ARTICLES REVIEW

Articles Review

Articles Review

Core podiatry involves treatment of the nails, corns and callus and also giving footwear and foot health advice. Though it is an integral part of current podiatric practice little evidence is available to support its efficacy in terms of research and audit data. This information is important in order to support the current NHS commissioning process where services are expected to provide data on standards including outcomes. This study aimed to increase the evidence base for this area of practice by conducting a multi-centre audit in 8 NHS podiatry departments over a 1-year period.

The outcome measure used in this audit was the Podiatry Health Questionnaire which is a self completed short measure of foot health including a pain visual analogue scale and a section for the podiatrist to rate an individual's foot health based on their podiatric problems. The patient questionnaire was completed by individuals prior to receiving podiatry care and then 2 weeks after treatment to assess the effect of core podiatry in terms of pain and foot health.

1047 patients completed both questionnaires, with an age range from 26-95 years and a mean age of 72.9 years. The podiatrists clinical rating at baseline showed 75% of patients had either slight or moderate podiatric problems. The differences in questionnaire and visual analogue scores before and after treatment were determined according to three categories - better, same, worse and 75% of patients' scores either remained the same or improved after core podiatry treatment. A student t-test showed a statistical significant difference in pre and post treatment scores where P < 0.001, though the confidence interval indicated that the improvement was relatively small.

Core podiatry has been shown to sustain or improve foot health and pain in 75% of the patients taking part in the audit. Simple outcome measures including pain scales should be used routinely in podiatric practice to assess the affect of different aspects of treatments and improve the evidence base for podiatry.

A large number of the general population experience foot problems which is highlighted by a review of foot survey data from the UK and overseas (Australia, America and Europe) . Various methods have been used to survey the incidence of foot problems, including an examination by a professional, face to face or telephone interviews and postal questionnaires. A summary of combined surveys found that between 20-78% of people suffer from corns, callus and bunions, between 20-49% have lesser toe deformities and 28-56% have toenail problems . The incidence and types of foot problems are variable when reported via surveys due to the types of populations studied and whether foot problems are self reported or assessed by a health professional. In the past the vast majority of surveys have concentrated on foot problems in older people, whether in residential care, on a hospital ward or living in the community. Understandably, when a professional diagnoses and reports foot problems the incidence is higher than when compared with those that are self ...