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Background: Hallux Abducto Valgus (HAV) is a very common, multifactorial, painful foot condition associated with a deformation of the big toe. Dysfunctions in the biomechanics of the first ray such as hypomobility or hypermobility have been suggested to play a key role in several foot conditions. Surgical interventions should be considered as a last option for patients presenting with hallux valgus. Many conservative, non-surgical treatments have proved inefficient, therefore there is scope for an innovative, non- surgical solution to reduce HV development and support proper foot function. Research Question: The purpose of this study is to determine the availability and efficacy of the current non- surgical treatment modalities through a systematic review and to perform a systematic literature search to identify studies which have analyzed the effect of non-surgical foot appliances on hallux valgus, the effect of hallux valgus appliances on foot function, including muscle action, 1st ray biomechanics, hallux valgus angle and plantar pressure distribution, the effect of hallux valgus applications on pain, deformity and disability, to perform a quality assessment to identify the rigor of the identified studies. Methods: The systematic review was conducted in PubMed in order to determine the availability and efficacy of present non-surgical treatment modalities for the control of the hallux valgus progression and for this investigation we used relevant search terms. We followed the Effective Public Health Practice Project Quality Assessment Tool recommendations for the assessment of risk of bias and the report was performed following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Eight studies were eligible for selection. Hallux Abducto Valgus was the pathology to be evaluated with the use of soft and semi-rigid orthoses, taping, custom-made foot orthoses, static and dynamic orthoses. In most studies the reduction of the level of pain and the prevention of HAV progression was the effect of the non-surgical treatment., peer-reviewed

Background: Treatment of venous ulcers often includes incorporation of dressings, for reduction of bio-load. Evidence is lacking with regards to which dressing is ideal for healing chronic venous wounds. This study aimed to compare the healing effect of polyvinyl alcohol (PVA) antimicrobial foam dressing impregnated with two organic pigments (gentian violet and methylene blue) vs. silver antimicrobial foam dressing., Research Design and Method: A quasi-experimental study was conducted. 28 participants were divided into two groups and treated with one of the antimicrobial foams. Patients reviewed weekly for 3 weeks. Wound healing was assessed using the Bates-Jensen Wound Assessment Tool., Results: Over a period of 3weeks, both the PVA antimicrobial foam with two organic pigments and the silver antimicrobial foam dressings were effective in reducing mean BJWAT scores and wound healing (p < 0.001). The former was significantly better at week 1 (p = 0.001) and 2 (p = 0.014) but not at week 3 (p = 0.881)., Conclusion: PVA antimicrobial foam with two organic pigments showed some superiority over silver antimicrobial foam dressings in chronic venous ulcers. This should be considered when treating chronic venous ulcerations since the rate of healing was greater despite the extreme severity of ulcers at the start of the study., peer-reviewed

Background: The difference in general endurance between running with a minimalist shoe versus structured footwear is a topic of debate amongst both runners and researchers. Studies investigating the effect of structured and minimalist footwear on general endurance are still lacking. Therefore, the purpose of this study was to explore the difference between running in minimal versus structured footwear on endurance amongst long distance recreational runners., Methods: Thirty healthy long distance recreational runners were recruited for this study. Treadmill running in two different shod conditions: ‘Trial 1’ with structured footwear and ‘Trial 2’ with minimalist footwear was conducted. The Bruce Treadmill Protocol was used to estimate the VO2 max of each athlete were the time taken to reach volitional exhaustion was recorded and interpreted via two equations depending on whether the participant was male or female. The results of the equations estimating the participants' VO2 max were compared between the two types of footwear., Results: The results of this study found a significant difference in general endurance when wearing minimalist footwear versus structured footwear (p = 0.038), indicating a higher efficiency when running with minimalist footwear. No significant difference was found in the mean Borg 6-20 RPE (Rate of Perceived Exertion rating scores) between structured and minimalist footwear (p = 0.32). However, although no significant difference was found, it is important to note that whilst all the participants wearing both structured and minimalist footwear reached stage 7 on the BTP protocol, in stages 8 and 9 the number of participants in minimalist footwear exceeded those in structured footwear implying better endurance when using minimalist footwear., Conclusion: This finding provides important information to the running community, clinicians and researchers alike with regards to the efficacy when using minimalist shoes in long distance running. Since physical exercise and sports are today being advocated as important elements to improve general health status and weight loss, with recreational running being picked up by many individuals, it is of utmost importance to provide recreational runners and their coaches with evidence-based information regarding potential implications when choosing the appropriate footwear for distance running., peer-reviewed

Purpose: To compare the efficacy of laser therapy versus conventional treatment (stretching exercises and silicone heel cups) for the short-term management of CPHP., Methods: A case-control study was carried including 18 participants with 26 symptomatic limbs with CPHP. Each participant received one of two treatments; laser therapy or conventional treatment Progress was monitored using two pain scales; VAS pain scale and the Foot Function Index where participants were asked to rate their pain at the start of the study (Time 0) and after 3 weeks (Time 1)., Results: Both treatment options showed a significant reduction in pain scores (p, Conclusion: Laser therapy, when compared to conventional treatment, is a better short-term treatment option for the management of CPHP. Further research in this area is warranted to ensure best patient care, to further clarify long-term efficacy and optimal treatment parameters of Laser Therapy., peer-reviewed

Olympic-style sliding-seat rowing is a sport that has been extensively researched, with studies investigating aspects related to the physiology, biomechanics, kinematics, and the performance of rowers. In contrast, studies on the more classic form of fixed-seat rowing are sparse. The aim of this study is to address this lacuna by analysing for the first time the specific kinematics of fixed-seat rowing as practised by able-bodied athletes, thus (i) documenting how this technique is performed in a manner that is replicable by others and (ii) showing how this technique compares and contrasts with the more standard sliding-seat technique. Fixed-seat rowing was replicated in a biomechanics laboratory where experienced fixed-seat rowers, marked with reflective markers following the modified Helen–Hayes model, were asked to row in a manner that mimics rowing on a fixed-seat boat. The findings from this study, complimented with data gathered through the observation of athletes rowing on water, were compared to sliding-seat ergometer rowing and other control experiments. The results show that, in fixed-seat rowing, there is more forward and backward thoracic movement than in sliding-seat rowing (75–77° vs. 44–52°, p < 0.0005). Tilting of the upper body stems was noted to result from rotations around the pelvis, as in sliding-seat rowing, rather than from spinal movements. The results also confirmed knee flexion in fixed-seat rowing with a range of motion of 30–35°. This is less pronounced than in standard-seat rowing, but not insignificant. These findings provide a biomechanical explanation as to why fixed-seat rowers do not have an increased risk of back injuries when compared with their sliding-seat counterparts. They also provide athletes, coaches, and related personnel with precise and detailed information of how fixed-seat rowing is performed so that they may formulate better and more specific evidence-based training programs to meliorate technique and performance., peer-reviewed

Every 30 seconds a limb is lost somewhere in the world due to diabetes! (International Diabetes Federation and International Working Group of the Diabetic Foot, 2005) Diabetic foot ulceration and amputations are a worldwide concern, including Malta where some 500 partial or full amputations of the foot are carried out annually. In the EU, 450,000 amputations cost €2.5 billion yearly (Raghav A et al., 2018), resulting in major economic consequences both for patients and healthcare systems alike. If managed timely, ulceration may be prevented in 80% of the cases. Diabetic foot infections are potentially disastrous complications that progress rapidly following minor traumas. For a long time, scientists have been fighting against infection and it is evident that wound infection is a challenging situation for all healthcare professionals. It has been suggested that infections present in diabetic foot ulcerations are the largest cause of lower extremity amputations, impacting the patient’s quality of life significantly (Camilleri Attard F., Gatt A., Formosa C. 2021). Our research leads us to believe that an increase in pressure on the sole of the foot, followed by a rise in temperature before ulceration, can also be key indicators that could detect those areas which are about to develop a wound, known as a diabetic ulcer (Perren et al 2021). Thus identifying and correcting increased plantar pressures and altered biomechanical factors are key to prevention amongst other risk factors. Diabetic foot amputation and hospitalization are still on the increase. This may suggest that current management of the diabetic foot is not effective, clearly demonstrating the need for the implementation of new and effective strategies aimed primarily at prevention of ulceration. Where the high-risk foot is concerned, “time is tissue” (Setacci C, 2012). One cannot simply afford to wait for complications such as infection to develop as this might mean limb loss and ultimately even death. [Excerpt], peer-reviewed