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01-12-2019 | Research | Uitgave 1/2019 Open Access

Journal of Foot and Ankle Research 1/2019

The impact of multimorbidity on foot health outcomes in podiatry patients with musculoskeletal foot pain: a prospective observational study

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2019
Auteurs:
Gordon J. Hendry, Linda Fenocchi, Helen Mason, Martijn Steultjens
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s13047-019-0346-x) contains supplementary material, which is available to authorized users.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Background

Multimorbidity is prevalent and adversely affects health outcomes. Foot pain is common and one of the primary reasons for utilisation of podiatry services. At present, little is known about the impact of multimorbidity on foot health and related outcomes following podiatric intervention. The aims of this study were to evaluate whether there is a difference in foot health outcomes following exposure to podiatric foot care for people with and without multimorbidity; and ii) to evaluate whether the presence or absence of multimorbidity affects patients’ perceptions of change in foot pain.

Methods

The PROMFoot study is a prospective cohort study of adults with a new episode of foot pain attending the podiatry service within the NHS Greater Glasgow and Clyde health board. Baseline medical comorbidity status (no condition, single condition, multiple conditions), longitudinal data on foot health measured using the Foot Health Status Questionnaire (FHSQ), and patient rating of change scores for foot pain were obtained from the PROMFoot study at baseline, and 3 and 6 months after podiatric intervention. Foot health scores (pain, function, footwear and general foot health) and perceptions of change for foot pain were compared between comorbidity groups.

Results

A total of 115 participants (59% female) with a mean age of 55 years were included. Multimorbidity was common, affecting 61 participants (53%); while 28 (24.3%) and 26 (22.6%) reported single or no medical comorbidities respectively. Significantly worse foot health scores for all FHSQ domains were observed for the multimorbidity group at baseline, 3 and 6 months. Change scores for foot pain were similar between groups and demonstrate modest improvements, however multimorbidity group membership was strongly associated with a perceptions of change in foot pain. Multimorbidity was independently associated with poorer foot function outcomes at 3 months, and poorer foot pain and foot function outcomes at 6 months.

Conclusions

Multimorbidity was associated with poor foot health outcomes and lower rates of self-perceived improvement in foot pain over 6 months following podiatric intervention in a sample of patients attending podiatric biomechanics clinics for a new episode of foot pain.

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Extra materiaal
Additional file 1: Table of demographic characteristics of the whole sample versus the closed cohort. Table comparing demographic characteristics between the whole sample which includes some missing data, and the closed cohort with complete data at each time point. (DOCX 12 kb)
13047_2019_346_MOESM1_ESM.docx
Additional file 2: Table of FHSQ domain scores for the closed cohort. Table displays FHSQ domain scores at each study time point and results of between group sensitivity analysis. (DOCX 12 kb)
13047_2019_346_MOESM2_ESM.docx
Additional file 3: Table of FHSQ domain change scores scores for the closed cohort. Table displays FHSQ domain change scores at each study follow-up and results of between group sensitivity analysis. (DOCX 12 kb)
13047_2019_346_MOESM3_ESM.docx
Additional file 4: Cross-tabulation contingency table of perceptions of foot pain change according to multimorbidity group. Table displays results of cross-tabulation frequencies and chi-square sensitivity analysis of associations between group membership and perceptions of foot pain change. (DOCX 12 kb)
13047_2019_346_MOESM4_ESM.docx
Additional file 5: Unadjusted and adjusted associations between multimorbidity and foot health outcomes. Table displays results of multivariate linear regression analyses for associations between multimorbidity and FHSQ outcomes at 3 and 6 months, which are unadjusted and adjusted for baseline FHSQ domain, age and BMI. (DOCX 14 kb)
13047_2019_346_MOESM5_ESM.docx
Additional file 6: Graph of FHSQ domain scores for closed versus open cohorts. Graphical representation of median FHSQ domain scores at each study time point for closed versus open cohorts. (TIF 252 kb)
13047_2019_346_MOESM6_ESM.tif
Additional file 7: Graph of FHSQ domain change scores for closed versus open cohorts. Graphical representation of median FHSQ domain change scores at each study follow-up for closed versus open cohorts. (TIF 132 kb)
13047_2019_346_MOESM7_ESM.tif
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