Artículos (Podología)

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Therapeutic approach for toenail onychomycosis: Literature review and cost-effectiveness analysis
(Board, 2014-06-30) Córdoba Fernández, Antonio; Távara Vidalón, Priscila; Mandredi-Márquez, María José; Podología; CTS589: Avances en Cirugía Podológica; CTS1136: Patología y Función del Pie
Toenail onychomycosis is a very prevailing pathology (50% of the onycopathologies) with rather high rates of failure and relapse. Most of the cases originate from dermatophytes. The type of onychomycosis, the causative agent, and the factors dependant on the hosts are determining for the correct therapeutic approach of this pathology with rather high failure and relapse rates. Here, we analyse different treatment options focusing on the ideal pharmacologic approach according to current research of cost-effectiveness, pharmacoeconomics and safety.
Factors Related to the Etiology of Hallux Abducto Valgus: A Systematic Review
(MDPI, 2026) Moreno-Fresco, Marta María; Mizzi, Stephen; Munuera Martínez, Pedro Vicente; Távara Vidalón, Priscila; Podología; CTS1136: Patología y Función del Pie
Background: The origin of hallux abducto valgus (HAV) is considered to be multifactorial; however, evidence regarding the factors involved in its development is scattered and often contradictory. Understanding the factors that contribute to the onset of HAV is crucial for informing both prevention and clinical management strategies. This review aims to explore the etiological factors associated with the development of HAV. Methods: A literature search was conducted in PubMed, Embase, Web of Science and Scopus. The search included observational studies that investigated etiological or risk factors related to the development of HAV. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklists, and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: A total of 36 observational studies (20 cross-sectional and 16 case–control) were included, involving 14,500 participants, predominantly females. Genetic evidence indicated strong familial aggregation and variants in collagen- and extracellular matrix-related genes as potential hereditary determinants. The most consistent biomechanical factors were first-ray hypermobility, abnormal foot pronation and reduced activity of the abductor hallucis muscle. Additionally, female sex, older age and prolonged use of narrow or inadequate footwear were identified as recurring predictive variables. Overall, the findings support a complex etiological model based on the interaction of intrinsic and extrinsic factors. Conclusions: The development of HAV appears to be determined by the interaction of genetic, structural and biomechanical factors that alter first-ray stability and forefoot function. Current evidence supports a multifactorial etiological model with a strong hereditary component and higher susceptibility in women. Longitudinal studies employing standardized methods are needed to establish causal relationships and quantify the relative contribution of each factor.
Effectiveness of physical exercise on foot pain and function in adults with rheumatoid arthritis: systematic review and meta-analysis
(Royal belg rheumatol soc; Springer london LTD; Springer Science and Business Media LLC, 2026-03-21) Cruz-López, Alejandro; Rayo-Pérez, Ana María; Tovaruela Carrión, Natalia; Távara Vidalón, Priscila; Munuera Martínez, Pedro Vicente; Podología; CTS601: Hermes; CTS1136: Patología y Función del Pie
Background Foot involvement is highly prevalent in rheumatoid arthritis (RA), affecting over 90% of patients during the disease course. However, the specific impact of structured exercise on foot pain and functional limitations remains insufficiently understood. This systematic review and meta-analysis aimed to evaluate the effectiveness of supervised exercise programs on foot-specific outcomes in adults with RA. Methods We conducted a systematic review and meta-analysis following PRISMA guidelines, searching five databases for randomized and controlled quasi-experimental trials evaluating supervised exercise interventions in adults with RA and foot involvement. Primary outcomes included foot pain and physical function measures. Data were pooled using random-effects models, and risk of bias was assessed using Cochrane tools. Analysis was performed with RevMan 5.4 and STATA 17. Results Thirteen studies (n = 548) were included; ten entered the meta-analysis. Exercise significantly reduced foot pain (SMD − 0.68, 95% CI − 0.89 to − 0.46; p < 0.001) and improved function (Health Assessment Questionnaire SMD − 0.73, 95% CI − 0.96 to − 0.49; 6MWT MD + 47.6 m, 95% CI 31.4 to 63.8; Time Up-and-Go SMD − 0.40, 95% CI − 0.59 to − 0.21). Aquatic exercise and Tai Chi showed larger pain reductions, while high-intensity interval training improved functional outcomes. Programs ≥ 12 weeks yielded greater effects. Risk of bias ranged from low to some concerns; non-randomized studies showed moderate–serious confounding risk. Conclusions Supervised, structured exercise reduces foot pain and improves function in RA, with aquatic and combined modalities particularly beneficial. Findings support implementation within multidisciplinary care.
Reporting and utilization of patient‐reported outcomes measures in the evaluation of foot orthoses treatment: a systematic review
(Biomed central LTD; Wiley, 2026-03-16) Jiménez‐Guillén, Javier; Tovaruela Carrión, Natalia; Moreno‐Fresco, Marta María; Munuera Martínez, Pedro Vicente; Podología; Instituto de Biomedicina de Sevilla (IBIS); CTS601: Hermes; CTS1136: Patología y Función del Pie
Purpose Currently, there is no patient-reported outcome measure (PROM) specifically for evaluating foot orthoses treatments. This led us to ask the following question: What is the quality of the validated foot and ankle PROMs used to evaluate foot orthosis interventions? To do so, we analyzed the psychometric properties of these PROMs and identified the most widely used and those with the best measurement properties. Methods Two literature searches were conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. The methodological quality of the articles was assessed using the updated COSMIN checklist. Psychometric evidence for the properties investigated in the articles was assessed using the updated COSMIN criteria for good psychometric properties. Ratings of methodological quality and psychometric evidence were synthesized using the method of Schellingerhout et al. (2012). Results A total of 205 articles were included, identifying 11 validated PROMs for foot and ankle used in the evaluation of foot orthoses. The Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ) were the most commonly used, whereas the Victorian Institute of Sport Assessment-Achilles tendon (VISA-A) questionnaire demonstrated the best measurement properties. Conclusion The VISA-A, the Foot and Ankle Outcome Score (FAOS), and the Revised Foot Function Index (FFI-R) appear to be useful PROMs for evaluating foot orthoses treatments; however, more evidence is needed to make more robust and reliable statements.
Reporting and Utilization of Patient-Reported Outcomes Measures in the Evaluation of Foot Orthoses Treatment: A Systematic Review
(John Wiley & Sons, Inc., 2026-03) Jiménez Guillén, Iván; Tovaruela Carrión, Natalia; Moreno-Fresco, Marta María; Martínez Nova, Alfonso; Munuera Martínez, Pedro Vicente; Podología; CTS1136: Patología y Función del Pie; CTS601: Hermes
Purpose: Currently, there is no patient‐reported outcome measure (PROM) specifically for evaluating foot orthoses treatments.This led us to ask the following question: What is the quality of the validated foot and ankle PROMs used to evaluate footorthosis interventions? To do so, we analyzed the psychometric properties of these PROMs and identified the most widely usedand those with the best measurement properties.Methods: Two literature searches were conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. Themethodological quality of the articles was assessed using the updated COSMIN checklist. Psychometric evidence for theproperties investigated in the articles was assessed using the updated COSMIN criteria for good psychometric properties.Ratings of methodological quality and psychometric evidence were synthesized using the method of Schellingerhout et al.(2012).Results: A total of 205 articles were included, identifying 11 validated PROMs for foot and ankle used in the evaluation of footorthoses. The Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ) were the most commonly used,whereas the Victorian Institute of Sport Assessment‐Achilles tendon (VISA‐A) questionnaire demonstrated the best mea-surement properties.Conclusion: The VISA‐A, the Foot and Ankle Outcome Score (FAOS), and the Revised Foot Function Index (FFI‐R) appear tobe useful PROMs for evaluating foot orthoses treatments; however, more evidence is needed to make more robust and reliablestatements.
Menstrual cycle effects on foot and ankle musculoeskeletal biomechanics: a systematic review and meta-analysis
(Elsevier, 2026) Regife-Fernández, Laura; Radcliffe, Ceridwen R.; Castro Méndez, Aurora; Podología; Instituto de Biomedicina de Sevilla (IBIS); CTS601: Hermes
Background Hormonal fluctuations throughout the menstrual cycle are associated with a higher prevalence of musculoskeletal injuries in women; however, their impact at the foot and ankle level remains underexplored. The aim of this systematic review and meta-analysis was to examine the potential biomechanical effect of the ovulatory phase on foot and ankle structure compared to other phases of the menstrual cycle, given its possible association with injury occurrence. Methods A systematic search was conducted in PubMed, Scopus, Web Of Science, and Embase (last 10 years), following PRISMA guidelines. Cohort studies, non-randomized trials, and case-control studies were included. Quality assessment was performed using the JBI critical appraisal tool. A quantitative synthesis (meta-analysis) was performed for homogeneous variables (muscle stiffness). Results Fifteen studies were selected. The systematic review demonstrated increase in foot length, reduction in fascial thickness, and greater longitudinal arch collapse during the ovulatory phase. Tone and stiffness of the tibialis anterior and peroneus longus muscles were greater during the menstrual phase. During ovulation, lower stiffness was observed during active contraction and increased tibialis anterior activation. Greater postural sway and oscillation were recorded during ovulation in complex static tasks, and, along with the menstrual phase, in dynamic balance tests. The meta-analysis indicated a tendency towards lower tibialis anterior stiffness during the follicular phase compared to the ovulatory phase. Conclusion The ovulatory phase appears to be associated with an interaction of structural alterations (ligament laxity and arch collapse) and neuromuscular changes (reduced muscle stiffness and inefficient motor control) that, together, could constitute a risk factor for local pathologies such as plantar fasciitis and chronic ankle instability.
Tenotomía longitudinal ecoguiada para el tratamiento de fascitis plantar. Nota técnica y revisión sistemática
(Graphimedic SA DE CV, 2023) Bermejo, M.; Lucar-López, G.; Ballester-Alomar, M.; Córdoba Fernández, Antonio; Martínez-Souto, C.; Villamizar, M.; Guevara-Noriega, K. A.; Podología; CTS589: Avances en Cirugía Podológica
Introducción: la fascitis o fasciosis plantar es una causa de dolor en el pie, en la cual frecuentemente se encuentran casos resistentes al tratamiento conservador. La cirugía queda reservada para los pacientes que no han respondido a tratamientos conservadores, ondas de choque o infiltraciones con corticosteroides. El objetivo de este trabajo es realizar una revisión sistemática de la literatura disponible y describir una técnica para el tratamiento de la fascitis o fasciosis plantar consistente en el rasgado longitudinal de la aponeurosis plantar asistido con ecografía. Material y métodos: se realizó una búsqueda sistemática de publicaciones previas sobre la tenotomía longitudinal en el tratamiento de la fascitis plantar. Se incluyeron los encabezados de temas médicos o MeSH (Medical subjects headings por sus siglas en inglés), en inglés: Curettage, Tenotomy y Plantar Fasciitis. La búsqueda electrónica incluyó las bases de datos de PubMed, Embase, Cochrane central register of controlled trials, Trip database y National Institute for Health and Care Excellence (NICE por sus siglas en inglés). Se realizó una descripción detallada de la técnica con la intención de que pueda ser reproducida. Conclusión: la tenotomía longitudinal representa una alternativa para el tratamiento de la fascitis plantar. Se basa en la extrapolación del conocimiento en el territorio Aquíleo con una base fisiopatológica de respaldo. Se trata de una técnica no invasiva que se puede realizar de forma ambulatoria y que permitiría la rápida incorporación del paciente a sus actividades. La tenotomía longitudinal podría evitar al paciente someterse a cirugías de mayor envergadura.
Analysis of pain and effectiveness in digital block of the first toe using syringe vs. carpule: Frost's H vs. modified Frost's H randomized clinical trial
(MDPI, 2024-07-17) Rayo-Pérez, AM; Rayo Rosado, Rafael; Rayo-Martín, R; Reina Bueno, María; Podología; CTS589: Avances en Cirugía Podológica; CTS589: Avances en Cirugía Podológica
Background: Currently, there is no scientific evidence regarding pain in the anesthetic block of the first toe according to the method of application. However, clinical evidence has highlighted the use of the carpule due to the low pain it causes during the administration of the anesthetic. Most studies on anesthesia and pain, especially using the carpule and distraction methods, belong to the field of dentistry. Objective: To compare the pain and effectiveness between the anesthetic block of the first toe using a carpule and syringe with Frost's H technique and the modified Frost's H technique. Method: A total of 564 subjects were selected and divided into four groups. Subjects were subjected to experimental conditions (randomization through the Random Allocation Software program 2.0), and divided into group 1 = 138 subjects, corresponding to the block with syringe and Frost's H, group 2 = 141 subjects, corresponding to the syringe group and modified Frost's H, group 3 = 141 subjects, corresponding to the carpule group and modified Frost's H, and group 4 = 144 subjects, corresponding to the carpule group and Frost's H. The same researcher generated the random allocation sequence, enrolled the participants, and assigned them to the interventions. Each subject was unaware of the anesthetic procedure assigned by the researcher. Outcome parameters were pain after anesthetic infiltration and its effectiveness. Results: The anesthetic block with carpule showed a lower pain score compared to the anesthetic block with syringe (2.8 vs. 5.3; p < 0.001). However, when analyzing effectiveness, a higher efficacy rate was obtained in the anesthetic blocks performed using the modified Frost's H technique (97.5% vs. 88.1%; p < 0.001). Conclusions: The anesthetic block with carpule and the modified Frost's H technique is less painful and more effective than the traditional anesthetic block.
Ultrasound relationship of plantar fat and predislocation síndrome
(MDPI, 2025-04-25) Rayo Pérez, Ana María; Rayo Martín, Rafael; Rayo Rosado, Rafael; Costa Martiniano, Joao Miguel; García de la Peña, Raquel; Podología; CTS589: Avances en Cirugía Podológica
Background: Plantar fat plays a crucial role in protecting and cushioning the metatarsals. Its degeneration is a risk factor for the development of metatarsalgia and, consequently, predislocation syndrome. Objectives: To evaluate the relationship between plantar fat thickness and predislocation syndrome in an adult population, and to determine a possible association between a decrease in forefoot plantar fat and the presence of symptoms. Material and Methods: A retrospective observational study was conducted, including records of patients who visited the podiatry clinic between December 2022 and December 2023. Fifty complete records were selected, divided into two groups, one healthy and one pathological, aged between 18 and 70 years. An ultrasound examination of the plantar area of the second metatarsophalangeal joint was performed to assess the thickness of the fat and plantar plate. Results: The analysis of the 50 records, divided into healthy and pathological groups, reveals significant differences in the thickness of plantar fat and the plantar plate between the two groups. Subjects with predislocation syndrome have a significantly lower plantar fat thickness (0.566 cm) compared to the healthy group (0.941 cm) and also show a greater thickness of the plantar plate (0.359 cm vs. 0.244 cm). Statistical tests confirm these differences with high significance (p < 0.001). The ROC curve shows that plantar fat thickness is a good predictor of predislocation syndrome, with an area under the curve (AUC) of 0.923, emphasizing the utility of this measure in identifying the condition. Conclusions: Preliminary studies suggest that a reduction in plantar fat increases the predisposition to develop predislocation syndrome at the level of the second metatarsophalangeal joint.
Asociación entre la movilidad del primer radio del pie y el dolor lumbar: estudio observacional transversal
(Federación Española de Podólogos; Inspira Network Group, 2025) Granados-Gómez, Patricia; Reina Bueno, María; Gómez-Castro, Mercedes; Munuera Martínez, Pedro Vicente; Podología; CTS1136: Patología y Función del Pie
Introducción: El objetivo del estudio fue analizar si existe una diferencia en la movilidad del primer radio del pie entre personas con y sin dolor lumbar, y si dicha movilidad pudiera estar relacionada con la presencia de lumbalgia. Pacientes y métodos: Se realizó un estudio observacional transversal con 400 adultos entre 18 y 65 años. Se evaluó la dorsiflexión, la plantarflexión y la movilidad total del primer radio mediante un instrumento validado. Se clasificaron los pies como normales o con movilidad alterada según criterios clínicos y se registró la presencia de dolor lumbar mediante escala visual analógica. Resultados: No se encontraron diferencias clínicamente relevantes en la movilidad del primer radio entre personas con y sin lumbalgia en general. Sin embargo, al comparar pies normales sin lumbalgia con pies con movilidad alterada y con lumbalgia, se observó una disminución significativa en la plantarflexión (media: 6.4 mm vs. 5.1 mm), lo que sugiere una posible relación entre la movilidad reducida del primer radio y el dolor lumbar. Conclusiones: La disminución de la plantarflexión del primer radio podría estar asociada con la presencia de lumbalgia. Este hallazgo destacó la importancia de considerar la biomecánica del pie en el abordaje integral del dolor lumbar y sugirió la necesidad de futuras investigaciones para confirmar esta relación.
Ultrasound assessment of the spring ligament and posterior tibial tendon in healthy subjects: a descriptive study
(Elsevier, 2024-08) Martínez-Sañudo, Beatriz; Lopezosa-Reca, Eva; Vallejo-Márquez, Mercedes; Fornell, Salvador; Martínez Franco, Alfonso; Tejero García, Sergio; Podología; Cirugía; CTS972: Análisis Biológico y Funcional del Ejercicio Físico
Background: The main aim of this study was to ultrasonographically analyse the thickness and the relationship between the Superomedial Bundle of the Spring Ligament and the Posterior Tibial Tendon in healthy subjects and its relationship with different epidemiological variables. Methods: Fifty-five healthy feet with a mean of 47 years old measuring the same ultrasound model and researcher. Demographic variables (age, sex, laterality, BMI, type of sports activity performed, and type of work activity) were collected from all participants. The thickness of the PTT and the Spring Ligament was measured in both longitudinal and transverse diameters. The intraclass correlation coefficient (ICC) was also analysed to assess the agreement of the measurements between a researcher and the ultrasound specialist radiologist. Results: The mean thickness of the Spring ligament was 5.07 mm (95 % CI 4.75-5.38), while that of the PTT in its long axis was 3.58 mm (95 % CI 3.37-3.79). Regarding the interobserver agreement analysis, the intraclass correlation coefficient for measurements between observers was 0.91 (CI95 %: 0.698-0.977) which denotes a high degree of similarity between the clinician and the radiologist. Conclusion: This study describes the relationships between the thickness of the posterior tibial tendon and the superomedial Bundle of the Spring ligament in healthy subjects, as well as their variability according to certain epidemiological variables such as age, gender, occupation, and sport. On the other hand, the measurements taken by a researcher high agreement with those taken by a radiologist specialized in ultrasound.
La salud podológica como estrategia de equidad y prevención desde la atención primaria
(Elsevier, 2026-02) Tovaruela Carrión, Natalia; López López, Daniel; Gómez Salgado, Juan; Podología; CTS601: Hermes
Caminar sin dolor no es una cuestión de bienestar, es fundamental para la autonomía, vida activa, implicación y participación social de las personas, así como para su calidad de vida. Las patologías del pie tienen una elevada prevalencia, entre el 61-79% y su frecuencia aumenta con la edad1. A pesar del reconocimiento del impacto funcional de la salud podológica, persisten desigualdades en la accesibilidad a sus servicios, especialmente entre poblaciones con menos recursos o en zonas rurales. Esta situación genera un acceso desigual a intervenciones preventivas que podrían mejorar la calidad de vida y reducir la carga sobre otros niveles asistenciales. (extracto)
What footwear do people with diabetes mellitus use? A narrative review
(MDPI, 2025-12-01) Carral-Sota, R; Reina Bueno, María; Vázquez-Bautista, Carmen; Benhamú Benhamú, Salomón; Palomo Toucedo, Inmaculada Concepción; Podología; CTS1136: Patología y Función del Pie; CTS601: Hermes
Background/Objectives: The prevention of foot ulcers is a priority for the preservation of the integrity of limbs in subjects with Diabetes Mellitus. Footwear is one of the main causes of ulceration regarding this chronic disease. An in-depth study of the influence of footwear is necessary for the establishment of a prevention strategy for foot injuries. This paper aims to identify the type of footwear used by patients with Diabetes Mellitus and to analyse its characteristics and fit to the foot. Methods: The scientific literature was retrieved from the PubMed, Web of Science, and Dialnet databases that covered publications from 2016 to 2025. The inclusion criteria accepted articles that focused on footwear fit and its relationship with ulceration in diabetic patients. Results: A total of 27 articles were selected for study. These articles describe the fitting and features of footwear for a correct adjustment for people with Diabetes. Conclusions: Most of the population with Diabetes Mellitus use poorly adjusted footwear. Incorrect length and width, as well as unsuitable features of the sole and upper, cause patients to become susceptible to the creation of ulcers.
Spatiotemporal and foot kinematic differences during gait in individuals with cavus foot
(Nature publishing group; Nature portfolio; Springer Science and Business Media LLC, 2026-12-29) Tovaruela Carrión, Natalia; Casado-Hernández, Israel; Becerro-de-Bengoa-Vallejo, Ricardo; Losa-Iglesias, Marta Elena; López-López, Daniel; Gómez Salgado, Juan; Bayod-López, Javier; Podología; CTS601: Hermes
Cavus foot, defined by a high medial arch, alters plantar pressure distribution and gait biomechanics, often leading to increased forefoot and heel loading, joint stiffness, and musculoskeletal complications. However, specific kinematic differences compared to normal feet remain underexplored. This study aims to analyse gait kinematics differences in subjects with cavus foot versus those with normally aligned feet. A case-control study was carried out in 100 subjects (50 with bilateral cavus foot and 50 with neutral foot) using the PODOSmart® system, which consists of one pairs of smart insoles, which are available in six sizes covering European sizes 36 to 47, to measure spatiotemporal parameters and segmental foot kinematics with a sampling frequency of 208 Hz. spatiotemporal Kinematic gait analysis showed statistically significant differences (p = 0.003) in the case group, with a shorter duration of the taligrade phase of gait in both the left and right feet. The subject with pes cavus showed rapid heel contact, presenting a shorter duration of the taligrade phase of gait compared to subjects with normal feet, which is related to the supination characteristic of this deformity.
Forensic stature estimation: a systematic review of the correlation between footprints and individual height
(Humana Press INC; Springer Science and Business Media LLC, 2025-10-30) García-Mora, Sara; Regife-Fernández, Laura; Tovaruela Carrión, Natalia; Manfredi Márquez, María José; Vázquez-Castro, María; Alvárez-Cordero, Juan; Correa-Rodriguez, Rosario; Castro Méndez, Aurora; Podología; Instituto de Biomedicina de Sevilla (IBIS); CTS601: Hermes
Anthropometric identification is crucial in legal contexts, where height is a relevant distinguishing characteristic. The estimation of height through plantar impressions is a tool used in forensic podiatric examinations, and it is relevant to be familiar with the most suitable techniques for correlating the length of the footprints with height. This systematic review aims to evaluate forensic identification methods by analysing inked footprint collection and measurement techniques, their correlation with height, and the available scientific evidence. A systematic review of the available literature was conducted in the following databases: PubMed, Embase, Scopus, Web of Science, CINAHL, and Dialnet. Descriptive observational studies linking the length of plantar impressions of healthy adults of both sexes with their height were included. Seven studies published between 2012 and 2020 were selected. All studies showed statistically significant correlations between height and plantar impression measurements, analyzed using Pearson´s correlation coefficient. The inked footprint method was the most widely used and demonstrated high reliability. Additionally, techniques based on foot contours and pedigraphs also showed strong correlations with height and foot length. However, the scientific evidence on this topic is limited, highlighting the need for further research to optimise these techniques and enhance their validity for forensic applications.
Consensus-based guidelines for intervention protocols targeting the foot spring mechanism during landing: a modified Delphi study
(Elsevier, 2025-09-01) Radcliffe, Ceridwen R.; Brown, Nicholas A. T.; Newman, Phil; Bull, John; Spratford, Wayne; Foot Spring Training Consensus Group; Castro Méndez, Aurora; Wang, Lin; Podología; CTS601: Hermes
Objectives To reach consensus of opinion on exercise selection and prescription guidelines for training the energetic function of the foot for landing tasks. Design A modified Delphi design with three rounds of questionnaires. Methods Twenty-eight expert participants (clinicians n = 16, biomechanists n = 9, exercise physiologist n = 1, sport/exercise scientist n = 1, and athletic trainer n = 1) completed three rounds of questionnaires whereby they answered open-ended questions about optimal foot function, suggested exercises and prescription parameters to target the foot spring and ranked their level of agreement to exercises and prescription statements on 5-point Likert scales. Results Forty-six exercises were presented to participants, of which 23 reached consensus of agreement. Fifty-four exercise prescription statements were generated from the open responses of participants, and of these, 21 statements reached consensus of agreement, and one reached consensus of disagreement. Conclusions The exercises that reached consensus were multi-joint, functionally integrated exercises. The exercises included plyometric-based exercises, which is consistent with published literature that has shown that plyometric training increases musculotendinous stiffness and energy recycling. The exercises, however, were dissimilar to exercises previously used in foot training literature. The exercise prescription statements that reached consensus aligned with American College of Sports Medicine (ACSM) exercise prescription guidelines, and the prescription parameters used in plyometric-training literature.
Comparative effectiveness of conservative therapies for plantar fasciitis: A retrospective observational study
(MDPI, 2025-09-05) Rayo Pérez, Ana María; Juárez Jiménez, José María; Ortiz Romero, Mercedes; Gordillo Fernández, Luis María; García de la Peña, Raquel; Podología; CTS589: Avances en Cirugía Podológica; CTS042: Investigación y desarrollo en biomecánica deportiva y cirugía podológica
Background: Plantar fascitis is a common cause of heel pain in adults. Although various conservative treatments have been studied, comparative real-world effectiveness remains underreported. Objective: To retrospectively evaluate and compare the clinical effectiveness of percutaneous neuromodulation, extracorporeal shockwave therapy (ESWT), and custom foot orthoses in patients with plantar fasciitis. Methods: A retrospective observational study was conducted from January 2020 to December 2023 at a podiatric clinic. Inclusion and exclusion criteria were applied to medical records, and 120 patients were divided into three groups according to treatment, with 7 patients excluded due to noncompliance with follow-up. Pain intensity (VAS) and functional improvement (FFI) were assessed at baseline, 1 month, and 6 months post-treatment. Statistical analysis included paired t-tests, ANOVA, effect size (Cohen’s d), and 95% confidence intervals. The STROBE checklist was followed. Results: All three interventions showed significant improvement in pain and function at 6 months (p < 0.05). Neuromodulation achieved the highest pain reduction (VAS mean difference −6.2, d = 1.02), followed by ESWT (d = 0.78) and orthoses (d = 0.65). Functional scores improved similarly across all groups, with no significant difference at 6 months (p = 0.12). Conclusions: Percutaneous neuromodulation demonstrated greater clinical effectiveness in pain reduction compared to ESWT and orthoses, although functional outcomes were similar. Further prospective studies are needed to confirm these findings.
Variations in centre of pressure and balance performance induced by footwear drop in healthy adults
(Springer Science and Business Media LLC, 2025-10-01) Fragua-Blanca, Raquel; Tovaruela Carrión, Natalia; Tena-León, Manuel Jesús; Escamilla Martínez, Elena; Podología; CTS601: Hermes
Background Posturography is a diagnostic technique that quantifies postural control through Centre of Pressure (CoP) displacement analysis on a force platform. Footwear characteristics, particularly heel-to-toe drop, may influence balance by modifying plantar pressure distribution and proprioceptive feedback. The aim of this study was to evaluate the impact of different footwear drops (0 mm, 5 mm, 10 mm) on postural control in healthy young adults, considering sex, BMI, and shoe size. Methods A cross-sectional study was conducted in 117 participants (56 men, 61 women) using the Dinascan/IBV® platform and the Romberg test. CoP displacement and velocity were analyzed. Results Significant differences were observed in CoP total displacement (p < 0.001), mean velocity (p < 0.001), and medio-lateral dispersion (p = 0.024) when comparing 0 mm to 5 mm and 10 mm drops. Sex differences were significant at 0 mm drop for maximum medio-lateral force (p < 0.001) and mean velocity (p = 0.042), with men exhibiting greater values. At 5 mm drop, men showed significantly higher swept area (p = 0.029) and anteroposterior displacement (p = 0.007) than women. Conclusions Small variations in footwear drop can affect postural control, particularly in the medio-lateral plane. Sex and BMI significantly influence CoP behavior, suggesting the need to consider these factors in footwear design and clinical balance assessments.
Effects of plantar static pressure distribution in subject with bilateral hallux limitus: a detailed case-control study
(AME Publishing company, 2025-08-12) Tovaruela Carrión, Natalia; Becerro de Bengoa Vallejo, Ricardo; Losa-Iglesias, Marta Elena; López López, Daniel; Gómez‐Salgado, Juan; Bayod López, Javier; Podología; CTS601: Hermes
Background: Hallux limitus (HL) is defined as the restriction of dorsiflexion (DF) in the first metatarsophalangeal joint (IMTFJ) under closed kinetic chain conditions, where the distal segment is fixed and the foot is in contact with the ground. This biomechanical condition compromises the Windlass mechanism during the propulsive phase of gait, generating pain and functional disability. Therefore, the aim of this research was to examine the aspect of foot shape linked to distribution of static plantar pressure in individuals with bilateral HL compared to subjects with normal foot. Methods: A total of 90 subjects participated in this case-control study, divided into two groups: 45 individuals with bilateral HL and 45 healthy individuals without any known foot pathology. A portable pressure platform was used to measure each subject’s static plantar pressure. Results: Individuals with HL showed significantly increased contact surface in the forefoot (left: 36.67±8.30 vs. 28.91±7.94 cm2) and heel (left: 30.85±7.70 vs. 24.55±7.17 cm2; right: 31.01±7.98 vs. 25.71±7.64 cm2), and higher medium peak pressure in the left foot (HL: 27.90±5.41 kPa vs. control: 22.58±6.57 kPa) (P<0.001). Conclusions: Individuals with bilateral HL showed altered static plantar pressure distribution and increased contact surface in the forefoot and heel compared to healthy controls. Limitations include sex imbalance between groups and lack of dynamic data. These findings may reflect compensatory adaptations and support the need for tailored interventions to improve foot function in this population.
Clinical and Demographics Aspects of Foot Angioleiomyomas: Case Reports and Systematic Review
(MDPI, 2025-08-01) Córdoba Fernández, Antonio; Mir-Gil, Joaquín; Díaz-Baena, Carolina; Ballesteros-Mora, Marina; Córdoba-Jiménez, Victoria Eugenia; Castro Méndez, Aurora; Podología; Instituto de Biomedicina de Sevilla (IBIS); CTS589: Avances en Cirugía Podológica; CTS601: Hermes
Background and Clinical Significance: Angioleiomyoma (ALM) is a benign tumor that generally presents as a single lesion and, according to the updated WHO classification, includes the following three histological subtypes: solid (or capillary), cavernous, and venous. Typically, ALMs are described as well-defined nodules in the lower extremities but are unusually located in the acral locations and toes. We summarize two cases of ALM and perform a systematic review to provide foot surgeons with the most up-to-date and useful information on the epidemiological aspects, anatomical distribution, and specific histological subtypes of ALM in the foot. Materials and Methods: A systematic review was carried out according to the criteria of a PICO framework, and a systematic search and data processing were carried out according to the PRISMA guidelines. We analyzed patient demographics, clinical characteristics, diagnostic workup, treatment, and clinical outcomes. Each one of the included articles was independently assessed for methodological quality and risk of bias by an independent evaluator. The risk of bias of the included studies was assessed based on their characteristics. Results: This systematic review included 14 case series with 172 reported cases of ALM. One hundred and seventy-two (18.57%) were cases of ALM located on foot, excluding the ankle region. The female-to-male ratio was 1.48. The most common location was the hindfoot (41.5%), followed by the forefoot (20.2%) and the midfoot (8.9%). In 29.4% of cases, the location of the lesions could not be determined. The most frequent location of the lesions was subcutaneous (69%), followed by subaponeurotic (16.5%) and skin (14.5%) locations. The most frequent histological presentation was the solid histologic subtype (65%), followed by the venous subtype (21%) and the cavernous subtype (14%), respectively. Of the total reported cases of ALM located in foot, 63.1% presented as solid painful lesions. Calcified presentations occurred in 7% of cases, with more than half of the cases located in the hindfoot. Surgical excision was the treatment of choice in the two herein reported cases of solid ALM located in the hindfoot, one of them with a calcified presentation. No recurrence was observed in either case after two and five years of follow-up, respectively. All cases reviewed after surgical excision showed a low recurrence rate with a favorable prognosis regardless of the histological subtype and a very rare tendency toward malignancy. Conclusions: ALMs of the foot present as well-defined, painful nodules in the subcutaneous tissue of middle-aged women. Solid histological subtypes are the most prevalent. Histopathological analysis is usually essential for confirmation. Treatment consists primarily of direct excision, with remarkably low recurrence rates.

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