Podiatric Care in Pregnancy

NewsBot · Jun 19, 2016

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Is Podiatric Care Indicated in Pregnant Patients With Pre-existing Diabetes of >10 Years Duration?
Bossert, Frederick R. MD; Lynch, Erica BS; Haverly, David DPM; Kipikasa, Joseph MD; Torres, Carlos MD; Sadanandan, Sunanda DO
Obstetrics & Gynecology: May 2016

INTRODUCTION: Diabetes affects over 6% of the population and can lead to severe end organ damage. Thus, obstetricians screen their patients for ophthalmologic, renal, and cardiac damage. One aspect often overlooked is the podiatric exam, a common site for diabetic pathology. This study sought to determine the incidence of podiatric pathology in asymptomatic diabetic pregnant patients of >10 years duration irrespective of diabetic type.

METHODS: We conducted a retrospective medical chart review from January 1, 2005 to December 31, 2005 and identified 98 patients with pre-existing diabetes of greater than 10 years duration who underwent complete podiatric exam and diabetic foot care counseling by a board-certified podiatric surgeon.

RESULTS: Of the 98 patients included, we found an overall podiatric pathology presence of 52.0% (N=51); onychomycosis 19.8%, dyshidrosis 7.1%, fissure 5.1%, prokeratosis 3.1%, metatarsalgia 8.1%, tinea pedis 4.1%, *neuropathy 13.3%, *ulceration 4.1%, *periostitis 2.0%. The incidence of significant podiatric pathology was 19.4%. (*indicates significant pathology).

CONCLUSION: We found significant podiatric health issues in this high-risk population. Our data set suggests the need to include a podiatric examination as part of the contemporary care of pregnant patients with pre-existing diabetes of at least 10 years duration, to allow for education, intervention, and possible decrease in disease progression. A complete podiatric examination should be done in addition to other end organ surveillance commonly employed, such as, 24-hour urine protein, EKG, ophthalmology, and selected echocardiography.
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Admin2 · Jun 19, 2016

Related Topics:
Foot Function and Pregnancy
Why don't pregnant women fall over?

NewsBot · Mar 28, 2017

Impact of the quality of life related to foot health in a sample of pregnant women: A case control study
López-López, Daniel PhD, BSc, MsC, DP; Rodríguez-Vila, Inés DP; Losa-Iglesias, Marta Elena RN, PhD, MsC, DP; Rodríguez-Sanz, David PhD, MsC, PT, DP; Calvo-Lobo, César PhD, Msc, PT; Romero-Morales, Carlos PhD, MsC, PT; Becerro-de-Bengoa-Vallejo, Ricardo RN, BSc, MLIS, DPM, PhD, DHL, FFPM, RCPS
Medicine: March 2017 - Volume 96 - Issue 12 - p e6433

Abstract: Pregnancy women coincide with numerous anatomical and physiological changes, which are believed to have a harmful effect on the quality of life related to foot health. The goal of this research was to identify and compare the impact foot health and overall health in a sample of pregnancy women and women without pregnancies with normalised reference values.

A sample of 159 participants of a mean age of 30.13 ± 6.28 came to the area of midwifery center where self-reported data were registered, informants’ with a 1 or various pregnancy was determined and the scores obtained were compared in the foot health status questionnaire (FHSQ). This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health, and footwear.

The pregnant women group showed a worse quality of life related to health in general and to foot health specifically at the following domains, foot function, footwear, general foot, health, physical activity, social capacity, and vigor (P < 0.05) and there were no differences at foot pain and general health (P > 0.05).

Pregnant women present a negative impact on the quality of life related to foot health, which appears to be associated with the pregnancy period.
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NewsBot · Mar 5, 2019

Effect of intrinsic and extrinsic foot muscle strengthening exercises on foot parameters and foot dysfunctions in pregnant women: a randomised controlled trial
Preetha RamachandraPratap KumarAsha KamathArun G Maiya
International Journal of Therapy and RehabilitationVol. 26, No. 2 Original Research:26 Feb 2019

Background/Aims:
The medial longitudinal arch of the foot is supported by both active and passive systems. Focusing on the active system by strengthening the intrinsic and extrinsic foot muscles and its effect on the foot parameters in pregnant women has been underresearched.

Methods:
A total of 86 primigravidae (women who were pregnant for the first time) were recruited at the 18th week of gestation. The control group received routine antenatal exercises and the study group received intrinsic and extrinsic foot exercises along with the routine antenatal exercises. The outcome measures evaluated were foot parameters and foot dysfunctions, which were reassessed at the 24th and 32nd week of gestation.

Results:
The results suggested that there was a significant difference between the study group and control group in terms of foot width, navicular height, truncated foot length and normalised navicular height truncated, which indicated that there was a significant drop in the arch of the foot (pronation) in the control group compared to the study group (P=<0.001). The foot dysfunctions reported by the study group were significantly less compared to the control group.

Conclusions:
A comprehensive foot exercise programme was found to be effective in reducing the drop in arch height and also in preventing foot dysfunctions in pregnant women.
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NewsBot · Nov 2, 2019

Effect of Arch Support on Prevention of Foot Pain During Pregnancy
MOHAMED A. AWAD et al
Med. J. Cairo Univ., Vol. 87, No. 2, March: 881-888, 2019

Background: During pregnancy women experience several
changes in the body's physiology, morphology and hormonal
system. These changes may affect the balance and body
stability and can cause discomfort and pain.
Aim of Study: This study was conducted to investigate
the effect of arch support on prevention of foot pain during
pregnancy.
Material and Methods: Sixty pregnant women shared in
this study. They were selected randomly from Al-Zahraa
University Hospital, Al-Azhar University, in Cairo. Their ages
were ranged from 20 to 30 years old and their BMI were less
than 30Kg/m2
. They were divided randomly into two groups
equal in number: Group A (control group) which consisted of
30 pregnant women received no intervention and group B
(study group) which consisted of 30 pregnant women wore
arch support from the beginning of 2ndtrimester till 6 weeks
postpartum. All women in both groups were evaluated through
Navicular Index (NI) and Visual Analog Scale (VAS) before
treatment (at the beginning of the 4thmonth of pregnancy),
at the end of third trimester (at the end of 9 thmonth of
pregnancy) and at the end of puerperium (six weeks postpartum).
Results: Results of this study revealed that there was no
statistically significant difference in navicular index between
both groups (A and B) at the 4th month of pregnancy and after
six weeks postpartum (p=0.403). But there was statistically
significant difference between them at
9th
month of pregnancy
in favour of group B (decrease) (p=0.002). There was a
statistically significant difference in VAS between both groups
at both 9thmonth of pregnancy and 6 weeks postpartum in
favour of group B (decrease) (p=0.001).
Conclusion: It can be concluded that wearing arch support
prevents foot pain during pregnancy.
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NewsBot · Jan 19, 2020

The effect of physiotherapy intervention on the load of the foot and low back pain in pregnancy.
Poděbradská R, Šarmírová M, Janura M, Elfmark M, Procházka M.
Ceska Gynekol. 2019 Winter ;84(6):450-457.

OBJECTIVE:
Pregnant women are at elevated risk for functional and structural changes in the movement system. Common problems are loss of foot arch height and low back pain which can have strong influence on the decrease in quality of life.

AIMS:
The aim of the study was to assess effect of physiotherapy intervention for preventing and treating changes in foot structure as well as low back pain during pregnancy.

DESIGN:
Parallel intervention study.

SETTING:
Department of Midwifery, Faculty of Health Sciences, Palacký University Olomouc.

METHODS:
Twelve healthy pregnant women were randomly divided into the experimental and control groups. The women in the experimental group performed daily exercises aimed at the foot arch. The McGill Pain Questionnaire and the Pregnancy Mobility Index were used to measure level of pain and its impact on quality of life. The Foot Posture Index, Navicular Drop test, Chippaux-Šmirák index, and a podoscope were used to evaluate load and anthropometry of the foot. The data were collected at the turn of the first and second trimester and in the third trimester of pregnancy.

RESULTS:
Statistically significant differences between the baseline and post-intervention were found only in the control group. Pain score obtained from the visual analogue scale as well as the Pregnancy Mobility Index score increased significantly (p = 0.04, p = 0.03 resp.). The Foot Posture Index results increased significantly on both the right (p = 0.04) and left (p = 0.04) lower limb. Chippaux-Šmirák index significantly increased on the right lower limb (p = 0.03).

CONCLUSIONS:
The intervention prevented or reduced the changes in the foot structure and low back pain. This intervention can be recommended in primary or secondary prevention to increase quality of life in pregnant women.
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NewsBot · Mar 5, 2023

Foot health status in pregnant women
Seipati Letompa et al
Foot (Edinb). 2022 Aug 24;55:101938

Background: Pregnancy is associated with physiological changes such as increased body mass index, postural changes, hormonal imbalance and changes in foot morphology. Due to an increased uterus and body mass, the centre of gravity is displaced anteriorly and superiorly as a means to produce and maintain stability and balance. An influx of relaxin mostly in the third trimester leads to ligament laxity which in turn causes the feet to become longer, flatter and broader. This structural change may remain permanent in some women. Structural changes, increased body weight and increased pressure in the lower limbs may also lead to lower limb oedema which makes it harder to find adequate fitting shoes and may be associated with causing or exacerbating foot pain in pregnant women. The purpose of this study was to determine the overall Foot Health Status (FHS) in pregnant women and also to compare the foot health status in the different trimesters.

Methods: A quantitative approach, using a descriptive cross-sectional study design was utilized and a validated foot health status questionnaire was used. Data was analysed using a Statistical Package for Social Sciences (SPSS) version 1.04 program and presented in the form of tables.

Results: All pregnant women had a poor foot health status in the area of vigour, particularly in the third trimester. In the third trimester, women's physical activity was diminished and they appeared to have greater footwear difficulties. However, it was found that despite having minimal foot pain, pregnant women maintained good foot function and good social capacity. The least amount of foot pain was felt in the second trimester.

Conclusion: As a woman progresses in her pregnancy, her foot health status declined in the areas of footwear, physical activity and vigour.
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