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COVID-19 lockdown disrupts support networks integral to maintaining foot health: a mixed-methods study

COVID-19 lockdown disrupts support networks integral to maintaining foot health: a mixed-methods study
COVID-19 lockdown disrupts support networks integral to maintaining foot health: a mixed-methods study
Background: in response to the COVID-19 pandemic, populations were advised to remain at home to control viral spread. Government-mandated restrictions on free movement affected individuals’ engagement with physical activity, with reported increases leading to biopsychosocial health benefits and conversely increased sedentary behaviour leading to poorer health. Good foot health is key to enabling physical activity and maximal participation in activities of occupation and daily living.

Methods: a population-based cross-sectional study was performed, using a web-based platform. Quantitative and qualitative data were captured through responses to closed and open survey questions. Anybody with a foot health condition was eligible to participate in the online survey. Links were sent through professional networks, support groups and charities, using a snowball strategy to maximise participation.

Results: two hundred fifty-five respondents completed the survey. Most (n = 193, 75.69%) reported an ongoing foot pain or problem that had been present for 4 weeks or longer, whilst 49 respondents (19.22%) noted a new pain or problem. Pain was the most frequently reported symptom (n = 139, 54.51%), whilst change in appearance of the foot was also commonly reported (n = 122, 47.84%), often alongside the observable presence of swelling. Musculoskeletal foot symptoms were frequently reported (n = 123, 48%), and were significantly associated with reported reduced physical activity (X2 = 6.61, p = 0.010). Following qualitative analysis five themes and 11 subthemes emerged, informed by 49 independent codes. A central theme of lockdown disrupting support networks, both formal (healthcare providers) and informal (friends or family members) emerged. The 5 sub-themes were: 1. foot pain is a constant companion, 2. self-care, 3. ‘cope or crumble’ scenarios, 4. future intent to access healthcare and 5. reduced ability to undertake physical activity.

Conclusions: pain was the most frequently reported foot problem during COVID-19 lockdown restriction. Lockdown restrictions disrupted support networks integral to maintaining foot health. Poor foot health impacted people’s ability to remain physically active. Complaints previously considered relatively ‘minor’ such as support for skin and nail care, were found to be exacerbated by restricted support networks, leading to greater negative impact.
COVID-19, Exercise, Foot heath, Infection, Mixed methods, Pain, Physical activity, Self-care, Self-management, Support, Survey, Unmet need
1757-1146
Cherry, Lindsey
95256156-ce8c-4e7c-b04d-b6e459232441
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Portillo Vega, Maria Carmen
f913b5c5-b949-48f2-b1d0-eb7505484d5c
Cherry, Lindsey
95256156-ce8c-4e7c-b04d-b6e459232441
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Culliford, David
25511573-74d3-422a-b0ee-dfe60f80df87
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Portillo Vega, Maria Carmen
f913b5c5-b949-48f2-b1d0-eb7505484d5c

Cherry, Lindsey, Gates, Lucy, Culliford, David, Walker-Bone, Karen and Portillo Vega, Maria Carmen (2021) COVID-19 lockdown disrupts support networks integral to maintaining foot health: a mixed-methods study. Journal of Foot and Ankle Research, 14 (1), [46]. (doi:10.1186/s13047-021-00486-4).

Record type: Article

Abstract

Background: in response to the COVID-19 pandemic, populations were advised to remain at home to control viral spread. Government-mandated restrictions on free movement affected individuals’ engagement with physical activity, with reported increases leading to biopsychosocial health benefits and conversely increased sedentary behaviour leading to poorer health. Good foot health is key to enabling physical activity and maximal participation in activities of occupation and daily living.

Methods: a population-based cross-sectional study was performed, using a web-based platform. Quantitative and qualitative data were captured through responses to closed and open survey questions. Anybody with a foot health condition was eligible to participate in the online survey. Links were sent through professional networks, support groups and charities, using a snowball strategy to maximise participation.

Results: two hundred fifty-five respondents completed the survey. Most (n = 193, 75.69%) reported an ongoing foot pain or problem that had been present for 4 weeks or longer, whilst 49 respondents (19.22%) noted a new pain or problem. Pain was the most frequently reported symptom (n = 139, 54.51%), whilst change in appearance of the foot was also commonly reported (n = 122, 47.84%), often alongside the observable presence of swelling. Musculoskeletal foot symptoms were frequently reported (n = 123, 48%), and were significantly associated with reported reduced physical activity (X2 = 6.61, p = 0.010). Following qualitative analysis five themes and 11 subthemes emerged, informed by 49 independent codes. A central theme of lockdown disrupting support networks, both formal (healthcare providers) and informal (friends or family members) emerged. The 5 sub-themes were: 1. foot pain is a constant companion, 2. self-care, 3. ‘cope or crumble’ scenarios, 4. future intent to access healthcare and 5. reduced ability to undertake physical activity.

Conclusions: pain was the most frequently reported foot problem during COVID-19 lockdown restriction. Lockdown restrictions disrupted support networks integral to maintaining foot health. Poor foot health impacted people’s ability to remain physically active. Complaints previously considered relatively ‘minor’ such as support for skin and nail care, were found to be exacerbated by restricted support networks, leading to greater negative impact.

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2021.06.17_COVID_foot_survey_manuscript_revision_round_2_clean - Accepted Manuscript
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Accepted/In Press date: 23 June 2021
Published date: 30 June 2021
Additional Information: Funding Information: The authors wish to thank the staff and patients of Solent NHS Trust Podiatry service who helped contribute to the design of this research. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: COVID-19, Exercise, Foot heath, Infection, Mixed methods, Pain, Physical activity, Self-care, Self-management, Support, Survey, Unmet need

Identifiers

Local EPrints ID: 450285
URI: http://eprints.soton.ac.uk/id/eprint/450285
ISSN: 1757-1146
PURE UUID: 8b682264-1d1a-4a4d-bd87-036380a7e3cf
ORCID for Lindsey Cherry: ORCID iD orcid.org/0000-0002-3165-1004
ORCID for Lucy Gates: ORCID iD orcid.org/0000-0002-8627-3418
ORCID for David Culliford: ORCID iD orcid.org/0000-0003-1663-0253
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459
ORCID for Maria Carmen Portillo Vega: ORCID iD orcid.org/0000-0003-1583-6612

Catalogue record

Date deposited: 20 Jul 2021 16:32
Last modified: 26 Nov 2021 03:04

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Contributors

Author: Lindsey Cherry ORCID iD
Author: Lucy Gates ORCID iD
Author: David Culliford ORCID iD

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