlation between knowledge and practice scores was observed among nurses (0.331, p < 0.05) and care workers (0.339, p < 0.001). Conclusions Despite the presence of several barriers toward enhanced care delivery to clients needing it most, nurses and care workers clearly understood the importance of foot care. These findings indicate that foot care should be focused by nurses and care workers to improve the knowledge and practice of foot care and to suggest future implications that efficient and understandable tools are needed considering their current working situation.
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Affiliation(s)
- Kashiko Fujii
- Graduate School of Medicine, School of Health Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi Prefecture 461-8673 Japan
| | - Takuyuki Komoda
- Department of Plastic and Reconstructive Surgery, Gifu Heart Center, 4-14-4 Yabuta Minami, Gifu City, Gifu Prefecture 500-8384 Japan
| | - Atsuko Maekawa
- Faculty of Nursing, Shubun University, 6 Nikko-cho, Ichinomiya-City, Aichi Prefecture 491-0938 Japan
| | - Mariko Nishikawa
- Graduate School of Nursing, University of Human Environments, 3-220 Ebata-Cho, Obu City, Aichi Prefecture 4740035 Japan
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11
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Fujii K, Stolt M. Intervention study of a foot-care programme enhancing knowledge and practice among nurses and care workers at in-home service providers. Nurs Open 2020; 7:1039-1051. [PMID: 32587723 PMCID: PMC7308698 DOI: 10.1002/nop2.479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022] Open
Abstract
Aim To evaluate the foot-care educational programme for nurses and care workers at in-home service providers. Design A non-randomized controlled study with random cluster sampling method. Methods Study participants were nurses and care workers of 21 in-home service providers, including home-visit nursing and care providers, 1-day care service centres or care centres with rehabilitation programme in Japan. Foot-care programme with foot-care tools as a package or standard care comprising 3-5 sessions over 2 months was provided to 110 participants (87 were on analysis). The outcomes were changes in foot-care knowledge and scores in pre-post interventions. Data were analysed with descriptive statistics, t test, logistic regression analysis and ANCOVA. Results Before adjusting for background, total scores of knowledge and practice categories were higher than the baseline in the intervention group (43 participants) compared with the control group (44 participants). After background correction due to potential bias of non-random cluster sampling, significant between group differences were observed in mean score changes in skin and consultation subscales of the practice category.
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Affiliation(s)
- Kashiko Fujii
- Graduate School of MedicineSchool of Health SciencesNagoya UniversityNagoya CityJapan
- University of Human EnvironmentsObuJapan
| | - Minna Stolt
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
- Turku University HospitalTurkuFinland
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12
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Amiri S, Behnezhad S, Azad E. Back pain and depressive symptoms: A systematic review and meta-analysis. Int J Psychiatry Med 2020:91217420913001. [PMID: 32220220 DOI: 10.1177/0091217420913001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Low back pain is a common disorder that has many consequences. This study is an attempt to meta-analyze the risk of depression symptoms in back pain. METHOD Four databases were selected for review, and this search was conducted using key words. Eleven eligible articles were selected for review and meta-analysis was conducted. Subgroup analyses were continued with study design and the method of measuring depression. Also, the heterogeneity and publication bias were examined. RESULTS Eleven cohort and cross-sectional articles are used in the meta-analysis between back pain and depressive symptoms. The odds ratio 2.07 was calculated for this relationship. In prospective-cohort studies, 1.71 (95% confidence interval = 1.24-2.36) results indicated that back pain is a risk factor for depression symptoms and in cross-sectional studies, pooled odds ratio (2.33; 95% confidence interval = 1.29-4.21) showed that back pain is associated with depression symptoms. Some degree of publication bias was not found in the study. CONCLUSIONS Back pain is an effective factor in increasing the likelihood of depression. Adoption of effective prevention and treatment approaches can play an important role in reducing the psychological consequences in these individuals.
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Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Esfandiar Azad
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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13
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Abstract
Painful foot disorders are highly prevalent among older adults causing a significant impact on mobility, function, and risk of falls. Despite its significance, foot pain is often interpreted as a normal part of aging and relatively ignored by health care providers as well as by the older people themselves. Accurate diagnosis of the cause of foot pain is possible for most cases via clinical evaluation without a costly workup. Clinicians should consider, not only musculoskeletal pathologies but also vascular and neurological disorders in older patients with foot pain. Fortunately, most patients improve with physiatric, nonoperative interventions involving biomechanical analysis, function-oriented rehabilitation programs and therapeutic exercise, the use of proper footwear and orthoses, and selected percutaneous interventions, as indicated. In this review, we discuss the physiologic changes of the aging foot relevant to foot pain, the impact of painful foot disorders on function and other key outcomes, and principles of diagnosis and intervention. We also briefly describe painful foot disorders of the older people commonly encountered in a physiatric practice.
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14
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Arnold JB, Halstead J, Grainger AJ, Keenan AM, Hill CL, Redmond AC. Foot and Leg Muscle Weakness in People With Midfoot Osteoarthritis. Arthritis Care Res (Hoboken) 2020; 73:772-780. [PMID: 32170831 DOI: 10.1002/acr.24182] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/03/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare foot and leg muscle strength in people with symptomatic midfoot osteoarthritis (OA) with asymptomatic controls, and to determine the association between muscle strength, foot pain, and disability. METHODS Participants with symptomatic midfoot OA and asymptomatic controls were recruited for this cross-sectional study from general practices and community health clinics. The maximum isometric muscle strength of the ankle plantarflexors, dorsiflexors, invertors and evertors, and the hallux and lesser toe plantarflexors was measured using hand-held dynamometry. Self-reported foot pain and foot-related disability were assessed with the Manchester Foot Pain and Disability Index. Differences in muscle strength were compared between groups. Multivariable regression was used to determine the association between muscle strength, foot pain, and disability after adjusting for covariates. RESULTS People with midfoot OA (n = 52) exhibited strength deficits in all muscle groups, ranging from 19% (dorsiflexors) to 30% (invertors) relative to the control group (n = 36), with effect sizes of 0.6-1.1 (P < 0.001). In those with midfoot OA, ankle invertor muscle strength was negatively and independently associated with foot pain (β = -0.026 [95% confidence interval (95% CI) -0.051, -0.001]; P = 0.045). Invertor muscle strength was negatively associated with foot-related disability, although not after adjustment for depressive symptoms (β = -0.023 [95% CI -0.063, 0.017]; P = 0.250). CONCLUSION People with symptomatic midfoot OA demonstrate weakness in the foot and leg muscles compared to asymptomatic controls. Preliminary indications from this study suggest that strengthening of the foot and leg muscles may offer potential to reduce pain and improve function in people with midfoot OA.
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Affiliation(s)
- John B Arnold
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK, University of South Australia, Adelaide, South Australia
| | - Jill Halstead
- University of Leeds, NIHR Leeds Biomedical Research Centre, and Leeds Community Healthcare NHS Trust, Leeds, UK
| | - Andrew J Grainger
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Anne-Maree Keenan
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Catherine L Hill
- The Queen Elizabeth Hospital and University of Adelaide, Adelaide, South Australia
| | - Anthony C Redmond
- University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK
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15
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Fujii K. Effect of foot care interventions for older adults using day care services. Nurs Open 2019; 6:1372-1380. [PMID: 31660164 PMCID: PMC6805289 DOI: 10.1002/nop2.333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/05/2019] [Accepted: 06/14/2019] [Indexed: 01/02/2023] Open
Abstract
AIM This study explored the prevalence of foot problems among older adults and the effectiveness of foot care interventions for improving toe-gap force and foot flexibility. Foot problems are very common among people aged 65 years and older. However, the effects of foot care interventions on components underlying these issues (i.e., toe-gap force and foot flexibility) are unclear. DESIGN This was a quasi-experimental study. METHODS Eighteen older adults were divided into three groups: medical foot care intervention, combined intervention and control group. The combined intervention group received medical foot care, foot hygiene and five-toed socks. Toe-gap force and foot flexibility were measured. RESULTS The most common foot problems were hallux valgus, toe deformities, nail discoloration and thickness and dryness. Significant differences in right foot toe-gap force were observed between the combined intervention and control groups. There were no significant differences in foot flexibility between groups.
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Affiliation(s)
- Kashiko Fujii
- Department of Nursing, Graduate School of MedicineNagoya UniversityNagoyaJapan
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16
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Laslett LL, Menz HB, Otahal P, Pan F, Cicuttini FM, Jones G. Factors associated with prevalent and incident foot pain: data from the Tasmanian Older Adult Cohort Study. Maturitas 2018; 118:38-43. [PMID: 30415753 DOI: 10.1016/j.maturitas.2018.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/23/2018] [Accepted: 10/15/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To describe factors associated with prevalent and incident foot pain in a population-based cohort of older adults (n = 1092). STUDY DESIGN Longitudinal observational study. MAIN OUTCOME MEASURES Prevalent foot pain, incident foot pain after 5 years. METHODS Potential correlates included demographic factors, anthropometry, leg strength, metabolic factors, steps per day (using pedometer), pain at 6 other sites, and psychological wellbeing. Data were analysed using log binomial models. RESULTS Participants were aged 50-80 years (mean 63 years), 49% male, mean body mass index (BMI) 27.8 ± 4.7 at baseline. The prevalence of foot pain at baseline was 38% and the incidence of new pain over 5 years was 20%. BMI, pain at other sites (neck, hands, knees, pain at three or more sites), and poorer psychological wellbeing were independently associated with baseline foot pain. Baseline BMI and pain in the neck, hands, and knees were independently associated with incident foot pain; but change in weight or BMI, total number of painful joints and psychological wellbeing were not. Self-reported diabetes and cigarette smoking were not associated with prevalent or incident foot pain. CONCLUSIONS This study demonstrates that greater body weight and joint pain at multiple sites were consistently associated with prevalent foot pain and predict incident foot pain. Addressing excess body mass and taking a global approach to the treatment of pain may reduce the prevalence and incidence of foot pain in older adults.
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Affiliation(s)
- L L Laslett
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - H B Menz
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.
| | - P Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - F Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - F M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
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17
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Drake C, Mallows A, Littlewood C. Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross-sectional and prognostic associations. Musculoskeletal Care 2018; 16:329-338. [PMID: 29766646 DOI: 10.1002/msc.1246] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/23/2018] [Accepted: 03/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Plantar heel pain (PHP) is often disabling, and persistent symptoms are common. Psychosocial variables are known to affect pain and disability but the association of these factors with PHP has yet to be established. The purpose of the present systematic review was to determine if psychosocial variables are associated with the presence, severity and prognosis of PHP. METHODS A systematic review of the literature and qualitative synthesis was carried out. Electronic searches of MEDLINE, CINAHL, SPORTDiscus, PsycINFO and EMBASE were undertaken from the inception of the respective databases up to November 2017. Any study design incorporating measurements of psychosocial variables with participants with plantar heel pain were included. The quality of included articles was appraised using the Newcastle Ottawa Scale. RESULTS Five articles from four studies were included in the review, with a total of 422 participants. Moderate-level evidence suggested a clinically unimportant association with the incidence of PHP and depression, anxiety and stress, and limited evidence suggested a clinically unimportant association with job dissatisfaction. Moderate-level evidence suggested that there may also be an association between depression, anxiety, stress and catastrophization and PHP pain, and between depression, anxiety, stress, catastrophization and kinesiophobia and PHP function. We also found moderate-level evidence that a psychological disorder may be associated with a poorer outcome to shockwave therapy. CONCLUSION In light of this review, the association of psychosocial variables and plantar heel pain cannot be ruled out. Given recommendations to adopt an individualized and stratified approach to other musculoskeletal conditions, clinicians should remain vigilant to their presence.
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Affiliation(s)
- Chris Drake
- Physiotherapy Department, Mid-Yorkshire Hospitals NHS Trust, UK
| | - Adrian Mallows
- School of Health & Human Sciences, University of Essex, UK
| | - Chris Littlewood
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit, David Weatherall Building, Keele University, Staffordshire, ST5 5BG
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18
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Walsh TP, Gill TK, Evans AM, Yaxley A, Chisholm JA, Kow L, Arnold JB, Shanahan EM. Changes in foot pain, structure and function following bariatric surgery. J Foot Ankle Res 2018; 11:35. [PMID: 29988337 PMCID: PMC6022514 DOI: 10.1186/s13047-018-0277-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/14/2018] [Indexed: 12/25/2022] Open
Abstract
Background Bariatric surgery candidates have a high prevalence of foot pain, depression and elevated plantar pressures. There is, however, limited research into how these factors interact pre- and post-surgery. The aims of this study were therefore to investigate the mechanical and non-mechanical factors associated with foot pain severity before, and the change after, surgery. Methods Bariatric surgery candidates underwent baseline and six-month follow-up measures. Foot pain was measured with the Manchester-Oxford Foot Questionnaire. Mechanical measures included body mass index (BMI), dynamic plantar pressures, radiographic foot posture, and hindfoot range of motion. Depressive symptoms, the non-mechanical measure, were assessed by questionnaire. Multivariable linear regression was used to determine which variables were associated with foot pain at baseline and at follow-up. Multilevel repeated models assessed the associations between foot pain and plantar pressure, adjusting for the interaction between group and follow-up time. Results Forty-five participants (84% female), with mean (SD) age of 45.7 (9.4) years were recruited. Twenty-nine participants had bariatric surgery and 16 participants remained on the waiting list (controls). Following bariatric surgery, foot pain reduced significantly by - 35.7 points (95% CI -42.2 to - 28.8), while depressive symptoms and whole foot peak pressures had a significant mean change of - 5.9 points (95% CI -10.3 to - 1.5) and - 36 kPa (95% CI -50 to - 22), respectively. In multivariable analysis, depressive symptoms were associated with foot pain at baseline β = 0.7 (95% CI 0.2 to 1.2) after controlling for age, gender, BMI, foot posture and plantar pressure. Depressive symptoms were also associated with foot pain at follow-up in those undergoing bariatric surgery, β = 1.2 (95% CI 0.8 to 1.7). Foot posture and hindfoot range of motion did not change following surgery and a change in plantar pressures was not associated with a change in foot pain. Conclusions Foot pain severity in bariatric surgery candidates was associated with depressive symptoms at baseline. Reduced foot pain following bariatric surgery was associated with an improvement in depressive symptoms, without a significant change in foot posture or foot function. Foot pain severity in bariatric candidates may be mediated by non-mechanical or non-local factors before and following surgery.
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Affiliation(s)
- Tom P Walsh
- 1College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042 Australia.,2Department of Orthopaedics and Trauma, The Queen Elizabeth Hospital, Woodville South, South Australia 5011 Australia
| | - Tiffany K Gill
- 3Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Angela M Evans
- 4Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086 Australia
| | - Alison Yaxley
- 5Nutrition & Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia 5042 Australia
| | - Jacob A Chisholm
- 6Department of Gastrointestinal Surgery, Flinders Medical Centre, Bedford Park, South Australia 5042 Australia
| | - Lilian Kow
- 6Department of Gastrointestinal Surgery, Flinders Medical Centre, Bedford Park, South Australia 5042 Australia
| | - John B Arnold
- 7Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia 5000 Australia
| | - E Michael Shanahan
- 1College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042 Australia.,Department of Rheumatology, Southern Adelaide Local Health Network, Bedford Park, South Australia 5042 Australia
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19
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Nakagawa R, Yamaguchi S, Kimura S, Sadamasu A, Yamamoto Y, Sato Y, Akagi R, Sasho T, Ohtori S. Association of Anxiety and Depression With Pain and Quality of Life in Patients With Chronic Foot and Ankle Diseases. Foot Ankle Int 2017; 38:1192-1198. [PMID: 28814108 DOI: 10.1177/1071100717723133] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The purposes of this study were to clarify the incidence of anxiety and depression among patients with chronic foot and ankle diseases and to examine the independent association of anxiety and depression with pain and quality of life. METHODS Patients who visited the foot and ankle clinic from April 2015 to November 2016 were recruited. Anxiety and depression in patients were assessed using the Hospital Anxiety and Depression Scale. Pain and quality of life were evaluated using the visual analog scale (VAS) and Self-Administered Foot Evaluation Questionnaire (SAFE-Q), respectively. Furthermore, patient characteristics, including age, sex, body mass index, pain in other body areas, social support, employment, and household income, were surveyed. A multiple regression analysis was performed to examine the independent association of anxiety and depression with pain and quality of life. A total of 250 patients were included in the analysis. RESULTS The prevalence of anxiety and depression was 30% and 27%, respectively. The VAS and all SAFE-Q subscale scores were significantly worse in patients with anxiety or depression than in patients without the same (median VAS 63 vs 49 for anxiety, P = .005; 68 vs 47 for depression, P < .001). Furthermore, the multiple regression analyses showed that the presence of anxiety ( P = .02) and depression ( P < .001) was independently associated with increased pain, and it led to low scores on all SAFE-Q subscales ( P < .001 for all subscales). CONCLUSION About 30% of patients with chronic foot and ankle disease had anxiety or depression. The presence of these psychological symptoms was independently associated with worse pain and impaired quality of life after controlling for patient characteristics. Clinicians need to recognize the possibility of concurrent anxiety and depression to provide a more holistic treatment for chronic foot and ankle disease. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Ryosuke Nakagawa
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Satoshi Yamaguchi
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.,2 Collage of Liberal Arts and Sciences, Chiba University, Chiba, Japan
| | - Seiji Kimura
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Aya Sadamasu
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Yohei Yamamoto
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Yasunori Sato
- 3 Chiba University Hospital Clinical Research Center, Chiba, Japan
| | - Ryuichiro Akagi
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Takahisa Sasho
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.,4 Center for Preventive Medical Sciences, Chiba University, Japan
| | - Seiji Ohtori
- 1 Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
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20
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Walsh TP, Arnold JB, Gill TK, Evans AM, Yaxley A, Hill CL, Shanahan EM. Foot pain severity is associated with the ratio of visceral to subcutaneous fat mass, fat-mass index and depression in women. Rheumatol Int 2017; 37:1175-1182. [PMID: 28516238 DOI: 10.1007/s00296-017-3743-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/12/2017] [Indexed: 12/31/2022]
Abstract
Body composition and poor mental health are risk factors for developing foot pain, but the role of different fat deposits and psychological features related to chronic pain are not well understood. The aim of this study was to investigate the association between body composition, psychological health and foot pain. Eighty-eight women participated in this study: 44 with chronic, disabling foot pain (mean age 55.3 SD 7.0 years, BMI 29.5 SD 6.7 kg/m2), and 44 age and BMI matched controls. Disabling foot pain was determined from the functional limitation domain of the Manchester Foot Pain and Disability Index. Body composition was measured using dual X-ray absorptiometry and psychological health (catastrophisation, central sensitisation and depression) was measured using three validated questionnaires. Between-group analyses found that foot pain was not significantly associated with body composition variables, but was significantly associated with all psychological health measures (P < 0.001-0.047). Within-group analyses found that the severity of foot pain was significantly correlated with body composition measures: fat mass (total, android, gynoid, and visceral), fat-mass ratios [visceral/subcutaneous (VAT/SAT), visceral/android], fat-mass index (FMI), and depression. In multivariable analysis, VAT/SAT (β 1.27, 95% CI 0.28-2.27), FMI (β 0.14, 95% CI 0.02-0.25) and depression (β 0.06, 95% CI 0.00-0.12) were independently associated with foot pain severity. Psychological health, not body composition, was associated with prevalent foot pain. For women with foot pain, VAT/SAT, FMI and depression were associated with severity. Further work is needed to determine if a reduction in fat mass reduces the severity of foot pain.
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Affiliation(s)
- Tom P Walsh
- School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia. .,Department of Orthopaedics and Trauma, The Queen Elizabeth Hospital, Woodville South, SA, 5011, Australia.
| | - John B Arnold
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Tiffany K Gill
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Angela M Evans
- Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Alison Yaxley
- Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia
| | - Catherine L Hill
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.,Department of Rheumatology, The Queen Elizabeth Hospital, Woodville South, SA, 5011, Australia
| | - E Michael Shanahan
- School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia.,Department of Rheumatology, Southern Adelaide Local Health Network, Adelaide, SA, 5041, Australia
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21
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Gill TK, Menz HB, Landorf KB, Arnold JB, Taylor AW, Hill CL. Identification of Clusters of Foot Pain Location in a Community Sample. Arthritis Care Res (Hoboken) 2017; 69:1903-1908. [PMID: 28229556 DOI: 10.1002/acr.23212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/24/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To identify foot pain clusters according to pain location in a community-based sample of the general population. METHODS This study analyzed data from the North West Adelaide Health Study. Data were obtained between 2004 and 2006, using computer-assisted telephone interviewing, clinical assessment, and self-completed questionnaire. The location of foot pain was assessed using a diagram during the clinical assessment. Hierarchical cluster analysis was undertaken to identify foot pain location clusters, which were then compared in relation to demographics, comorbidities, and podiatry services utilization. RESULTS There were 558 participants with foot pain (mean age 54.4 years, 57.5% female). Five clusters were identified: 1 with predominantly arch and ball pain (26.8%), 1 with rearfoot pain (20.9%), 1 with heel pain (13.3%), and 2 with predominantly forefoot, toe, and nail pain (28.3% and 10.7%). Each cluster was distinct in age, sex, and comorbidity profile. Of the two clusters with predominantly forefoot, toe, and nail pain, one of them had a higher proportion of men and those classified as obese, had diabetes mellitus, and used podiatry services (30%), while the other was comprised of a higher proportion of women who were overweight and reported less use of podiatry services (17.5%). CONCLUSION Five clusters of foot pain according to pain location were identified, all with distinct age, sex, and comorbidity profiles. These findings may assist in the identification of individuals at risk for developing foot pain and in the development of targeted preventive strategies and treatments.
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Affiliation(s)
- Tiffany K Gill
- University of Adelaide, Adelaide, South Australia, Australia
| | | | - Karl B Landorf
- La Trobe University, Bundoora, Victoria, Australia, and Melbourne Health, Parkville, Victoria, Australia
| | - John B Arnold
- University of South Australia, Adelaide, South Australia, Australia
| | - Anne W Taylor
- University of Adelaide, Adelaide, South Australia, Australia
| | - Catherine L Hill
- The Queen Elizabeth Hospital, Woodville, South Australia, Australia
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Cotchett M, Munteanu SE, Landorf KB. Depression, Anxiety, and Stress in People With and Without Plantar Heel Pain. Foot Ankle Int 2016; 37:816-21. [PMID: 27137796 DOI: 10.1177/1071100716646630] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Depression, anxiety, and stress are prevalent in patients with musculoskeletal pain, but the impact of these emotional states has not been evaluated in people with plantar heel pain. The aim of this study was to evaluate the association between depression, anxiety, and stress with plantar heel pain. METHODS Forty-five participants with plantar heel pain were matched by sex and age (±2 years) to 45 participants without plantar heel pain. Levels of depression, anxiety, and stress were measured using the Depression, Anxiety and Stress Scale (short version) in participants with and without plantar heel pain. Logistic regression was conducted to determine if levels of depression, anxiety, or stress were associated with having plantar heel pain. RESULTS Univariate analysis indicated that participants with plantar heel pain had greater levels of depression (mean difference = 4.4, 95% CI 2.3 to 6.5), anxiety (mean difference = 2.6, 95% CI 0.9 to 4.3), and stress (mean difference = 4.8, 95% CI 1.9 to 7.8). After adjusting for age, sex, BMI, and education, for every 1 unit increase in depression, anxiety, or stress (in the DASS subscales), the odds ratios for having plantar heel pain were increased by 1.3 (95% CI 1.1 to 1.6), 1.3 (95% CI 1.1 to 1.5), and 1.2 (95% CI 1.1 to 1.3), respectively. CONCLUSION Symptoms of depression, anxiety, and stress were independently associated with plantar heel pain. Larger prospective studies are necessary to evaluate the temporal association between these emotional states and plantar heel pain. LEVEL OF EVIDENCE Level III, cross sectional, observational.
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Affiliation(s)
- Matthew Cotchett
- Department of Community and Allied Health, La Trobe Rural Health School, College of Science Health and Engineering, La Trobe University, Bendigo, Victoria, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, College of Science Health and Engineering, La Trobe University, Bundoora, Melbourne, Victoria, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, College of Science Health and Engineering, La Trobe University, Bundoora, Melbourne, Victoria, Australia
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Gill TK, Menz HB, Landorf KB, Arnold JB, Taylor AW, Hill CL. Predictors of foot pain in the community: the North West Adelaide health study. J Foot Ankle Res 2016; 9:23. [PMID: 27418949 PMCID: PMC4944307 DOI: 10.1186/s13047-016-0150-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/30/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Foot pain has been shown to be prevalent across all age groups. The presence of foot pain may reduce mobility and impact on the ability to undertake activities of daily living. The aim of this study was to determine factors that are predictive of foot pain in a community based sample of the general population. METHODS This study analysed data from the North West Adelaide Health Study, a cohort study located in the northwestern suburbs of Adelaide, South Australia. Data were obtained between 2004-2006 and 2008-2010, using a self-completed questionnaire, computer assisted telephone interviewing, and a clinical assessment. The sensitivity, specificity and positive predictive values of variables were determined and generalised linear models ascertained the variables associated with the highest relative risk of self-reporting foot pain in 2008-2010 based on the data obtained in 2004-2006. RESULTS The prevalence of foot pain in 2004-2006 was 14.9 % (95 % CI 13.6-16.4) and in 2008-2010, 29.9 % (95 % CI 27.5-32.5). Variables with the highest sensitivity were: female sex, ever having back pain, self-reported arthritis, body mass index (BMI) classified as obese and having foot pain in 2004-2006, while most variables demonstrated high specificity. Those with the highest risk of reporting foot pain in 2008-2010 were those with depressive symptoms, self-reported arthritis, high BMI, self-reported upper limb pain and foot pain (in general or in specific regions of the foot) in 2004-2006. CONCLUSION Foot pain is common in the general population and those with the greatest risk of foot pain potentially represent a high level of chronicity and potential burden on the health system. Addressing the factors that predict foot pain, as well as the provision of targeted messages to highlight the importance of managing foot pain, may help reduce the impact on the population.
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Affiliation(s)
- Tiffany K. Gill
- />School of Medicine, Faculty of Health Sciences, The University of Adelaide, Level 7, SAHMRI, North Tce, Adelaide, SA 5000 Australia
| | - Hylton B. Menz
- />School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3083 Australia
| | - Karl B. Landorf
- />School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3083 Australia
- />Melbourne Health, Allied Health Department, 300 Grattan Street, Parkville, VIC 3050 Australia
| | - John B. Arnold
- />Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA 5000 Australia
| | - Anne W. Taylor
- />Population Research and Outcome Studies, Discipline of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Catherine L. Hill
- />Rheumatology Unit, The Queen Elizabeth Hospital, Woodville Rd, Woodville, SA 5011 Australia
- />School of Medicine, The University of Adelaide, Adelaide, SA 5005 Australia
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