Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus
López López Daniel1,*, Callejo González Lucía1, Elena Losa Iglesias Marta2, Luis Saleta Canosa Jesús1, Rodríguez Sanz David3, Calvo Lobo Cesar3, Becerro de Bengoa Vallejo Ricardo4
1 Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain 2 Faculty of Health Sciences, Universidad Rey Juan Carlos, Spain 3 Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain. 4 School of Nursing, Physiotherapy and Podiatry. Universidad Complutense de Madrid, Spain.
Hallux Valgus (HV) is a highly prevalent forefoot deformity in older people associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal (MTP) joint and it is believed to be associated with varying degrees of HV effect on the quality of life related to foot health.The aim of this study is to compare the impact of varying degrees of HV on foot health in a sample of older people. The sample consisted of 115 participants, mean age 76.7 ± 9.1, who attended an outpatient center where self-report data were recorded. The degree of HV deformity was determined in both feet using the Manchester Scale (MS) from stage 1 (mild) to 4 (very severe). Scores obtained on the Foot Health Status Questionnaire (FHSQ) were compared. This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The stage 4 of HV shown lower scores for the footwear domain (11.23 ± 15.6); general foot health (27.62 ± 19.1); foot pain (44.65 ± 24.5); foot function (53.04 ± 27.2); vigour (42.19 ± 16.8); social capacity (44.46 ± 28.1); and general health (41.15 ± 25.5) compared with stage 1 of HV (P<0.05) and there were no differences of physical activity (62.81 ± 24.6). Often, quality of life decreases in the elderly population based in large part on their foot health. There is a progressive reduction in health in general and foot health with increasing severity of hallux valgus deformity which appears to be associated with the presence of greater degree of HV, regardless of gender.
López López Daniel,Callejo González Lucía,Elena Losa Iglesias Marta, et al. Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus[J]. Aging and disease,
2016, 7(1): 45-52.
Type, severity and duration. Evaluation of foot pain in terms of type of pain, severity and duration.
Extreme pain in the feet and significant if acute in nature.
Free from pain, no discomfort
Evaluation of the feet in terms of impact on physical functions.
Severely limited for the performance of numerous physical activities due to their feet, such as walking, working and moving about.
Patients are able to carry out all physical activities desired, such as walking, working and climbing stairs.
General foot health
Self-perception of the feet (assessment of body image with respect to feet).
Perception of poor condition and status of the feet.
Perception of excellent condition and status of the feet.
Lifestyle relating to footwear and feet.
Great limitations to find suitable footwear.
No problem obtaining suitable footwear. No limitations with respect to footwear.
Table 1 Basic domains of foot health assessed by the Foot Health Status Questionnaire. Section 1 domains.
1.What level of foot pain have you had during the past week?
2.How often have you had foot pain?
3.How often did your feet ache?
4.How often did you get sharp pains in your feet?
5.Have your feet caused you to have difficulties in your work or activities?
6.Were you limited in the kind of work you could do because of your feet?
7.How much does your foot health limit you walking?
8.How much does your foot health limit you climbing stairs?
9.How would you rate your overall foot health?
10.It is hard to find shoes that do not hurt my feet.
11.I have difficulty in finding shoes that fit my feet.
12.I am limited in the number of shoes I can wear.
13.In general, what condition would you say your feet are in?
Table 2 13 questions of the Foot Health Status Questionnaire that assess 4 health domains of the feet: pain, function, general health and footwear.
Meaning of Lowest Score (0)
Meaning of Highest Score (100)
Evaluation of subject´s self-reportedhealth status.
Poor perception of helth status.
Very good general health status.
Evaluation of ability in terms of impact on physical function.
Severely limited in performing a broad raange of physical activities.
Can perform all desired physical activitues with no impairment or disability.
Self-perceptions of ability to socially interact.
Limited ability to interact without problems, socially isolated.
Good ability to interact socially and experience no isolation.
Lifestyle issues to perceived energyand activity participation.
Lacks energy to do things.
No problems with energy levels.
Table 3 Definitions of the Foot Health Questionnaire. Section 2 Domains.
14. In general, how would you rate your health?
15. The following questions ask about activities you might do during a typical day. Does your health now limit you in these activities?
a. Vigorous activities, such as running, lifting heavy objects, or (if you wanted to) your ability to participate in strenuous sports.
b. Moderate activities, such as cleaning the house, lifting a chair, playing golf or swimming.
c. Lifting or carrying bags of shopping.
d. Climbing a steep hill.
e. Climbing one flight of stairs.
f. Getting up from a sitting position.
g. Walking more than a kilometer.
h. Walking one hundred meters.
i. Showering or dressing yourself.
16. To what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors or social groups?
17. These questions are about how you feel during the past month. For each question, please give the one answer that comes closest. How much of the time during the past 4 weeks:
a. Did your feet get tired?
b. Did you have a lot of energy?
c. Did your feet feel worn out?
d. Did you feel full of life?
18. During the past 4 weeks, how much of the time has your emotional problems or physical health interfered with your social activities (like visiting with friends, relatives, etc.)?
19. How true or false is each of the following statements for you?
a. I seem to get sick a little easier than other people.
b. I am as healthy as anybody I know.
c. I expect my health to get worse.
d. My health is excellent
Table 4 Questions of the Foot Health Status Questionnaire that assess section 2 domains
Total Group Mean ± SD Range N= 115
Male Mean ± SD Range N= 43
Female Mean ± SD Range N= 72
P Value Male vs. Female
76.70 ± 9.1 (65-96)
75.58 ± 9.18 (65 -96)
77.38 ± 9.02 (65-94)
71.38 ± 12.1 (48-105)
77.35 ± 10.17 (53-104)
67.82 ± 11.81 (48-105)
163.96 ± 7.24 (150-183)
169.16 ± 5.2 (156-183)
160.86 ± 6.48 (150-177)
26.96 ± 6.62 (17.93 - 82)
28.18 ± 9.01 (18.78 - 82)
26.93 ± 4.56 (17.93 - 38.57)
Level of education
0.80 ± 0.82 (0-3)
0.95 ± 0.9 (0-3)
0.71 ± 0.76 (0-3)
Table 5 Socio-demographic and clinical characteristics of the sample population.
HV 1 Mean (SD) Range N = 13
HV 2 Mean (SD) Range N = 44
HV 3 Mean (SD) Range N = 32
HV 4 Mean (SD) Range N = 26
87.76 ± 6.1 (75-94)
71.28 ± 23.3 (13-100)
52.59 ± 30.0 (0-100)
44.65 ± 24.5 (6-94)
85.31 ± 13.4 (50-100)
78.09 ± 20.7 (19-100)
58.69 ± 28.5 (6-100)
53.04 ± 27.2 (13-100)
57.54 ± 22.2 (17-83)
36.34 ± 25.9 (0-83)
31.22 ± 28.9 (17-83)
11.23 ± 15.6 (0-67)
General Foot Health
84.69 ± 13.8 (60-100)
60.34 ± 29.3 (0-100)
45.59 ± 29.2 (0-100)
27.62 ± 19.1 (0-60)
65.38 ± 15.1 (50-100)
55.45 ± 24.1 (10-90)
57.19 ± 22.6 (0-100)
41.15 ± 25.5 (10-90)
75.23 ± 17.9 (50-100)
66.21 ± 21.3 (17-100)
67.47 ± 22.5 (20-90)
62.81 ± 24.6 (6-100)
73.38 ± 12.4 (50-100)
68.66 ± 28.3 (0-100)
55.72 ± 30.6 (0-100)
44.46 ± 28.1 (0-100)
55.38 ± 12.1 (50-100)
49.91 ± 15.4 (19-88)
46.25 ± 15.3 (13-81)
42.19 ± 16.8 (13-88)
Table 6 Comparisons of FHSQ scores with varying degrees of HV.
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