Baropodometric Assessment of the Podiatric Profile of Nursing Students in Clinical Settings

Study Overview
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Brief Summary
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The nursing profession is highly affected by exhausting positions, namely prolonged standing and walking, which are the second work-related factor hindering foot health. In fact, the most common work-related disorders among nurses and nursing students are those related to lower limbs, particularly the foot and ankle. Such disorders, if not adequately prevented, contribute to the decrease in quality of life and high student drop-out rates. To effectively develop preventive interventions among students, namely self-care actions, it's important to assess with detail the relationship and influence that clinical settings have on foot health. According to some authors, the biomechanics of many foot disorders are still poorly understood, and more studies are needed. In this sense, the aim of this study is to understand the influence of prolonged standing and walking positions on nursing students' foot health. Moreover, what's the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms.

Detailed Description
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Work-related injuries, particularly musculoskeletal injuries, are usually an important cause of decreased quality of life and absenteeism from work, being very common in the nursing profession and also among students. Among the most common injuries are those related to the lower limbs, particularly feet and ankles, and the foot health of nurses is not satisfactory, with a great shortage of specific studies in this area and in this population. Although several studies identify this problem, few describe in detail the causes of pain or discomfort. On the other hand, the podiatry evaluations are poor, which limits a more detailed knowledge of the phenomenon under study. Some solutions, namely the development of ergonomic footwear are insufficient and few interventions are adequate to improve the foot health of nursing students. The present study aims to understand the influence of prolonged standing and walking positions on nursing students' foot health. Moreover, what's the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms. The observational study will consist of two moments (before and after clinical setting periods), in which the participants (Nursing students) will complete a four-dimensional foot health self-assessment instrument (skin health, nail health, foot structure, pain). Additionally, the podiatric profile will be assessed through a force platform scan, which will score force and pressure values. Moreover, foot posture and foot function will be evaluated, through the modified arch index (MAI) and pressure excursion index (CPEI), respectively. Relevant variables will include spatio-temporal, kinematic, and kinetic data.

Official Title
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Baropodometric Assessment of the Podiatric Profile of Nursing Students in Clinical Settings

Conditions
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Foot Diseases, Ankle Disorders Injuries

Intervention / Treatment
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* Other: Acute Clinical Settings


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A nursing student enrolled in a learning acute clinical setting (e.g., hospitals). No diagnosed chronic systematic diseases (e.g., rheumatoid arthritis). No diagnosed metabolic disorders (e.g., diabetes). No visible lower limb swelling. No venous or lymphatic insufficiency. Voluntary written consent. Exclusion Criteria: Presence of contraindications for baropodometric-related measurements; No consent to take part in the study. History of orthopaedic, neurological, and/or musculoskeletal problems likely to affect gait.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Nursing students<br>Nursing students exposed to standing environments (prolonged walking and prolonged standing) during acute clinical settings (e.g., hospitals). | Other: Acute Clinical Settings<br>* Acute clinical settings, like hospitals, where students are exposed to normal daily shift activities, involving prolonged walking and standing positions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Podiatric Profile at 5 months | It relates to specific foot-related dynamic variables while standing or walking, illustrating the actual behaviour of the foot during activity. The podiatric profile is assessed through a pedography platform, which gives values of pressure (throughout time), exerted force, and contact areas of the foot. | Evaluated before (Month 0) and after (Month 5) the exposure (acute clinical settings). | 
| Change in Foot Health at 5 months | Foot health relates to the observed clinical parameters, signs, and symptoms of this body part, namely skin, nails, and structure, and is evaluated through a subjective self-assessment Liker-type instrument with four dimensions related to general foot health. | Evaluated before (Month 0) and after (Month 5) the exposure (acute clinical settings). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Foot Self-Care Knowledge | Self-care knowledge is assessed through a four-dimensional questionnaire, where specific interventions for the promotion and prevention of foot and ankle disorders are evaluated. | During the exposure time; between Month 0 and Month 5. | 
| Student's perceptions | Nursing student's perceptions on the influence of foot health in their quality of life during exposure time. It is evaluated through semi-structured interviews and focus groups. | After exposure time (Month 5). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ankle disorders, nursing, foot health, foot self-care, foot disorders