OAR@UM Community:

Evaluation of footwear worn at the time of fall in a Maltese long-term elderly facility

2024-12-17T09:06:39Z

Title: Evaluation of footwear worn at the time of fall in a Maltese long-term elderly facility Abstract: Aim: The aim of this study was to investigate the relationship between footwear design and risk of falling in a sample of older adults living in a long-term care facility. Research Design and Method: A quantitative, post-positive study was conducted in Malta’s largest long-term care residence. This study consisted of 3 phases. Phase 1 evaluated footwear characteristics and fit worn by residents to provide an overview of the typical footwear worn in this population. A nonexperimental approach was utilised with 135 residents selected through random sampling. The most commonly worn footwear was analysed using the Footwear Assessment Form, and its fit was assessed by measuring the footwear’s length and width and comparing these to the participants’ foot measurements. Phase 2 focused on evaluating the footwear worn at the time of falls. Employing a prospective design, this phase recorded any falls sustained over a period of 9 months, resulting in 76 eligible falls. Details about each fall and the footwear worn at the time were documented using the same methodology as in Phase 1. Phase 3 aimed to evaluate the functional stability and balance of participants when wearing the footwear worn at the time of fall versus ‘adequate’ footwear as recommended by the literature. An experimental design was used, involving 41 eligible participants from Phase 2. Participants completed two clinical balance and stability tests, the Functional Reach Test (FRT) and Time Up and Go (TUG), with both sets of footwear. The goal was to determine if adequate footwear provided better balance and stability than the footwear worn at the time of fall. Results: Participants who sustained a fall were more likely to wear footwear with sub-optimal features such as heel height of more than 2.5cm and footwear having no fixation. Sandals were the most common type of footwear worn. Only 9.2% of participants who fell were wearing well-fitted footwear in terms of length and width. Participants performed significantly better in the TUG test when wearing ‘adequate’ footwear compared to the footwear worn at the time of fall. However, there was no significant difference in the FRT between the two types of footwear. Furthermore, none of the footwear characteristics were found to significantly impact the FRT and TUG test results. Conclusion: This study demonstrates that inadequate footwear increases the risk of falling among a geriatric population living in a long-term care facility. Footwear worn at the time of fall negatively affected the participants' balance during walking, as evidenced by the TUG test. However, participants’ stability over a fixed base of support, measured by the FRT test, was not affected when wearing ‘adequate’ footwear highlighting the importance of appropriate footwear for walking stability. None of the footwear characteristics significantly impacted changes in stability and balance during clinical balance tests. A plausible explanation for this, is that these tests are capable of detecting major changes between different types of footwear (e.g. adequate vs inadequate) but may not be capable of identifying subtle modifications in footwear design. Therefore, more research is required to better understand the impact of footwear on fall risk. Description: M.Sc.(Melit.)

An evaluation of podiatric intervention with regards to foot self-care practices amongst the independent elderly living in the community

2024-12-17T09:06:09Z

Title: An evaluation of podiatric intervention with regards to foot self-care practices amongst the independent elderly living in the community Abstract: Aim: The aim of this study was to identify any significant differences in foot health status and self-care practices after regular visits to the Podiatry Clinic in the elderly population who live independently. Methods: A multi-centre, non-experimental prospective study was conducted on 109 individuals aged 65 years and above and who made use of Podiatry Clinics within the local Health Centres at Primary Health sector. Patients were recruited by means of an intermediary from different health centres during their routinely scheduled appointment. Two questionnaires were used to screen for foot-related self-care practices and foot-related quality of life namely the Nottingham Assessment for Functional Footcare Revised (NAFF) and Foot Health Status Questionnaire (FHSQ) respectively. Participants were interviewed 4 times over a period of one year at 4-month intervals and asked to answer again the previously mentioned questionnaires. Changes in responses were recorded for analysis. For statistical analysis, data was categorized by gender, age and educational level groups Results: The normality of the data was tested using the Shapiro-Wilk test and non-parametric tests were utilized. The Kruskal-Wallis Test exhibited a significant improvement in mean NAFF scores and a significant decrease in FHSQ scores from T0 to T3. Additionally, the Spearman correlation found that no relationship between mean NAFF and total FHSQ scores. Mean NAFF scores demonstrated that the 85< age group was the only age group to have a non-significant improvement. Both gender groups exhibited significant improvements. Those with post-secondary education are the only educational level group to not have improved significantly. Mean FHSQ scores did not differ significantly between age, gender and educational level groups. Out of the domains of the FHSQ, the only significant difference noted was in Physical Activity domains in all age gender and educational level groups (except for primary and secondary level of education). A significant difference was noted in the Vigor domain in the 75-85 age group. Conclusion: The findings of this study suggest that in the independent living older adult population, visits to the podiatry clinic have been shown to improve foot-related self-care practices over a period of 1 year. This was observed by the higher frequency of positive footcare behaviours by the NAFF. On the other hand, the results show that foot-related quality of life did not improve in the sample population. Physical activity was the major aspect that the sample population regressed in. The findings of this study imply that improvement in the domains of the FHSQ are not dependent only on visits to the podiatrists and ability to self-care. There could be other intrinsic and extrinsic factors other than podiatric interventions that could influence the quality of life. It is important that podiatrists remain the first point of care when it comes to foot health however adopting a multidisciplinary approach is imperative so as to care for patients holistically. Description: M.Sc.(Melit.)

Investigation of foot conditions in a national sport school

2024-11-18T09:17:30Z

Title: Investigation of foot conditions in a national sport school Abstract: Background: The burgeoning interest in the musculoskeletal health of young athletes, particularly concerning foot conditions, has led to a focused investigation within the National Sport School in Malta. This study is propelled by the increasing awareness of how early sports specialisation and intensive training may predispose young athletes to a range of foot conditions, potentially impacting their performance and overall well-being. Despite the acknowledged risks, there exists a notable gap in the local literature regarding the incidence and factors associated with these conditions in young athletic populations. Aim: This research aims to investigate the foot conditions present in a National Sport School and investigate the correlating parameters, such as age, sex, BMI and type of sport. Research Design and Method: Adopting a cross-sectional design, this study recruited 50 athletes (100 feet analysed) ranging from the ages of 11 to 16 years old from Malta's National Sport School. The Foot Posture Index (FPI), goniometer and Manchester scale were used to assess for foot conditions. Demographic data such as age, sex, BMI and type of sport were also recorded. Results: The study has established that the most prevalent foot conditions among athletes at Malta’s National Sport School are a pronated foot type and Hallux Abducto Valgus, found in 52% and 38% of participants, respectively. Furthermore, it revealed that 68% of males exhibited a pronated foot posture (FPI score > 6) compared to 36% of females, indicating a notable sex-related variation in foot posture (P=0.024). Additionally, Hallux Valgus was significantly more common in females (P<0.001), especially those engaged in sports such as gymnastics, triathlon and basketball (P<0.001). Conclusion: These insights are critical, suggesting the necessity for foot assessments and potential interventions among young athletes. The findings advocate for the integration of routine foot health screenings, emphasising early detection and management of foot conditions to mitigate their impact on young athletes' performance, development and quality of life. Description: B.Sc. (Hons)(Melit.)

An evaluation of the podiatrists’ communication skills with patients having limited health literacy

2024-11-18T08:41:11Z

Title: An evaluation of the podiatrists’ communication skills with patients having limited health literacy Abstract: Background Patients with limited health literacy are known to have difficulty understanding complex diseases, drug prescription instructions and engaging in treatment protocols. By incorporating the right communication skills, such as using simpler vocabulary, drawing explanatory diagrams and speaking slowly, podiatrists have the potential to help patients adhere to the prescribed treatment plan and improve heath outcomes. Aim The aim of this study was to evaluate the podiatrists’ communication skills with patients having limited health literacy. Method Seventy-three podiatrists from private and government sectors were invited to partake in the study, of whom 57 agreed to participate. The podiatrists answered a questionnaire called “Communication with low health literate patients” which was extracted from a research paper entitled "Challenges and Solutions in communication with patients with low health literacy: Perspectives of healthcare providers" by Murugesu et al., (2022). The questions in the questionnaire utilised in this study were mainly quantitative in nature, with a few qualitative questions. The participants were prompted to answer the questionnaire accordingly, on-site at the participants' workplace during their preferred time. The questionnaire was administered only once and took approximately 20-30 minutes to complete. Results The results revealed that a number of podiatrists did not exhibit adequate communication skills when interacting with patients having low health literacy. Furthermore, podiatrists encountered a plethora of patients with limited health literacy on a weekly basis, thereby presenting diverse challenges for podiatrists. Additionally, this study has also highlighted the podiatrist’s disuse of methods such as the teach-back method and tools such as visual aids that are needed to improve podiatrists' communication skills with patients having limited health literacy. Furthermore, podiatrists requested the need for such tools to improve their communication with limited health literate patients. Another crucial finding from this study was that podiatrists often cited time constraints as the primary reason for not implementing appropriate communication skills when communicating with limited health literacy patients. Conclusion This study concluded that although a significant number of limited health literacy patients visit the podiatry clinic daily, a percentage of podiatrists do not always adapt their communication skills to such circumstances, and do not frequently use materials such as visual aids to address the patient's lack of health literacy. Moreover, this highlights the need for the introduction of a health literacy training program to educate podiatrists on the necessary communication methods when dealing with such patients. Description: B.Sc. (Hons)(Melit.)