Percepção de enfermeiros sobre as 3S ­ Smart Safe Shoes: meias para prevenção de quedas / Nurses perception of the 3S - Smart Safe Shoes: socks to prevent falls / Percepción de enfermeros sobre los 3S - Smart Safe Shoes: calcetines para prevenir caídas

Objetivo: analisar a percepção dos enfermeiros sobre o uso das 3S - Smart Safe Shoes na sua fase de protótipo e os resultados da avaliação do seu uso por idosos internados. Método: estudo de carater exploratório, descritivo e misto, entre novembro de 2021 e março de 2022. Incluiu idosos internados com capacidade de deambulação e identificados com risco de queda; e enfermeiros especialistas. Os dados quantitativos foram analisados por estatística descritiva e os qualitativos a partir de análise temática. Resultados: participaram 28 idosos e sete enfermeiros, ambos concordaram que as 3S ­ Smart Safe Shoes são confortáveis. Os enfermeiros consideram que as meias se adaptaram perfeitamente às diferentes regiões anatômicas do pé e que apresentam propriedades antiderrapantes nos pisos testados; e na maioria das situações, permitem uma boa mobilidade dos dedos, em todos os movimentos tibiotársicos (86%). Todos os enfermeiros destacam a facilidade de calçar as meias e consideram que estas devem ser incluídas como um elemento em estratégia de prevenção de quedas. Conclusão: as 3S - Smart Safe Shoes reunem as características necessárias para garantir uma marcha segura em idosos internados e o seu uso deve ser considerado em outros contextos.

Objective: to analyse nurse's perception about 3S - Smart Safe Shoes use in their prototype phase and describe their evaluation about this use by hospitalized elderly patients. Method: exploratory, descriptive and mixed study, between November 2021 and March 2022. It included hospitalized elderly people who were able to walk and identified as being at risk of falling; and specialist nurses. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. Results: 28 seniors and seven nurses participated, both agreed that the 3S ­ Smart Safe Shoes are comfortable. The nurses consider that the socks adapt perfectly to the different anatomical regions of the foot and that they have non-slip properties on the tested floors; and in most situations, they allow good mobility of the fingers, in all tibiotarsal movements (86%). All nurses highlight the ease of putting on stockings and consider that these should be included as an element in a fall prevention strategy. Conclusion: 3S - Smart Safe Shoes have the necessary characteristics to guarantee a safe gait in hospitalized elderly patients and their use should be considered in other contexts.

The Influence of the Shoe over the Medial Foot Arch and the Lower Limbs Kinematics in Toddlers / A influência de calçados no arco longitudinal medial do pé e na cinemática dos membros inferiores de crianças no início da fase de aquisição de marcha

Abstract Objective To evaluate the biomechanical behavior of the medial longitudinal arch (MLA) of the foot and the kinematic parameters of the lower limbs with biomimetic footwear (BF) and non-biomimetic (NB1, NB2, NB3 and NB4) footwear in children at the beginning of the gait acquisition phase. Methods Four toddlers were evaluated at the beginning of the gait acquisition phase under the following conditions: walking barefoot, ambulation with BF and NB1, NB2, NB3 and NB4 footwear in hard floor. BF is described as biomimetic because of its property of emulating natural and irregular floors through a dynamic internal insole. The MLA and kinematics of the hip, knee, and ankle during gait were evaluated by three-dimensional motion analysis system. The similarity between the kinematic curves of barefoot and footwear conditions was analyzed by root mean square error (RMSE). Results The use of BF presented the highest magnitude of MLA and the greatest difference in relation to barefoot condition (higher RMSE). The BF showed less difference in the kinematics of the knee and ankle joints during gait when compared to barefoot condition (lower RMSE). NB2 footwear presented hip kinematics more similar to barefoot condition (lower RMSE). Conclusion Biomimetics footwear and NB2 shoes (both with wider forefoot region) generated smaller differences in lower limbs compared to barefoot. In addition, the MLA was higher in the BF, probably because different design from other shoes.

Resumo Objetivo Avaliar o comportamento do arco longitudinal medial do pé (ALM) e os parâmetros cinemáticos dos membros inferiores durante a deambulação com calçados biomiméticos (CBs) e não biomiméticos (NB1, NB2, NB3 e NB4) em crianças no início da fase de aquisição da marcha. Métodos Foram avaliadas quatro crianças no início da fase de aquisição da marcha nas seguintes condições: andar descalço, andar com CBs e calçados NB1, NB2, NB3 e NB4 em solo plano. O calçado biomimético é descrito como biomimético por emular pisos naturais e irregulares por meio de uma palmilha interna dinâmica. O ALM e a cinemática do quadril, joelho e tornozelo durante a marcha foram avaliados por meio de sistema de análise do movimento tridimensional. A similaridade entre as curvas cinemáticas das condições descalça e com calçado foi analisada por meio do cálculo de root mean square error (RMSE). Resultados O CB foi o que apresentou maior magnitude do ALM e maior diferença do ALM em relação à condição descalça (maior RMSE). O CB apresentou ainda menor diferença na cinemática das articulações do joelho e tornozelo durante a marcha quando comparado à condição descalça (menor RMSE). O calçado NB2 apresentou a cinemática do quadril mais semelhante à condição descalça (menor RMSE). Conclusão Os calçados CB e NB2 que apresentam a região do antepé mais larga geraram menores diferenças na cinemática dos membros inferiores. Além disso, o ALM foi maior no CB provavelmente devido a seu design ser diferente daquele dos demais calçados.

Influence of unstable shoes on women with lumbopelvic postpartum pain: randomized clinical trial

ABSTRACT BACKGROUND: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. OBJECTIVES: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. DESIGN AND SETTING: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. METHODS: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. RESULTS: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. CONCLUSIONS: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks.

Footwear designed to enhance energy return improves running economy compared to a minimalist footwear: does it matter for running performance?

The present study compared the effects of a footwear designed to enhance energy return (thermoplastic polyurethane, TPU) vs minimalist shoes on running economy (RE) and endurance performance. In this counterbalanced and crossover design study, 11 recreational male runners performed two submaximal constant-speed running tests and two 3-km time-trials with the two shoe models. Oxygen uptake was measured during submaximal constant-speed running tests in order to determine the RE at 12 km/h and oxygen cost of running (CTO2) at individual average speed sustained during the 3-km running time-trials wearing either of the two shoes. Our results revealed that RE was improved (2.4%) with TPU shoes compared with minimalist shoes (P=0.01). However, there was no significant difference for CTO2 (P=0.61) and running performance (P=0.52) comparing the TPU (710±60 s) and the minimalist (718±63 s) shoe models. These novel findings demonstrate that shoes with enhanced mechanical energy return (i.e. TPU) produced a lower energy cost of running at low (i.e., 12 km/h) but not at high speeds (i.e., average speed sustained during the 3-km running time-trial, ∼15 km/h), ultimately resulting in similar running performance compared to the minimalist shoe.

Autocuidado en profesional de enfermería con relación al uso del calzado. Hospital de Clínicas, San Lorenzo- Paraguay 2017 / Self-care in nursing professional with regard to the use of the footwear. Hospital de Clínicas, San Lorenzo-Paraguay 2007

El objetivo fue analizar si el profesional de enfermería aplicaba el autocuidado en el uso del calzado en horario laboral. Es un estudio observacional, analítico, de corte trasversal con enfoque cuantitativo. La población estuvo constituida por 1.037 profesionales de Enfermería del Hospital de Clínicas, institución de carácter público, situada en la ciudad de San Lorenzo, Paraguay. Se incluyeron 366 profesionales de Enfermería a través de un muestreo probabilístico, la selección de la muestra fue multietápica con muestreo aleatorio simple. Se aplicó estadística descriptiva y chi2 para determinar asociaciones. Los hallazgos más relevantes fueron que mayoritariamente eran del grupo etario de 24 a 48 años con una media de 35 años; soltero, con una antigüedad de 10 años, con más de un empleo y del servicio de urgencias. Solo el 11,7% refirió conocer el calzado anatómico, sin embargo, 50,2% lo utilizaba. Más del 60% no tenía en cuenta las características del calzado anatómico al momento de adquirirlo, entre otros aspectos relacionados al utilizarlo en horario laboral. En el grupo etario de 31 a 35 años se concentró la mayor cantidad de trastornos músculo-esqueléticos (40%). En conclusión, el profesional de enfermería utilizaba de forma deficitaria el calzado adecuado; además, se ha encontrado evidencia de asociación (chi2 0,05) entre el tipo de calzado utilizado y la cantidad de trastornos músculo-esqueléticos que presentaba cada individuo

The objective was to analyze if the nursing professional applied self-care in the use of footwear during working hours. It was an observational, analytical, cross-sectional study with a quantitative approach. The population was constituted by 1,037 nursing professionals from the Hospital de Clínicas, a public institution, located in the city of San Lorenzo, Paraguay. The sample included 366 nursing professionals and the sampling wasprobabilistic while the selection of the multistage sample with simple random sampling. Descriptive statistics and Chi2 were applied to determine associations. The most relevant findings were that they were mainly in the age group of 24 to 48 years with an average of 35 years, single, with a career of 10 years, more than one job and from the emergency service. Only 11.7% referred to know the anatomical footwear, however, 50.2% used it. More than 60% did not take into account characteristics of the anatomical footwear at the time of purchase, among other aspects related to using it during working hours. The greatest number (40%) of musculoskeletal disorders were concentrated in the age group from 31 to 35 years. In conclusion, the nursing professional uses the right footwear in a loss-making way. In addition, evidence was found of an association between the type of footwear used and the number of musculoskeletal disorders that each individual presents

Análise do equilíbrio postural estático e da intensidade das dores musculoesqueléticas após o uso de palmilhas proprioceptivas por militares do serviço ostensivo / Análisis del equilibrio postural estático y de la intensidad de los dolores musculoesqueléticas después del uso de plantillas propioceptivas por militares del servicio ostensivo / Analysis of static postural balance and of intensity of musculoskeletal pains after the use of proprioceptive insoles by ostensive service militaries

RESUMO Para a manutenção do equilíbrio, o organismo utiliza os sistemas visuais, vestibulares e proprioceptivos, que enviam informações para o sistema nervoso central acerca das condições do corpo com o objetivo de estabilizá-lo. Este estudo avaliou o efeito das palmilhas proprioceptivas sobre o equilíbrio postural estático e as dores musculoesqueléticas após dois meses de uso, por meio de uma pesquisa analítica longitudinal com 15 militares saudáveis do sexo masculino com média de idade de 34±7,5 anos. Eles foram submetidos à avaliação do equilíbrio por meio da plataforma Medicapteurs® e pelo protocolo CNT. Não houve diferença estatística para os desvios do corpo e velocidade do centro de pressão. A pressão plantar teve mudança estatisticamente significante para o pé esquerdo e o pé direito correspondendo a p=0,0001 e p=0,0007, respectivamente. Houve redução das médias de dores nos joelhos, pés e calcanhares e diminuição significativa da dor lombar, com p=0,0180. O equilíbrio estático não foi alterado significativamente com o uso das palmilhas proprioceptivas pelos militares, contudo elas proporcionaram melhor redistribuição das pressões plantares e parecem atenuar as dores musculoesqueléticas das extremidades inferiores. Por isso as palmilhas podem ser consideradas para esse grupo uma terapêutica de prevenção contra lesões relacionadas à sua atividade laboral.

RESUMEN Para mantener el equilibrio el cuerpo utiliza los sistemas visuales, vestibulares y propioceptivos, que envían información al sistema nervioso central sobre las condiciones del cuerpo para estabilizarlo. Este estudio evaluó el efecto de las plantillas propioceptivas sobre el equilibrio postural estático y los dolores musculoesqueléticas después de dos meses de uso, a través de una investigación analítica longitudinal con 15 soldados sanos con una edad media de 34±7.5 años. Ellos fueron sometidos a evaluación de equilibrio a través de la plataforma Medicapteurs® y por el protocolo CNT. No hubo diferencia estadística para las desviaciones del cuerpo y para la velocidad del centro de presión. La presión plantar tuvo un cambio estadísticamente significativo para el pie izquierdo y el pie derecho correspondiente a p=0.0001 y p=0.0007, respectivamente. Hubo una reducción en las promedio de los dolores en las rodillas, pies y talones y una disminución significativa en el dolor lumbar, con p=0.0180. El equilibrio estático no se modificó significativamente con el uso de plantillas propioceptivas por los militares, sin embargo, proporcionaron una mejor redistribución de las presiones plantares y parecen ablandar los dolores musculoesqueléticas en las extremidades inferiores. Por lo tanto las plantillas pueden considerarse para ese grupo como una terapia de prevención contra lesiones relacionadas con su actividad laboral.

ABSTRACT To maintain the balance, the body uses visual, vestibular and proprioceptive systems, which send information to the central nervous system about the body's conditions in order to stabilize it. This study evaluated the effect of proprioceptive insoles on static postural balance and musculoskeletal pains after two months of use, through a longitudinal analytical study with 15 healthy male soldiers with a mean age of 34±7.5 years. They were subjected to balance evaluation through the Medicapteurs® platform and by CNT protocol. There was no statistical difference for the deviations of the body and speed of the center of pressure. Plantar pressure had a statistically significant change for the left and the right feet, corresponding to p=0.0001 and p=0.0007, respectively. There was a reduction in the mean values of the pains in the knees, feet and heels and a significant decrease in lumbar spine pain, with p=0.0180. The static balance was not significantly altered with the use of proprioceptive insoles by the militaries; however, these insoles provided a better redistribution of plantar pressures and seem to attenuate the musculoskeletal pains of the lower extremities. Therefore, insoles can be considered as a prevention therapy against injuries for this group related to their work activity.

Biomechanic of ballroom dance: corporate adaptations with different footwear / Biomecânica da dança de salão: adaptações corporais com diferentes calçados

ABSTRACT The aim of this study was to compare the joint amplitude, spine angulation and displacement of the center of mass during the execution of gafieira samba with and without high heels at different speed. In addition, the reproducibility of the movement was tested. Fifteen experienced dancers performed a sequence of gafieira samba steps under the conditions: high heels (7.5cm) and flats at two speeds according to the beat of music (72 and 96bpm). Kinematic analysis was performed on the Vicon® system with 11 cameras (100 Hz). Twenty-one reflective markers were positioned over the participants' bodies to calculate the center of mass and joint angles of the lower limbs and spine. Reproducibility was determined by the intraclass correlation coefficient and the comparison between conditions was tested by a Two-way Analysis of Variance, with the factors footwear and speed. The results indicated to a moderate to very high reproducibility in all variables analyzed. No differences were found between lumbar curvature, thoracic and displacement of the center of mass. There was no interaction between types of footwear and step execution speed, but analyzing the main factors, there was a decrease in the left ankle plantiflexion angle with increasing speed. The ankle angles showed a significant decrease under the condition flats when compared to high heels. In conclusion, high heels do not alter lumbar curvature, displacement of the center of mass and knee and hip joint amplitude in the execution of gafieira samba.

RESUMO O objetivo deste estudo foi comparar a amplitude articular, angulação da coluna e deslocamento do centro de massa durante execução do samba de gafieira com e sem salto alto em diferentes velocidades. Adicionalmente, a reprodutibilidade do movimento foi testada. Quinze dançarinas experientes realizaram uma sequência de passos de samba de gafieira nas condições: salto alto (7,5 cm) e sapatilha em duas velocidades de execução de acordo com o compasso das músicas (72 e 96bpm). A análise cinemática foi realizada no sistema Vicon® com 11 câmeras (100 Hz). Vinte e um marcadores reflexivos foram posicionados sobre o corpo das participantes a fim de calcular o centro de massa e ângulos articulares dos membros inferiores e coluna. A reprodutibilidade foi determinada pelo coeficiente de correlação intraclasse e a comparação entre condições foi testada por uma análise de variância Two way, com os fatores calçados e velocidade. Os resultados indicaram para uma reprodutibildade de moderada a muito alta em todas as variavéis analisadas. Não foram encontradas diferenças entre as curvaturas da lombar, torácia e deslocamento do centro de massa. Não houve interação entre tipos de calçado e velocidade de execução dos passos, porém analisando os fatores principais, ocorreu uma diminuição do ângulo de plantiflexão do tornozelo esquerdo com o aumento da velocidade. Os ângulos de tornozelo apresentaram diminuição significativa em situação do uso de sapatilhas, quando comparados ao salto. Conclui-se que o salto alto não altera a curvatura da lombar, deslocamento de centro de massa e amplitude articular do joelho e quadril na execução do samba de gafieira.

Modificaciones morfológicas del pie luego de ocho semanas de entrenamiento de carrera a pie descalzo / Foot morphological adaptations developed after eight weeks of barefoot running training

La carrera descalza ha sido ampliamente estudiada últimamente, pero poco se sabe de cambios anatómicos que produce en el pie. El objetivo de este estudio fue determinar estos cambios producidos de forma aguda y a largo plazo en sujetos que entrenan a pie descalzo. 29 sujetos divididos en dos grupos: Barefoot (BFGr) (n=17) y Shod (SGr) (n=12), realizaron un protocolo de efecto agudo consistente en correr durante 20 min sobre treadmill a 3.1 m/s y un protocolo de entrenamiento de 8 semanas de carrera de resistencia con aumento progresivo de volumen. BFGr realizó todas las sesiones a pie descalzo. Al finalizar cada protocolo se midió Foot Length (FL), Forefoot Width (FW), Hindfoot Width (HW), Navicular Height (NH), Arch Index (AI) y Maximum Surface (MS). Se efectuó ANOVA 3x2 para comprobar los efectos que el tiempo y la condición de calzado produjo. La condición de calzado produjo efectos significativos sobre todas las variables (FL: p=0.000, η2p=0.997; FW: p=0.000, η2p=0,997; HW: p=0.000, η2p= 0,994; NH: p=0.000, η2p=0.953; AI: p=0.000, η2p=0.898; MS: p=0.000, η2p=0.983) y el factor tiempo sobre AI (p=0.012, η2p=0.152) y MS (p=0.000, η2p=0.259). Hubo interacción significativa Tiempo x Condición en FW (p=0.036, η2p= 0.116) y NH (p=0.019, η2p= 0.143). MS aumentó luego del protocolo de efecto agudo (p=0.000) y a largo plazo (p=0.001) en BFGr. El porcentaje de sujetos con pie normal aumentó en BFGr y con pie plano aumentó en SGr. El entrenamiento de carrera a pie descalzo produce efectos, principalmente luego de un período de adaptación de 8 semanas, tendientes a un aumento armónico en la superficie de apoyo plantar con tendencia a una disminución relativa del área del mediopié, lo cual se tradujo en una disminución de sujetos con arco plantar de tipología plana.

Barefoot running has been studied extensively recently, but little is known of the anatomical changes that take place in the foot. The objective of this study was to determine the acute and chronic changes that are produced in subjects who train barefoot. 29 subjects divided into two groups, Barefoot (BFGr) (n=17) and Shod (SGr) (n=12), followed an acute effect protocol which consisted in running during 20 min on a treadmill at 3.1 m/s, and an eight-week long chronic effect protocol covering eight weeks of resistance running with progressively increasing volume. BFGr did all the sessions barefoot. At the end of each protocol Foot Length (FL), Forefoot Width (FW), Hindfoot Width (HW), Navicular Height (NH), Arch Index (AI), and Maximum Surface (MS) were measured. ANOVA 3x2 was run to verify the effects caused by time and the shod condition produced. Shod/ Unshod factor caused significant effects on all the variables (FL: p=0.000, η2p=0.997; FW: p=0.000, η2p=0,997; HW: p=0.000, η2p= 0,994; NH: p=0.000, η2p=0.953; AI: p=0.000, η2p=0.898; MS: p=0.000, η2p=0.983), and the time factor on AI (p=0.012, η2p=0.152) and MS (p=0.000, η2p=0.259). There was a significant Time x Condition interaction in FW (p=0.036, η2p=0.116) and NH (p=0.019, η2p= 0.143). MS increased after the acute (p=0.000) and the chronic (p=0.001) protocols in the BFGr. The percentage of subjects with normal feet increased in the BFGr and that with flat feet increased in SGr. Barefoot running training causes effects, mainly after an adaptation period of eight weeks, tending to a harmonic surface increase on the support plantar area, with a relative decrease of the midfoot area, which meant a decrease of subjects with plantar arch of flat type.

Zoonosis and veterinary waste disposal in rural practice / Zoonosis y disposición de desperdicios veterinarios en la práctica rural

The objectives of this study were to estimate: (a) the frequency of zoonoses in large animal veterinarians from rural areas of the province of Buenos Aires, Argentina, and (b) to describe the use and disposal of personal protective equipment (PPE) and selective veterinary clinical waste. A cross-sectional study was carried out on large animal veterinary practitioners in the Province of Buenos Aires (n = 106). One third (29.2%) of them had been diagnosed with a zoonosis by laboratory-methods, being brucellosis the most frequent (22.6%). The more years passed since their graduation, the greater the chances of becoming ill (p < 0.001). Gloves were the most adopted PPE; however, other elements had little or no use at all. Older and experienced professionals used PPE less frequently than young inexperienced practitioners. Some PPE was frequently reused and the final disposal of veterinary waste was often inappropriate. A change in behavior is an urgent need to preserve not only the veterinarians' health but also their families' wellbeing and to ensure proper disposal of potentially hazardous waste.

Los objetivos de este trabajo fueron los siguientes: a) estimar la frecuencia de zoonosis en veterinarios de grandes animales que desarrollan su labor en la provincia de Buenos Aires; b) describir el uso y la disposición de los elementos de protección personal (EPP) y otros residuos generados durante el trabajo de estos veterinarios. Para ello se realizó un estudio transversal en una muestra de 106 profesionales. En un tercio de ellos (29,2%) se había sido diagnosticado por métodos de laboratorio alguna zoonosis; la brucelosis fue la más frecuente (22,6%). Se encontró que a mayor tiempo transcurrido desde la graduación, mayor era la probabilidad de enfermarse (p< 0,001). Sobre la base de las respuestas obtenidas en cuestionarios estructurados, se determinó lo siguiente: que los guantes fueron el EPP más adoptado, mientras que otros elementos tuvieron escasa o nula adopción; que los profesionales de mayor edad y experiencia usaron EPP con menos frecuencia que los practicantes más jóvenes e inexpertos; y que algunos EPP se reutilizaban con frecuencia y que la eliminación final de los desechos veterinarios fue a menudo inapropiada. Considerando estos hallazgos, es claro que se requiere un cambio de comportamiento para preservar no solo la salud de los veterinarios, sino también para asegurar el bienestar de sus familias y garantizar la eliminación adecuada de los residuos potencialmente peligrosos.

Fatores de risco para a ocorrência das úlceras plantares decorrente da hanseníase de acordo com a árvore de decisão / Risk factors for plantar ulcers from leprosy according to the decision tree

Objective:To identify the risk factors for plantar ulcers in patients with leprosy.Methods:This is an epidemiological, observational, cross-sectional and analytical study. The population was composed of leprosy cases reported from 2005 to 2016. Pearson's Chi-square test or Fisher's exact test andMann-Whitney test were used for the univariate analysis, with a statistical significance of 5% (p < 0.05). In the multivariate analysis, a decision tree was elaborated using the CHAID algorithm. Results:Clinical form, degree of physical incapacity at discharge, affected nerve and the lack of insoles or adapted footwear before appearing to ulcer are risk factors for plantar ulcer. Conclusion:the need for an early diagnosis of leprosy was highlighted, as well as the efficient association of non-drug interventions with disability prevention techniques and the use of accommodating insoles and/or special shoes.

Objetivo:Identificar os fatores de risco para a ocorrência das úlceras plantares em pacientes com hanseníase. Métodos:Trata-se de um estudo epidemiológico, do tipo observacional, transversal e analítico. A população foi composta pelos casos de hanseníase notificados no período de 2005 a 2016. Para a análise univariada foram utilizados os testes Qui-quadrado de Pearson ou teste exato de Fisher e teste de Mann-Whitney, com significância estatística de 5% (p < 0,05). Na análise multivariada, foi elaborada árvore de decisão utilizando o algoritmo CHAID. Resultados: A forma clínica, grau de incapacidade física na alta, nervo acometido e o não uso de palmilhas ou calçado adaptado antes de surgir a úlcera são fatores de risco para a ocorrência de úlcera plantar. Conclusão:evidenciou a necessidade do diagnóstico precoce da hanseníase, como também da eficiente associação das intervenções medicamentosas e não medicamentosas por meio das técnicas de prevenção de incapacidade e uso de palmilhas acomodativas e/ou calçados especiais

Sports-related skin conditions

Skin diseases associated with athletic activities can be classified as skin infections, inflammatory reactions, trauma, and abnormal proliferation, depending on the cause of the condition. Athlete's nodule is a generic term for reactive nodules that occur in athletes. It is particularly common in the foot due to tight sneakers, repetitive pressure or friction, and inappropriate choice of shoes or other sports equipment. The diagnosis of black heel (calcaneal petechiae) should be considered when numerous black spots occur on the soles in patients who frequently engage in abrupt movements, such as starts, stops, or leaps. Palmoplantar eccrine hidradenitis may occur in athletes who play baseball, dance, and climb, activities in which repetitive and strong stimuli are applied to the floor of the hands and feet. Painful fat herniation should be suspected in cases of painful skin-colored firm nodules on the feet of athletes who place a large amount of weight on their feet when moving. Itching, urticaria, angioedema, chest tightness, and syncope occurring within 5 minutes after starting exercise should be suspected to be exercise-induced angioedema/anaphylaxis. Excessive force can cause deformation of nails, as in tennis toe and jogger's toenail. For the diagnosis and treatment of sports-related skin diseases, it is essential to pay attention to patients' hobbies and exercise habits, including sports, and to consider the relationship of those habits with the presumed mechanisms of the skin disease. In addition, thorough pre-exercise warm-ups, increasing strength gradually, and wearing proper equipment will help prevent the occurrence of sports-related skin diseases.

Effects of Critical Thinking and Communication Skills on the Problem-Solving Ability of Dental Hygiene Students / 치위생과학회지

BACKGROUND: This study aimed to investigate the effects of critical thinking and good communication skills on the problem-solving abilities of dental hygiene students. METHODS: A total of 508 dental hygiene students were convenience-sampled from 3 universities. RESULTS: The results revealed that critical thinking had the highest intellectual fairness score of 3.60, and systematicity was the lowest at 3.19. The values for communication skills were high in reaction, social adequacy, and concentration, with an average of 3.65. Problem-solving abilities were in the following order: clarification of the problem, seeking solutions, and decision making. According to general characteristics, more extroverted personalities possessed higher levels of critical thinking, communication skills, and problem-solving abilities (p<0.01). Critical thinking scores were high (p=0.016) in students who responded that peer relationship was difficult; however, their communication skills were the lowest (p<0.001). Additionally, problem-solving abilities were highest among students who reported a difficult peer relationship (p=0.001). The higher the satisfaction with dental hygiene academics, the higher the critical thinking, communication skill, and problem-solving ability (p<0.001). Critical thinking showed a high positive correlation with variables in the following order: clarification of the problem, performing the solutions, seeking solutions, decision making, and evaluation and reflection. The communication skills were also related to these variables listed above (p<0.01). With critical thinking, confidence, watchfulness, intellectual passion/curiosity, sound skepticism, objectivity, and systematicity all influenced the problem-solving ability. CONCLUSION: Communication skills were influenced by noise control, putting on the other's shoe, social tensions, and efficiency, which affected the problem-solving ability. Dental clinics require dental hygienists to have critical thinking to make analytical judgments and effective communication skills to solve human relation problems with patients and care-givers. Therefore, these skills should be developed in dental hygiene students to improve their problem-solving abilities.

Results of Simple Conservative Treatment of Midfoot Charcot Arthropathy

BACKGROUND: Traditionally, conservative management with an offloading orthosis, such as total contact cast (TCC), has been the standard of care for midfoot Charcot arthropathy. Considering complications of TCC and surgery, we treated midfoot Charcot arthropathy without TCC in our patients. The purpose of this study was to report clinical and radiological outcomes of conservative management of midfoot Charcot arthropathy. METHODS: A total of 34 patients (38 feet) who were diagnosed as having midfoot Charcot arthropathy between 2006 and 2014 were included. Patients started full weight bearing ambulation in a hard-soled shoe immediately after diagnosis. Outcomes such as progression of arch collapse, bony prominence, ulcer occurrence, limb amputation, and changes in Charcot stage were evaluated. RESULTS: Of 38 feet, arch collapse was observed in four while progression of bottom bump of the midfoot was observed in five feet. Foot ulcers related to bony bumps were found in two feet. CONCLUSIONS: Conservative treatment without restriction of ambulation is recommended for midfoot Charcot arthropathy because it is rarely progressive, unlike hindfoot-ankle arthropathy. In some cases, simple bumpectomy can be required to prevent catastrophic infection.

Forefoot disorders and conservative treatment / 영남의대학술지

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis

Abstract: Background: In our country, the Brazilian Standard Series is the most used for the etiological diagnosis of allergic contact dermatitis to shoes. However, there is no assessment of the usefulness of specific allergens for shoes. Objectives: To measure the improvement in diagnostic accuracy of allergic contact dermatitis to shoes with the use of a specific complementary series in patch testing and describe the characteristics of the affected population, such as gender, location of lesions, time of evolution, and the most common allergens. Methods: This retrospective study evaluated the results of 52 patients with suspected shoe dermatitis subjected to patch tests with the standard and specific series to quantify the gain in diagnostic accuracy. Results: Among the 52 suspected cases, 29 cases (56%) were confirmed. In 13 (45%) cases the diagnosis was determined through the specific series, which results in an 81% increase in the number of diagnoses. Study limitation: Small sample size. Conclusions: Women were more commonly affected, with a mean time for the final diagnosis of 45 months, and the most common localization was the dorsum of the feet. There was an increase in diagnostic accuracy with the introduction of new haptens in the patch test of patients with suspected shoes dermatitis.

The influence of heel height related on quality of life on the foot in a sample of women

SUMMARY Many women have worn high-heel shoes (HHS) at some point in their lives and many wear them on a daily basis, with higher prevalence between 39% and 78% observed in institutional and clinical settings. The purpose of this study was to describe and compare the scores obtained with regard to foot health and health in general in a sample of women that use HHS as opposed to a sample of women without HHS with normalized reference values. A sample of 120 participants with a mean age of 41.94 ± 13.912 came to a health center where self-reported data were registered. The subjects with and without HHS were determined and the scores obtained were compared in the Foot Health Status Questionnaire (FHSQ). This questionnaire is made of 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The women in the HHS group showed a worse quality of life related to health in general and to foot health specifically. Differences between the two groups were evaluated by means of a t-test for independent samples, showing statistical significance (P<0.01). Women with HHS present a negative impact on the quality of life related to foot health.

RESUMO Muitas mulheres usaram sapatos de salto alto (SSA) em algum momento de suas vidas e muitas usam diariamente, com maior prevalência entre 39% e 78%, observadas em contextos institucionais e clínicos. O objetivo deste estudo foi descrever e comparar os escores obtidos em relação à saúde dos pés e à saúde em geral em uma amostra de mulheres que utilizam SSA em oposição a uma amostra de mulheres sem SSA com valores de referência normalizados. Uma amostra de 120 participantes com idade média de 41,94 ± 13,912 chegou a um centro de saúde onde os dados autorrelatados foram registrados, os informantes com e sem SSA foram determinados e os escores obtidos foram comparados no Foot Health Status Questionnaire (FHSQ). Esse documento tem 13 questões que avaliam quatro domínios de saúde dos pés, nomeadamente dor, função, saúde geral e calçado. As mulheres do grupo SSA apresentaram pior qualidade de vida relacionada à saúde em geral e à saúde dos pés, especificamente. As diferenças entre os dois grupos foram avaliadas por meio de um teste t para amostras independentes, mostrando significância estatística (P <0,01). As mulheres com SSA apresentam um impacto negativo na qualidade de vida relacionada à saúde dos pés.

Acquired Change and Pain of Foot in Elderly People

As the aging of the foot progresses, the stiffness of the soft tissues, the reduction of the range of motion, the decrease of the muscle strength, and the flattening of foot are manifested. These changes increase the risk of foot pain, the problem of weight distribution and transmission, and the risk of falls, resulting in secondary complications and lowering quality of life. The most common deformities and diseases of the elderly foot are hallux valgus, hammertoes, hallux rigidus, Achilles tendinitis, plantar fasciitis, metatarsalgia, hyperkeratosis, and other deformities of the feet caused by chronic conditions. Systemic diseases that promote these foot problems include diabetes, peripheral nerve damage, repetitive ankle ligament injuries, deformities due to fractures, and obesity. Understanding the mechanisms of aging and the processing of biomechanics in the elderly will enable them to reach a healthy life through appropriate rehabilitation, exercise and educations during aging. In addition, it is necessary to promote the healthy life in elderly by customized exercise, training, and shoes.

Investigation of Floor Surface Finishes for Optimal Slip Resistance Performance

BACKGROUND: Increasing the slip resistance of floor surfaces would be desirable, but there is a lack of evidence on whether traction properties are linearly correlated with the topographic features of the floor surfaces or what scales of surface roughness are required to effectively control the slipperiness of floors. OBJECTIVE: This study expands on earlier findings on the effects of floor surface finishes against slip resistance performance and determines the operative ranges of floor surface roughness for optimal slip resistance controls under different risk levels of walking environments. METHODS: Dynamic friction tests were conducted among three shoes and nine floor specimens under wet and oily environments and compared with a soapy environment. RESULTS: The test results showed the significant effects of floor surface roughness on slip resistance performance against all the lubricated environments. Compared with the floor-type effect, the shoe-type effect on slip resistance performance was insignificant against the highly polluted environments. The study outcomes also indicated that the oily environment required rougher surface finishes than the wet and soapy ones in their lower boundary ranges of floor surface roughness. CONCLUSION: The results of this study with previous findings confirm that floor surface finishes require different levels of surface coarseness for different types of environmental conditions to effectively manage slippery walking environments. Collected data on operative ranges of floor surface roughness seem to be a valuable tool to develop practical design information and standards for floor surface finishes to efficiently prevent pedestrian fall incidents.

¿Afecta una clase de Educación Física a las dimensiones del pie de los niños? / Does a Physical Education lesson affect the foot morphology in school-aged children?

Resumen: Introducción: Analizar las variaciones que se producen en las medidas morfológicas del pie de los niños escolares, tras la realización de una clase de Educación Física. Metodología: Participaron voluntariamente 10 escolares (5 niños y 5 niñas) con una media de edad de 9.3 ± 0.5 años. Se llevó a cabo la digitalización de ambos pies de manera consecutiva, a través de un escáner en 3D modelo IFU-S-01, Japón. Se calcularon las dimensiones del pie en dos momentos diferentes, antes y después de una clase de Educación Física (pre y post ejercicio) donde se realizaron diferentes actividades que implicaban desplazamientos, saltos y amortiguaciones. Resultados: Al comparar las medidas del pie antes y después del ejercicio se observaron diferencias significativas en la altura del arco plantar, que fue mayor tras la realización de actividad física (p<0.05). El ancho del antepié presentó mayores valores tras el ejercicio sin significancia estadística (p=0.07; tamaño del efecto [ES] = 0.2). Además, se observaron correlaciones positivas entre el ancho del antepié y la altura del arco (r = 0.6; p<0.05); y negativas entre la longitud del talón a la cabeza del metatarso I y el ancho del antepié (r = - 0.7; p<0.05). Conclusiones: El tipo de actividades realizadas durante la clase de Educación Física (desplazamientos, saltos y amortiguaciones) podría causar mayor presión en la zona del antepié, provocando mayor altura del arco plantar. Los sistemas de desarrollo del calzado deportivo infantil deberían tener en cuenta tanto las longitudes del pie, cómo sus anchuras y alturas, para un mejor ajuste del zapato, previniendo lesiones osteomusculares futuras.

Abstract: Background: To analyze the changes in foot morphology in school-age children, after a Physical Education lesson. Methods: A total of 10 school-age children (5 girls and 5 boys) were recruited with a mean age of 9.3 ± 0.5 years that voluntary participated in this study. Measurements of both feet were obtained using a 3D foot digitizer model IFU-S-01 (Japan) in two different moments, before and after a physical education lesson (per-exercise and post-exercise), where different activities involving displacements, jumps and landings were performed. Results: By comparing foot morphology before and after exercise, significant differences in the arch height were found, which increased after exercise (p<0.05). The ball width shows greater changes after exercise but without significant differences (p= 0.07; effect size [ES] = 0.2). Furthermore, a positive correlation between the ball width and the arch height (p<0.05) and negative correlation between the distance from the heel to the first metatarsal and the ball width (r = - 0.7; p<0.05), were observed. Conclusions: The type of activities undertaken during physical education lesson (displacements, jumps and landings) increased the pressure on the forefoot, which would lead to a lager arch height. Development of children's sport footwear systems should take into account the foot lengths, widths and heights, for a better fit, preventing future musculoskeletal injuries.

Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear / Mudanças no fluxo sanguíneo das extremidades inferiores nas fases avançadas da gravidez e os efeitos de calçado especial

Background: During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives: The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods: Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen's d test to calculate effect size. Results: With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions: Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application

Contexto: Durante a gravidez, uma série de mudanças que afetam o fluxo venoso ocorrem no sistema circulatório, tais como menor tensão da parede venosa ou aumento da exposição a fibras de colágeno. Esses fatores podem causar estagnação sanguínea, inchaço das pernas ou dano endotelial e, consequentemente, levar ao desenvolvimento de doença venosa. Objetivos: O objetivo deste estudo foi avaliar o efeito do uso de calçados especiais projetados para melhorar a circulação sanguínea dos pés sobre as mudanças no fluxo venoso observadas nas fases avançadas da gravidez. Métodos: Trinta gestantes saudáveis participaram deste estudo às 25, 30 e 35 semanas de gestação. As participantes foram aleatoriamente designadas a um grupo experimental (n = 15) que recebeu calçados especiais, ou um grupo controle (n = 15). A cada sessão de coleta de dados, foram obtidas medidas Doppler do pico de velocidade do fluxo sanguíneo sistólico e da área transversal da veia poplítea direita, utilizando-se um aparelho de ultrassom MySonoU6 com transdutor linear (Samsung Medison). As diferenças foram comparadas utilizando-se o teste d de Cohen para calcular o tamanho do efeito. Resultados: Nas fases avançadas da gravidez, o pico da velocidade sistólica na veia poplítea diminuiu significativamente no grupo controle, porém aumentou significativamente no grupo experimental. Não houve mudanças significativas na área transversal da veia poplítea em nenhum dos grupos. Conclusões: Os achados do grupo experimental demonstraram que o uso dos calçados especiais testados pode evitar que a velocidade do fluxo venoso diminua nas fases avançadas da gravidez. No entanto, mais estudos são necessários para investigar os efeitos benéficos sobre o fluxo venoso do uso dos calçados testados e suas aplicações